Written Statement: Transforming access to urgent and emergency care services in Wales

Earlier this week, we published Health and Social Care in Wales COVID 19: Looking Forward, which sets out our approach to drive recovery and planning for the Health and Social Care sector in Wales, by building on new ways of working and opportunities to do things differently following the COVID-19 pandemic.  

The COVID-19 pandemic has had a profound effect upon the delivery of urgent and emergency care services and people’s behaviour in how they access these services.  While undoubtedly challenging, the pandemic has demonstrated the ability of our health and social care system to adapt quickly and has acted as a catalyst for testing innovative, outcome-focused approaches, with a renewed focus on delivering safe, person-centred services.

A Healthier Wales set out our vision for transformation, innovation and delivery, by building on and accelerating our aspirations for our health and social care system.  We now have a unique opportunity to harness the key principles set out in A Healthier Wales, alongside learning we have taken from our experience of responding to the COVID-19 pandemic over the past 12 months, to transform access to urgent and emergency care to improve experience and clinical outcomes and to deliver equitable services across Wales.

I am keen that we take every opportunity to learn and evolve while delivering modern health and care services that matter to people and meet their changing needs.  Through changing the way the urgent and emergency care system is both perceived and accessed by patients, our ambition is to:

• Ensure people receive the appropriate response, in the right setting, at the right time for the benefit of patients and staff;
• Optimise individual and population health outcomes and provide a better experience for all;
• Reduce pressures on key parts of the system to create capacity to focus on our sickest and most vulnerable patients; and
• Reduce risk of harm to patients by minimising avoidable healthcare contacts.

The transformation of access to urgent and emergency care will be supported by £25m recurrent funding from 2021/22 onwards.  This will enable accelerated delivery of a small number of key deliverables that, when taken together and seamlessly linked, form part of a transformed and integrated urgent and emergency care access model.

These key deliverables will focus on:

• Continued implementation of Contact First models to enable people to be signposted to the right place, first time according to their needs;
• Implementation of Urgent Primary Care Centre models to enable people with urgent primary care needs to more easily access advice, assessment and care closer to home;

• Enhancing the clinical response model for ambulance services to ‘hear, treat and refer’ people by providing clinically safe alternatives to transport to Emergency Departments and enable better management of people’s health needs in the community; and
• Effective implementation of same day emergency care services across Wales to enable people to be assessed, diagnosed and start treatment on the same day, improving patient experience and reducing unnecessary admissions to hospital.

While these initiatives have been established with national direction and funding over recent years, recurrent funding will enable longer term transformative and sustainable planning to embed and enhance these services for the future.

This recurrent funding will be managed nationally, with clear direction, expectations and milestones set for progress against the key deliverables.  A national transforming access to urgent and emergency care delivery plan will also be established with timescales, outcomes and outputs that can be measured and monitored.