Written Statement: Progress on Major Health Conditions Delivery Plans

In a written statement on 29 June, I announced £1m would be allocated to each of the 10 of the Welsh Government’s major health condition delivery plans. This statement sets out how this funding has been used to improve services for people in Wales.

Since their introduction, the delivery plans have helped to improve the care and treatment of people with a major condition:

• Stroke survival is improving in Wales – there has been an increase of almost 500 stroke survivors over the last 5 years
• Between 2004 and 2014 there has been a 10% fall in cancer mortality in Wales. For the first time, 5 year survival has reached 50% and one year survival 70%
• The number of diabetes-related deaths is falling and there have been falls in emergency admissions related to diabetes
• More than 8,000 fewer patients being treated for coronary heart disease over the last 5 years as incidence rates are falling
• Survival rates for people treated in critical care units in Wales are improving – 83% of people were discharged to another ward in 2014-15, up from 79% in 2011-12
• Smoking prevalence has fallen over the last 10 years – from 28% in 2004-05 to 20% in 2014
• The number of deaths from neurological conditions is relatively low in Wales (664 in 2013). When calculated as an age standardised rate for all deaths across the UK, the rate for Wales is below that of the other countries in the UK
• 93% of people who responded to the iWantGreatCare feedback survey (2014-15) of specialist palliative care in Wales were positive. The average Welsh score was 9.5 out of 10
• More than 88,000 people have been assessed and almost 48,000 have started a therapeutic intervention in Wales’ new local primary care mental health support services between April 2013 and December 2015.

Each of the delivery plans has an implementation group, which includes clinicians, health boards and third sector representatives. These groups have set the priorities for work to be carried out in the year ahead and have decided how the £1m will be spent to improve services and patient care. Examples include:

The stroke implementation group has commissioned the delivery of a unique training course written by clinicians to enhance pre-hospital clinical services for better patient outcomes to 1,500 paramedics. Training all emergency paramedics across Wales will ensure that more suspected stroke patients will have earlier entry onto the acute stroke pathway, improving the early detection and speedy treatment of patients with a suspected stroke. The group is also piloting an approach with primary and community care to identify those at risk of atrial fibrillation and ensure that the appropriate treatment is in place. This will reduce the number of people having strokes as well as supporting people to understand and manage their risk.

A quarter of the £1m allocated to the diabetes delivery plan is being invested in new posts to help health boards to improve services. These posts, which cover insulin pump provision, diabetic foot care, transitional care, are helping to reduce diabetes-related complications and improve patient outcomes.

The heart disease implementation group has prioritised and invested £850,000 in the development of community cardiology services. This will lead to improved access to cardiology services closer to home, speed up access to services and move care from hospitals into local communities.

The critically ill implementation group is investigating the potential to use its funding to pilot a patient management system and e-ICU system to improve critical care services by providing real time interaction with patients and decision support for clinicians; providing improved data and information management and allowing access to an all-Wales networked hub. If the pilot proves successful in improving the quality and sustainability of services, we will progress a full roll out programme.

The £1m to support the mental health delivery plan has been used to increase the availability of psychological therapies – it will contribute towards the recruitment of 46 new clinical posts for psychological therapies across Wales. As the posts are being recruited, it will help to reduce waiting times and train existing staff.

The liver disease delivery plan – the most recent delivery plan – was launched last year, in response to the doubling of liver disease-related deaths over the past 20 years. It aims to halt the rise in morbidity and mortality by 2020. The implementation group has agreed that its main project will be to fund alcohol care teams in each health board. It will use its share of the delivery plan funding to develop a core service in each health board, which will work to reduce alcohol-related re-admissions; improve the management of people admitted with alcohol-related problems and reduce the level of alcohol-related liver disease in the longer-term.

Progress has been made in each of the delivery plans and I would like to thank all of the members of the implementation groups who have set the priorities and taken this important work forward. Delivery plans remain an important part of our commitment to continually seek new ways to improve outcomes for patients. We remain committed to ensuring that quality improvement remains at the centre of our approach for the future of NHS Wales.