Written Statement: Quality Statement for Care of the Critically ill

Today, I am publishing our new Quality Statement for Care of the Critically ill, which replaces the current Delivery Plan for the Critically Ill and will continue to drive improvements in critical care services for people in Wales.

The National Clinical Framework published in March 2021 signalled a suite of quality statements, which set out our expectations for individual clinical services improvement over the medium term. These will be supported by detailed service specifications, to drive NHS delivery.

Critical care is provided to patients who have life-threatening injuries and illnesses and who require intensive monitoring and / or the support of failing organs. Due to our growing and ageing population, demand for critical care is increasing and it is this demand which makes it challenging to achieve improved outcomes for critically ill patients.

The Quality Statement for Care of the Critically Ill has been developed in partnership with the Critical Illness Implementation Group and a range of key partners, including the Wales Critical Care and Trauma Network Board. It focuses on improving services across Wales and reducing variations in care. The statement also describes what we should all expect to see from our critical care services in Wales – with a focus on safe, timely, effective, person-centred, efficient and equitable care. 

To achieve the vision set out in the Quality Statement, we need a strong focus on cross-working with other groups to address areas such as unscheduled and planned care, rehabilitation, people who are at the end of their lives and organ donation. It also requires collaboration with other major health condition areas, such as cardiac, cancer, major trauma and vascular services.

As set out in '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 healthcare systems, we need to speed up the pace of change within critical care, including the model of provision across Wales, to ensure that we have the right services in the right place for those who are critically ill.

We published the Task and Finish Group on critical care report and recommendations in July 2019. The report was honest about the challenges facing critical care, and provided a strategic view on the steps necessary to ensure services for people who are critically ill are fit for the future. The pandemic has meant that the NHS has been focused on dealing with the immediate challenges and therefore progress implementing the recommendations has not commenced in earnest in many areas.

Despite this, some progress has been made on a number of the including:

• The expansion of critical care beds prior to the pandemic with 6 additional beds in Cardiff and one in Ysbyty Glan Clwyd
• A dedicated adult critical care transfer service went live in South Wales on 16 August and is due to go live in North Wales on 4 October 2021.
• The establishment of long term ventilation beds

Implementing the Task and Finish group recommendations forms part of the quality attributes described within the Quality Statement.

Following publication of the Quality Statement, the next step will be to develop an implementation plan and service specification and these will be taken forward under the leadership of the Wales Critical Care and Trauma Network Board.

We are committed to improving high quality critical care services in Wales to ensure that patients with the most need have appropriate access to high quality critical care services. We know that very real pressures the pandemic have placed on the service and I want to take this opportunity to recognise and acknowledge the dedication and commitment shown by everyone working within critical care in very difficult circumstances.

I look forward to working with all our partners in the months and years ahead to deliver the important commitments set out in the Quality Statement for Care of the Critically Ill.

The quality statements for heart conditions and cancer and National Clinical Framework were published in March 2021.

The Task and Finish Group on critical care report was published in July 2019.