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Vaughan Gething MS, Minister for Health and Social Services

First published:
5 March 2021
Last updated:

I committed to providing an update in my response to the debate on support for palliative care during the pandemic held on 3 February 2021. It provides an update on the key issues raised during the debate and on wider palliative and end of life care progress.

We know that good palliative care can make a huge difference to the quality of life for people facing life limiting illness - helping them to die with dignity and facilitating a healthy grieving process for those left behind. The Welsh Government is committed to ensuring that anyone requiring palliative and end of life care in Wales should have access to the best possible care.

Hospices are central to this approach and we recognise the enormous contribution that they make to end of life care and the support they provide to patients, families and carers. We know that the pandemic has hit them particularly hard as their ability to fund raise has been significantly reduced through Covid-19 restrictions such as the ban on mass gatherings and the closure of retail outlets. This is why we have allocated £9.3m of emergency funding to hospices over the last 12 months to protect their core clinical services and to strengthen bereavement support.

The pandemic has shown, perhaps more clearly than any recent event, the scale and complexity of bereavement and the importance of good care for those experiencing it. This experience has driven the pace and has influenced much of the detail of the draft national framework for bereavement care which includes core principles, minimum standards and a range of actions to support regional and local planning. It also recognises that there will be long lasting effects from the pandemic and includes a section about learning lessons from Covid-19. The framework will be published for consultation in March 2021 and will be supported by an additional £1m funding from April 2021.

During the last decade, there has been undeniable progress in end of life care, such as access for non-cancer patients and transitional care, however the growing and changing shape of need; e.g. how we address end of life dementia care, progress in the use of advance and future care planning, technological advances and changing public expectation requires the End of Life Care Board to rethink its future priorities.

The extension of the current End of Life Care Delivery Plan until the end of March 2022, along with the £2m funding support, enabled the End of life Care Board to conduct a stocktake to set the future vision for services into the next decade.

The stocktake will establish a baseline capacity across both adult and children’s services and propose service and workforce development to meet future need. To support this work, the Paediatric Palliative Care Needs Assessment will provide robust data on which to plan services for the children and young people of Wales. Health boards and hospices are supporting this work which will be completed by the end of March 2021.

Welsh Government also remains committed to working with the End of Life Care Board to review funding for hospices. It is likely that the funding review will take approximately three months to complete and should be ready for consideration early into a new Welsh Government administration.

Any successor to the end of life care delivery plan will also need to take advantage of the opportunities set out in ‘A Healthier Wales’, including the concept of Quality Statements underpinned by NHS implementation plans within a NHS Executive function. Some preliminary engagement has been undertaken with stakeholders on the Quality Statements for cancer, heart conditions and stroke and we will be setting out more detail in the coming months.

We note the review by the Department of Work and Pensions into how the benefits system supports terminally ill people such as those with motor neurone disease (MND) has now concluded. Whilst accepting this matter is non-devolved, we will of course consider the review’s findings. In the meantime, specialist palliative care teams continue to provide care and support to MND patients and their friends and families.

Work is ongoing to roll out enablers from the Neighbourhood District Nursing pilots in urban, valley and rural areas of Wales between 2018 and 2020 to look at ways to improve palliative and end of life care for people in those communities. These include prudent skill mix incorporating administrative support; the introduction of band four health care support workers; and real time scheduling technology for greater flexibility, responsiveness and productivity

A National Nursing Lead has been appointed to take forward the learning from the pilots. The evaluation by University of South Wales can be accessed at: https://wihsc.southwales.ac.uk/prime-usw/prime-usw-research-portfolio/evaluation-neighbourhood-district-nursing-pilots-wales/.

Finally, we remember our health and social care professionals and third sector partners need support too.  We have worked with key partners to make available a multi-layered wellbeing offer, including a confidential Samaritans listening support helpline dedicated to health and care workers in Wales, as well as a number of free-to access health and wellbeing support apps such as Mind, Sleepio & Daylight and SilverCloud.

We have also provided additional funding to enhance and expand the Health for Health Professionals Wales (HHP Wales) service - a confidential, free, tiered model of psychological and mental health support available to everyone working for the NHS in Wales including students.

A range of national and local resources are available to staff and can be accessed through a helpful playlist on HEIW’s webpages along with signposting to help individuals identify the appropriate type and level of support for themselves, whether that is self-led, guided or direct one-on-one intervention. . https://heiw.nhs.wales/covid-19/health-and-wellbeing-resources/