Measurement vital for management

IN SOME ways the new figures on hospital discharges do not seem to be telling us much that is new.

It was already well known that the Welsh Government was slow to make testing mandatory for people leaving hospital to go to a care setting. It is also widely accepted that hospital discharges were one of the key avenues that enabled the virus to be seeded into the most vulnerable place in Welsh society.

However, there are several revelations in the new data that is reported in today’s edition. The first is that the numbers clearly show that not every single person going from hospital to a care setting was being tested in May. This is despite the fact it was made mandatory by the Welsh Government at the end of April.

Secondly, Betsi Cadwaladr Health Board has tested a substantially lower percentage of discharges than any other health board with only 6%. The next lowest is 29%, with some boards testing as much as 60%. Though some slack can perhaps be given for the fact that the north Wales health board is the largest, there is clear evidence that lessons have not been learnt. Within the last two weeks there have been examples of Wrexham Maelor Hospital discharging elderly patients without a test even when they knew they’d been in direct contact with a Covid-19 patient.

But perhaps the most stark insight from the data is not what is in there, but what isn’t.

When asked via a Freedom of Information Request how many of their discharges to care homes had not been tested, Cardiff and Vale refused to say. The rationale behind this was that it would take too many hours to work it out. However, every single other health board managed to do this. We saw the same issue with other questions asked, such as how many had died after discharge and how many were put into a brand-new care setting as opposed to their previous home. Some health boards had that data to hand easily, whereas others said they had it but it would take too long to find, and still others said it wasn’t even recorded.

What this tells us is that we have seven health boards doing things seven different ways. This makes it harder to get Wales-wide data, especially when you need it quickly. This is bad in normal times, but during a pandemic it could be deadly.

What you can measure you can manage, and if you can’t measure how can you possibly manage?