Written question WQ89657

Health boards and trusts have robust escalation arrangements in place to enable them to respond to pressures. This is done through a structured approach and ensures resources are targeted at those people in most urgent need of an intervention.

Escalation protocols are an operational matter for the health boards and trusts and are used to support them to determine the appropriate clinical response and the actions necessary to protect core services, to supply the best possible level of service, prioritising the most clinically vulnerable patients.

To confirm, the term ‘black alert’ does not feature in the existing national escalation and de-escalation framework.

There are four levels of escalation and, when a health board exhausts all actions at the highest level of escalation, a ‘business continuity incident’ (BCI) can be declared to enable an extraordinary set of actions; for example, calling in additional staff and diverting clinically trained managers to support.

As you know, the Cardiff and Vale University Health Board declared a BCI on Monday 7 November due to challenges with patient flow, and complex demand. By Wednesday 9 November, successful actions had enabled the health board to de-escalate from BCI to level four.

I have been very clear we are facing an exceptionally challenging winter period and we anticipate an extremely high and complex demand for some parts of the health and care system. Therefore, it is highly likely we will see further declarations of BCI.

Health boards, trusts and their partners have been planning for seasonal pressures all year round and have developed integrated plans to enable delivery of resilient services, as far as is possible during the difficult winter months. These plans will help to mitigate the concurrent risks presented by changing demand as a consequence of the winter period.

We have provided £50m over the past two years to help people access the right care, in the right place through our Six Goals programme. We have also reviewed and strengthened our approach to the coming Winter and will deploy a range of actions to ensure system resilience.