‘safety of patients at risk of Being compromised’ – claims
THE Welsh NHS has recorded its worst ever performance figures – prompting claims that patient safety is at risk of being compromised.
The Welsh Government has published its latest set of monthly NHS performance figures which look at A&E and ambulance waits, as well as referral to treatment times and delays in cancer treatment.
It revealed that just over two-thirds (66.8%) of patients spent fewer than four hours in an accident and emergency unit before being admitted, transferred or discharged in September.
That’s the worst performance in history, beating the 68.7% for August which was itself a record.
The Welsh Government wants 95% of people to be seen in that time but that has never been met.
The £350m flagship super hospital, The Grange University Hospital in Cwmbran, recorded the worst A&E waits of any emergency unit, seeing only 38% of patients in four hours last month.
In addition, 8,484 people had to wait more than 12 hours in Wales’ emergency units in September – the highest number ever recorded and up from 7,982 the month before.
Meanwhile the Welsh Ambulance Service recorded its worst response times to immediately life-threatening “red” calls last month since new targets were introduced in 2015.
Just over half (52.3%) of ‘red’ 999 calls arrived on scene within eight minutes, which is far below the target of 65% that has not been met for more than a year.
The worst-performing authority was Betsi Cadwaladr University Health Board (UHB) with only 45.2% arriving within the eight-minute target, but two other health boards posted less than a 50% – Hywel Dda UHB and Cwm Taf Morgannwg UHB.
Last month there was an average of 130 “red” calls each day, the highest since comparable data was first available in May 2019. The average number of 999 calls made per day to the service in September was the third highest on record and was only exceeded in December 2017 and December 2019.
Dr Suresh Pillai, vice president of the Royal College of
Emergency Medicine Wales, said: “We have had consistent deterioration in performance over the past five or six months. The situation is unsustainable.
“Emergency departments continue to be under severe strain, and we know these pressures are not limited to emergency departments but are increasing across the whole system.
“The figures are extremely concerning. Bed occupancy for general and acute beds has reached its highest since the start of the pandemic. This comes despite a drop in attendances which indicates that the patients attending emergency departments are the very sickest.
“Long stays have also risen once again with one in eight patients staying in a major emergency department for 12-hours or more while nearly a quarter of all attendances are staying for eight hours or more.
“Long stays are linked to patient harm and threaten patient safety. Staff are doing all they can to minimise this risk and deliver care as quickly and effectively as possible.”
Similarly, the number of people on an NHS Wales waiting list for treatment – also known as referral to treatment times – has now reached record levels.
In August, 657,539 patients were on the list – over 14,000 more than the previous month – with nearly 250,000 of them on there for nine months (36 weeks) or more. In comparison there were about 25,000 patients waiting 36 months or more at the very start of the pandemic.
The largest number of patients waiting are for trauma and orthopaedic surgery, general surgery and urology. Experts claim many of these patients will be in “considerable pain” and unable to carry out day-to-day tasks while they wait for their operation.
As all non-urgent outpatient appointments were suspended in March 2020 to prioritise urgent appointments and coronavirus cases, the length of waiting times for patients referred for treatment has increased markedly ever since.
Yesterday, health minister Eluned Morgan described the latest NHS performance figures as “sobering”.
“I think it’s important to level with the public that we’re unlikely to be able to eke into these numbers probably until the spring because of winter pressures we’re likely to be facing are significant,” she said.
“That is why it is important for our health boards to stand by all of those people who are waiting on lists to make sure that they get the pain relief and the support that they need dur
ing this really difficult time.” Baroness Morgan said it was highly unlikely that elective appointments and procedures would be cancelled across the entire NHS like 18 months ago despite the fact Covid infection rates are soaring.
“We won’t see operations stop altogether, and of course we’ll be making sure that cancer support is there, we’ll be making sure that mental health support is there, come what may. But we will have to monitor the situation and flex depending on how great those pressures come,” she added.
“But there is also a responsibility on the public to make sure that they play their part by making sure that they take up the opportunity of the Covid booster vaccination and the flu jab. But at the moment the rates [of Covid] are really high in Wales, and we’re hoping the half-term holiday will bring a degree of relief because at the moment, many of the cases are among our younger, school-aged children.”
When it came to NHS Wales figures for cancer, of the 1,535 people who started their cancer treatment in August, only 970 (63.2%) did so within the national target of 62 days - a slight improvement on the previous month.
Richard Pugh, head of partnerships for Macmillan Cancer Support in Wales, said: “These figures show that people are simply not getting their treatment on time, even before our health services begin to sail into a perfect storm of rising coronavirus cases combined with growing winter pressures.
“Cancer care simply must be protected, prioritised and sheltered through this, and it is essential that if peoples’ cancer treatments are to be affected that they are communicated with compassionately, clearly and at the earliest stage possible.”
Yesterday, as reported in the Echo, the Welsh Government unveiled its NHS winter plan in which an extra £40m was given to social care to help ease the pressure on hospital beds. This comes on top of £248m already announced for the NHS Covid recovery fund.
Commenting on the performance statistics, Plaid Cymru’s health spokesman Rhun ap Iorwerth said: “Today’s latest figures remind us of the scale of the challenge faced by the health and care sector.
“Those organisations who represent the workforce are right to call it a crisis, and it is why we need to see early signs that the winter plan announced today is leading to improvements.
“It’s not yet winter and pressure is already far beyond what could be considered to be sustainable.”
Welsh Conservative and Shadow Health Minister Russell George said: “The non-stop bad news about the Labour-run NHS is inevitably leading people to ask if it can get any worse. Sadly, each month shows us the answer is yes.
“Labour’s NHS is in crisis, and it is truly devastating to see the toll that is being taken on healthcare staff, with consequences for patient safety, which is becoming acute in every corner of Wales. People pay their taxes in the expectation that public services perform well but we are not seeing that in Wales where both emergency and elective care seems to be at breaking point.
“The Welsh Government must urgently tackle the crisis in the Welsh NHS, put aside their failed strategies, and implement Conservative calls for rapid diagnostic centres to spot cancers earlier, and introduce surgical hubs to deliver treatment to patients closer to home in Covid-light environments outside of hospitals.”
In response, a Welsh Government spokesman said: “The latest data shows pressure on our health and care system continues to grow. But our hardworking health and social care staff continue to deliver high quality care when people need it.
“Today the minister has published the Winter Plan which sets out how we will ensure essential services continue and minimise the impact on planned care. This is supported by extra funding for social services to help free up hospital beds.
“It’s encouraging to see improved performance against the 62-day target for cancer services. But Covid is still with us and restrictions and measures to keep our health settings safe are still massively reducing capacity to carry out planned care.
“We recognise the need to transform services to tackle longer-term issues and in recent months we have invested an extra £248m to help tackle the waiting list backlog.
“We have also developed with health boards new ways of working for emergency care supported by an extra £25m a year.
“This winter everyone can help our NHS by getting the flu jab as well as Covid and consider options like pharmacies and the 111 online service for non-urgent healthcare.”