Survival rates improving in critical care but more progress is needed

The report shows:

• survival rates in critical care departments are increasing,  83% compared to 79% in 2011-12
• less than 1% of all patients discharged from critical care were readmitted within 48 hours in the first quarter of 2016, demonstrating care and discharge processes are working well
• the number of patient transfers for non-clinical reasons has reduced over the last five years by 21%
• when critically ill patients are transferred between hospitals, these transfers are becoming safer; 79.4% of all transfers are graded as good or excellent in 2015 compared with 65.4% in 2009
• the number of patients being admitted to critical care units who have tested positive for MRSA or C.Difficile is falling over time
• critical care units in Wales now seek feedback on their service from carers using a National Carers survey to help improve services; patients often have a very sketchy recollection of this time period.

However, there is more to do to improve care to ensure that the most critically ill people get the most appropriate care, including, tackling staffing challenges, reducing the average length of stay and reducing delayed discharges to other wards. Some of these issues are also highlighted in the Faculty of Intensive Care Medicine workforce engagement report published earlier this month.

Health Secretary Vaughan Gething said:

“We know there are areas where care is improving; crucially, we have seen an increase in survival rates and reductions in the numbers of patients who are re-admitted to critical care soon after leaving it.

“This report demonstrates our commitment to transparency and also sets out where the NHS needs to improve so that we can make sure people have access to excellent critical cares across Wales.

“We have provided £1m to support the development of a fully electronic clinical information system across Wales. This investment will help provide additional support to smaller units.”

Dr Andrew Goodall, Chief Executive of NHS Wales said:

“The provision of care for the critically ill in Wales is challenging, so it is encouraging to see areas of improvement in critical care in Wales. This is a tribute to all those involved in the delivery of this important area.  

“However, we now need to build upon this and move quickly to tackle areas where progress is more problematic. The Faculty of Intensive Care Medicine has been clear about the challenges we – like other parts of the UK and further afield – face in terms of recruitment and rising demand for care. We want to tackle these challenges head on and see services improve and to do so with our clinical teams.

“We expect health boards to continue to collaborate and plan on a regional basis to tackle the issues faced by the service and meet the rising demand.

“Success in these areas relies on effective flow of patients through hospitals and into the community. This can only be resolved by health boards adopting a whole hospital approach to critical care. We will continue to work with them closely and take account of both these reports during the refresh of our delivery plans in Wales.”