My five point plan to help the Welsh NHS through the winter

Rhun ap Iorwerth MS, Plaid Cymru’s spokesperson for Health and Care

With one in five people in Wales on an NHS waiting list, we all know someone who is waiting for NHS treatment. Perhaps that person is you?

You’re going to understand the importance of reducing the extra burdens on the NHS, so that waiting lists can be reduced, and patients – you – can be seen as quickly as possible.

This is especially true as we approach what is usually the NHS’ most busy time: Winter.

There’s so much I could say on the topic of the NHS – the need for a long term workforce strategy, a technology overhaul, and a long term plan for cancer care. But what I’m focussing on today are the steps that need to be taken now, to get us through the next few months.

This is a time to bring in new ideas, implement new innovations, and in a Senedd debate this week I outlined priorities that some key health and care stakeholders told me they wanted us to focus on. We scrutinise Government, but we do so constructively.

The way I see it, there are five key areas of the patient journey through the NHS and there are things that can be done at each stage to reduce the burden on the NHS.

1.) Prevention

Let’s start with things we’re trying to stop, not least unnecessary or avoidable contact with the NHS. Things as simple as keeping pavements gritted – how many times do you hear of people slipping on icy paths, and how many of these incidents lead to hospitalisation? If we can reduce the number of people who need health care, then this is an easy ‘win’. It’s also going to free up the time at later stages of the patient journey.

We also need to be better at signposting people to the most appropriate access point to the health system. Attending A&E unnecessarily or calling an ambulance when one isn’t needed, adds to pressure that we can do without. So the alternative means of accessing help have to be properly supported, funded and promoted.

2.) Primary Care

The next stage is the need to make it easier for our doctors to spend more of their time with their patients. This means doing away with unnecessary paperwork – for example speeding up the introduction of electronic prescribing. We might be used to physically taking pieces of paper signed by our doctor over the road to our pharmacist, but other UK countries can do this with a press of the button.

There are also things that can be done to increase the number of doctors – such as relaxing the performers list restrictions to make it easier for UK doctors outside of Wales to work in Wales. I would also like to see government explore the scope for retired GPs to return, even if just to carry out a small number of remote consultations a week.

3.) Diagnosis and Referral

Alongside an ambitious and long term cancer care plan, Welsh government should give clear focus on immediate cancer priorities during this winter period. They must ensure that screening services continue alongside guaranteeing timely first treatment times. We can’t see these services stop again, even if we see in an increase in admissions to hospital for COVID. This brings me on to my next point.

4.) Treatments and Operations

There needs to be separation of elective and emergency activity through the form of COVID light surgical hubs across Wales, as has happened in Northern Ireland. With waiting lists for treatment at unprecedented highs, this is one way to keep surgical services going throughout the pressures of the pandemic and avoid the current stop start approach we currently have. COVID-light sites are also essential in reassuring patients that it is safe to present for care – how much better would you feel knowing that there was no COVID in the hospital you were attending for surgery? It’s been done in other countries, why not here?

5.) Leaving hospital

There are thousands of patients who are medically fit enough to be discharged from hospital but remain in a hospital bed while the authorities fight over whether their continuing care needs constitute “health” or “social care”. That patients remain in hospital longer than they need to is a crucial factor of ambulances being unable to offload new patients. As the situation is critical now, emergency consideration should be given to ‘step-down’ care facilities and scope to increase care home capacity. I would also like to see the implementation of a Wales-wide 24/7 social discharge service that will ensure patients are supported by social care to be discharged from hospital in a timely manner.

Making changes at all stages of the patient journey will help relieve pressure on the NHS, and improve outcomes for all patients. The benefit to interventions that happen at the start of the patient journey – that is, in signposting them to the right service, or preventing people needing healthcare services in the first place – will have cumulative benefits all the way through.

What’s crucial, is that these are the areas that key health and care stakeholders told me they wanted us to focus on. Right across the delivery of health and care there are short term things the government could be doing – and I hope that, in the spirit of constructive opposition, they will feel able to take on some of these suggestions, for the benefit of us all.