Written question WQ93799

The Welsh Government does not support the routine treatment of people in non-clinical or inappropriate settings, nor do we support incidences where people’s quality of care, privacy or dignity is compromised.

However, there are times when the NHS experiences intense pressures. This can be because of increased demand, a particular health emergency or illness, or as a result of pressure on system capacity. These challenges are not unique to Wales and may result in people experiencing longer stays in emergency departments while waiting to be admitted to a hospital bed or in a medical assessment unit, for example.

While the Welsh Government has a role to set expectations in terms of a strategic direction for health and care services in Wales and hold the NHS to account, health boards remain responsible for operational matters, including planning and delivery of services at a local level to meet the needs of the communities they serve. Each health board and NHS trust has in place escalation protocols which are used to support organisations to determine the appropriate clinical response and the actions necessary to protect core services during times of intense pressure. These protocols are intended to enable the best possible level of service, prioritising the most clinically vulnerable patients.

We recognise the urgent need to reduce the number of care delays across the NHS, whether these are delays for an ambulance response in the community, delays in people being admitted to a hospital bed from an emergency department, or delayed discharges when people are clinically well enough to leave hospital.

The Welsh Government and the Six Goals programme provides ongoing and direct support to all health boards and local authorities to reduce delayed ambulance handovers, delays in emergency departments and to improve flow through hospitals.

Reducing delayed discharges (pathway of care delays) is a priority for all health boards and local authorities – work is being prioritised through the Care Action Committee, which brings together Welsh Government, the NHS and local authorities. We are supporting the delivery of this plan with an additional £25m nationally, alongside more than £140m for Regional Partnership Boards and Further Faster funding for health boards.

We also recognise the importance of ensuring quality of care. The Wales Duty of Quality supports the core value of putting quality and safety above all else, as set out in the Welsh Government’s long-term strategy - A Healthier Wales - and requires all NHS bodies to take into account the Health and Care Quality Standards through which all decisions should be considered to improve the quality of health services and ensure focus is maintained on improving outcomes for the people of Wales.

The Welsh Government published a quality statement for care in emergency departments earlier this year, which sets out expectations for good-quality emergency. The RCN and other royal colleges contributed to its development.