Written Statement - Critical Care Capacity

The Parliamentary Review described the increasing demands and new challenges that face the NHS and social care – greater care needs as we grow older, lifestyle changes, public expectations and new and emerging medical technologies. These challenges have been acutely felt by critical care services in recent years and these have been exacerbated at times, such as during the winter.

We have met with a number of critical care consultants and listened to their views. It is clear there is a significant strain within critical care services and this has been increasing in recent years. Despite this those who require critically ill support continue to receive high standards of critical care thanks to the dedication of staff who have been working in a highly pressurised environment

As set out in the plan for health and social care – A Healthier Wales, hospital based services such as critical care remain an essential and visible part of our future health and care system. As with other services, we need to speed up changes within critical care and look at the model of provision across Wales, to ensure we have the right services, in the right place for those who are critically ill.

Our approach to critical care will build on the work already being taken forward through the implementation of the Delivery Plan for the critically ill, but we now want to take a firmer central hand in directing this work at a national level.  As such, some services will be developed based on a national model designed to ensure that the appropriate skilled workforce is in place across Wales.  

This will involve a phased approach to redesigning the way services for people who are critically ill are provided in Wales. We identified the need to support services which are already in place across Wales to ensure we utilise our existing capacity as effectively as possible, develop and expand the skilled workforce, and ensure that investment in additional critical care capacity is targeted to support the development of specialist services. We also intend to ensure an effective system is in place to transfer patients to more specialist care when they need it and return them to the most appropriate local setting for their ongoing care.

I am announcing today new recurrent funding of £15 million to support this programme of work.  I have established a Task and Finish Group, chaired by the Deputy Chief Medical Officer, Professor Chris Jones which will include representation from the Welsh Health Specialised Services Committee and the directors of finance and planning from each of the Local Health Boards. The Group will oversee the allocation of funding and be supported by several work streams to develop our national model of care for those who are critically ill.

The national model will include the expansion of outreach teams, post anaesthesia care units, establishment of a long term ventilation unit, more transparent performance measures, options for transfer of critically ill patients as well as the development/expansion of skilled workforce and increasing the number of critical care beds. Alongside the national model, we will work with the service to implement appropriate performance measures that will allow us to track the impact of this investment.  Tackling all of these areas is necessary if we are to secure sustainable critical care services for the future.  This is a 3 to 5 year programme of work, but I expect to see early progress in the next few months before the winter.  

I will make an oral statement in the autumn providing further detail and setting out the progress made.