Blog post

Reflections on the current position in Wales

Darren Hughes, director of the Welsh NHS Confederation, reflects on the position of the NHS in Wales and communicating the reality to the public.

1 February 2022

A very Happy New Year from the Welsh NHS Confederation (if we’re still allowed to say that!). A fresh start is wished for by many, I think we’re all hoping 2022 will see us moving from ‘pandemic response mode’ towards a ‘new normal’, whatever that may look like.

Since the vaccination programme began, over 6.5 million doses of Coronavirus vaccine have been administered in Wales. This is over twice the population of Wales.

For starters, it's brilliant that over 1.8 million people in Wales have already had their booster dose. Bearing in mind the speed at which this programme has been delivered, not to mention the fact that many of those eligible couldn’t receive their booster when invited due to Covid, and at a time of high staff absence levels from Covid, this is an astonishing achievement. It’s something that deserves more credit than it’s received, perhaps getting lost in the political turmoil we hear about each day. There could be an element of politicians and the public coming to expect the NHS to deliver these things, too, as they step up to challenges time after time. Unless there is long-term commitment from governments to invest in the workforce and social care, this won't be easy.

Since the vaccination programme began, over 6.5 million doses of Coronavirus vaccine have been administered in Wales. This is over twice the population of Wales. When considering that younger groups have only recently become eligible for first and second doses, this too is mind-blowing. 

We must remember that despite cases declining, they’re still high and thousands of staff are still absent with Covid.

With transmission of the Omicron variant stabilising following a steep peak, hope is returning once more. Hospitalisations from Covid also seem to be steadying, although continue to put extra pressure on intensive care units and all other wards. Although Covid hospitalisations haven’t been at a record high, in part thanks to the vaccination programme, GPs and health professionals in primary care have been absorbing much of this demand as many patients turn to them for support with Covid and other symptoms and conditions.

Whilst figures are encouraging, the presence of Covid and the implications on the delivery of care remain with us and will do for many years to come. We must remember that despite cases declining they’re still high and thousands of staff are still absent with Covid. Frontline staff still have to work in PPE, waiting rooms and beds must be socially distanced, often halving capacity on wards, extra cleaning and hygiene practices still have to be undertaken and staff are regularly being tested. This is all easy to forget for politicians and the public when not faced with it on a daily basis.

Given the changing narrative in the UK media over the last month around the threat from Omicron, NHS leaders in Wales are very concerned public perception will be that the NHS is returning to ‘normal’ and frustration around waiting times (for both emergency and scheduled care) will come to the forefront once more.

Leaders and clinicians are doing everything they can to prevent any further delays to treatment, but patient safety should always come first.

We’ve been working hard to communicate the reality of the situation to our key stakeholders, politicians and the public, including the impact of staff absence on the NHS’ ability to meet demand, gaining coverage on national and local publications across Wales. We’ve raised the importance of recognising that all parts of the system are experiencing extreme levels of demand - not just in our hospitals, but in social care, GP surgeries, pharmacies and community services too.

As we look to the not-too-distant future, health boards will look to reintroduce paused planned care and routine treatments as soon as it is safe to do so. Leaders and clinicians are doing everything they can to prevent any further delays to treatment, but patient safety should always come first.

An area of ongoing focus for leaders across the health and care system is patient flow through hospitals and delayed transfers of care, i.e. the ability to discharge medically fit patients back into the community where ongoing support is needed. This is currently being scrutinised in the Senedd as part of the Health and Social Care Committee’s inquiry into hospital discharge and its impact on patient flow through hospitals, for which we submitted written evidence on behalf of our members. We highlighted that the NHS is working with local authorities to develop partnerships and initiatives to assist in reducing the current (extreme) pressures on the system. One major development taking place across Wales is the systematic approach to discharging patients from hospital to assess their strengths and identify care and support requirements.

While difficult times still lie ahead, NHS organisations continue to work in partnership to develop initiatives which aim to enable long-term transformation. Our latest briefing, Transforming NHS services to improve patient experience, includes examples from each NHS organisation in Wales, showcasing how they are working to transform services to help respond to demand, support the population and plan for the future.

This year must and will be a time of transformation for the health and care system, to ensure people receive the care they need and a services that healthcare staff are determined to deliver now and into the future.