Senedd roundup: Plans to restart more routine activity in the NHS due tomorrow

Owen Donovan, Senedd Home

The government is to publish a review tomorrow that details how health boards across Wales can begin to restart routine operations and cancer services in the coming weeks.

Most non-urgent operations and appointments were cancelled in March to help the NHS deal with the coronavirus outbreak

Last week Dr Andrew Goodall, NHS Wales chief executive, said it was important for the NHS to start taking a phased approach to returning to a “more routine level of activity” but predicted it could be months before the number of cancer referrals and emergency admissions return to the level before the coronavirus crisis struck.

Dr Goodall also observed that cancer referrals were lower than expected but had recovered from the lowest figures seen at the end of March and revealed that activity in hospital emergency departments was down by a third compared to last year.

Speaking at Tuesday’s coronavirus press briefing, Health Minister Vaughan Gething acknowledged that pausing some NHS services to deal with the surge of admissions caused by the pandemic came with consequences and voiced concern at the lack of screening services: “We asked for these plans to be created to look at how we restart more activity, so it’s absolutely a significant concern for me because I understand perfectly well that in ending many areas of NHS activity in mid-March, when I made that choice, it came with consequences.”

“It allowed us to prepare for the coronavirus peak and save more lives, but it also meant that it put off demand and activity and that would have to be resolved and dealt with.”

“It’s really important people don’t put off urgent or emergency treatment – the NHS is there to help everyone.”

Tuesday’s report from Public Health Wales confirmed seven more deaths due to coronavirus in Wales. This takes the total number of deaths since the outbreak began in March to 1,354.

The total of confirmed cases of Covid-19 has increased by 67 cases, bringing the total to 14,121. There were 2,492 tests carried out yesterday.

Coronavirus deaths in Wales continue to slow

The latest figures from the Office for National Statistics record a total of 2,122 deaths involving coronavirus in Wales from the start of the outbreak in March up to the 22 May.

There were 134 deaths involving Covid-19 in the week of the 22^nd – the lowest weekly total since the start of April.

The virus accounted for 19.4% of all deaths registered in Wales, although the weekly total of deaths has now declined for the last four weeks.

The total number of deaths in Wales was 692. This is 78 deaths (12.7%) higher than the five-year average

In the ONS’ comparison between the statistic in Wales and the regions of England, excess deaths in Wales is the lowest except for south west England. The north east of England had the highest percentage of excess deaths at 40.8%.

There were 44 deaths registered in care homes in Wales.

The ONS figures differ from those issued daily by Public Health Wales. PHW’s calculation is on date of occurrence rather than date of notification of the deaths and counts the total number of deaths reported to them among patients who had tested positive for COVID-19, regardless of place of death.

The ONS figures are based on all deaths registered involving COVID-19 according to death certification, whether in or out of hospital.

Tory MPs demand evidence for five-mile travel limit advice

A group of 11 Welsh Conservative MPs has written to the Welsh Government asking ministers to explain the “scientific basis” behind the decision to allow more activity outdoors – but only locally.

From Monday lockdown restrictions were eased to allow people in Wales to go outdoors and meet others from another household, but only within a local area designated as within five miles as a “rule of thumb”.

A letter penned by Ynys Mon MP Virginia Crosbie, and signed by all Welsh Tory MPs with the exception of Welsh Secretary Simon Hart and Wales Office minister David TC Davies, asked for the scientific basis for the travel rule and interpretation of it “given that in England there is no restriction on how far you can travel”.

The letter also questioned if “delays in linking up to the UK testing portal and delays in rolling out Wales’ own track and trace digital platform impacted the reluctance to lift measures”.

Evidence

Ms Crosbie said: “As a former scientist, I appreciate just how much the evidence needs to inform decision-making, especially at such a crucial time for people’s health in Wales.

“However, when decisions made in Wales are markedly different to those in England, it is only fair that people in my constituency of Anglesey and across Wales understand the evidence upon which those conclusions were arrived.”

The latest paper from the Welsh Government’s Technical Advisory Cell, which provides scientific advice to ministers, says: “Permitting outdoor contact with members of other households, while continuing to maintain a 2 metre distance, would have no more than a very small impact on overall transmission rates. This could probably be safely allowed before contact tracing is in place.”

Routine dental treatment unlikely to restart until 2021

The Chief Dental Officer, Dr Collete Bridgman, wrote to dental practices on May 22nd (pdf) saying that dentistry – which has been partially postponed due to the coronavirus pandemic – would gradually return in three phases.

Emergency dental treatment is currently being provided at designated Urgent Dental Centres (UDCs) and according to the letter just under 7,000 people have received an urgent assessment as of 22nd May 2020, with more than 22,600 prescriptions issued.

Under the phased reopening plans, NHS dental practices can begin to see patients face-to-face from 1st July 2020, while those with urgent dental needs or requiring aerosol-generating procedures (like drilling) would continue to be referred to UDCs.

Backlog

A backlog of postponed treatments would begin to be addressed from October 2020, but dentists aren’t set to return to unrestricted routine treatment until January-March 2021.

A new NHS dental contract which will emphasise ongoing care and preventative treatment is still set to be rolled-out across Wales; 40% of NHS dental practices are currently trialling the new contract.

The British Dental Association have called for quicker action, while dentist Dr Lowri Leeke told BBC Wales: “We’re used to wearing our visors, masks, gloves and scrubs and keeping everything sterile – I don’t see why we can’t start working as normal sooner than January.”

Calls for further expansion of testing amid concern at north Wales infection rates

The Welsh Conservatives have urged the Welsh Government to address the recent increase of Covid-19 cases in north Wales Covid-19 by further expanding testing in the social care sector.

Figures released by Public Health Wales show that (as of May 30) north Wales continues to record the highest number of positive Coronavirus cases of any Welsh region.

The Shadow Minister for Social Care and Older People, Janet Finch-Saunders MS, has also raised her concerns over the collection of Covid-19 statistics, regarding to people receiving domiciliary or community care.

Valiant

Mrs Finch-Saunders said:”Regardless of setting or community size, all individuals who receive social care support should be tested if the Welsh Government is committed to protecting our valiant front-line staff.

“It is an old adage that actions speak louder than words. Therefore, I urge Welsh Ministers to address the growing test disparity between our social care and healthcare sectors as a matter of urgency.

“I am also troubled about the pervasive ignorance with regards to Covid-19 statistics and the domiciliary care setting.

“More frequent updates and a firmer grasp of the data is necessary should the Welsh Government wish to find any success in its test, trace, protect protocol.”