Premature infants to receive single-dose antibody treatment to guard against RSV

BABIES born very prematurely in Wales will now be offered long-acting protection against respiratory syncytial virus (RSV), a common but potentially serious winter virus, under a new NHS scheme.

The innovative treatment, nirsevimab, is a monoclonal antibody that provides extended protection with just one injection—replacing the need for monthly doses of the older medicine, palivizumab, which was previously given to high-risk infants.

The rollout of nirsevimab will bolster NHS Wales’ winter preparedness and help reduce avoidable hospital admissions from RSV, a virus that hospitalises thousands of babies each year.

The change follows recommendations from the Joint Committee on Vaccination and Immunisation (JCVI), which advised that nirsevimab should replace palivizumab due to its greater effectiveness. The JCVI also recommended that eligibility be extended to all babies born before 32 weeks of gestation who are entering their first RSV season.

These infants, born before 32 weeks, are especially vulnerable as they receive limited or no protection from the maternal RSV vaccine given to pregnant women at 28 weeks.

RSV is extremely common, infecting up to 90% of children within their first two years of life, and it can reinfect older children and adults. However, babies under one year old—and particularly those born prematurely—face significantly higher risks. RSV can cause bronchiolitis, leading to inflammation of the small airways and serious breathing difficulties.

Data presented to the JCVI showed that babies born very prematurely are three times more likely to be hospitalised due to RSV and ten times more likely to require intensive care than full-term babies.

It is hoped this targeted protection will help reduce seasonal pressures on the NHS. The impact of RSV on children and older adults in the UK is estimated to exceed that of influenza.

The RSV season typically runs from October to March, peaking in December. The expanded protection programme will provide essential defence during this critical period.

Jeremy Miles, Cabinet Secretary for Health and Social Care, said: “We are following the JCVI’s advice to offer this new treatment to babies most at risk during the RSV season.

“By switching to a single, longer-lasting injection, we can offer better protection while reducing the burden on families and the NHS.

“This is part of our wider efforts to ensure NHS Wales is prepared for the winter and able to protect the most vulnerable in our communities.”

THE SENEDD would have the final say on whether to implement assisted dying in NHS Wales, but services could be available outside the public sector, the health secretary confirmed.

Peter Fox, the Conservative chair of the Senedd’s health committee, sought clarity on the Welsh Government’s position and its powers to implement assisted dying in Wales

Health secretary Jeremy Miles said the Welsh Government maintained a neutral position as he drew a distinction between enacting the UK end of life bill and its implementation.

He explained enactment is reserved to Westminster but providing voluntary assisted dying services in Wales is a discretionary power in the hands of the Welsh Government.

He told the committee: “Those services could only be introduced in devolved areas following regulations laid by the Welsh ministers… and subject to an affirmative Senedd vote. For anything which is in devolved competence there will need to be regulations passed by the Senedd before the service can be provided.”

Giving evidence on July 16, Mr Miles suggested options for services outside of the NHS would be available in the private sector in Wales and England as in other parts of the world.

Pressed on whether ministers could refuse to implement elements, Wales’ health secretary said: “In devolved competence, yes, and even if the [Welsh] Government wanted to and the Senedd didn’t want to approve it – the Senedd would have that ability as well.”

Mr Fox asked: “On regulations – if they are not made by the Welsh Government and consequently approved by this Senedd, the NHS in Wales will not be able to provide assisted dying services – is that the case?”

“That is correct,” Mr Miles replied, later suggesting a decision on whether to provide services in the health service would be made after the next Senedd election in May 2026.

The Welsh Parliament rejected the principle of assisted dying in a historic vote last year, with Senedd Members voting 26-19 against with nine abstaining.

The Senedd rejected a similar motion a decade earlier in December 2014.

But, this side of the election, politicians will get a vote on a legislative consent motion (LCM), the means by which the Senedd signifies consent for proposed UK laws in devolved areas.

While the Sewel convention states the UK Parliament would “not normally” legislate on devolved matters without consent, it is not legally binding.

But Mr Miles suggested the vote would influence Welsh ministers’ decision-making.

James Evans, the Tory shadow health secretary who backed assisted dying in October’s vote, questioned the capacity of the NHS Wales executive and the Welsh Government.

His opposite number replied that he did not have particular concerns about the capacity to introduce regulations but said: “There is a huge system change that goes with it.”

Mr Miles, who was among the majority of Senedd Members to vote against assisted dying, pointed out that the LCM vote will be on a specific proposal rather than a principle.

He added: “My view is that ministers in the Senedd ought to be making the decisions about how this service is delivered in Wales and, indeed, whether it’s delivered in Wales.”

Mr Evans raised concerns about potential for a “two-tier” cross-border system as he warned assisted dying services in Wales could only be available privately for those who can afford it.

Mr Miles said equity of access, cross-border provision and workforce issues – such as health staff opting out of the assisted dying process – would be among the key considerations.

He explained Kim Leadbeater’s bill would change the Suicide Act, which is largely reserved to Westminster, to allow non-public provision in Wales without regulations in the Senedd.

He said Wales has powers to regulate some independent health providers but he stressed it remains early in the bill’s journey and: “We’re talking about hypotheticals at this point.”

He told the committee: “There are lots of choices that any government would have to make in terms of how such a service was developed and delivered.”

SWANSEA Bay maternity services and Cardiff and Vale health board will be escalated to the second-highest level of government intervention, Wales’ health secretary confirmed.

Jeremy Miles announced Swansea’s services will be escalated to level four on the five-point oversight scale following a damning family-led review on maternity and neonatal services.

Mr Miles said the families’ distressing report and a review commissioned by the health board showed people were not listened to and services fell well below expected standards.

The health secretary apologised to families for their experiences, with some describing examples of severe birth trauma, which he said must never happen again.

He told the Senedd: “As a result of the issues raised today and the ongoing concerns from women and families about patient experience, staff attitudes and care provided, I am increasing the escalation level of Swansea Bay’s maternity and neonatal services.”

Mr Miles, who issued a written statement providing more detail of the response, said ministers have commissioned an assessment on all maternity and neonatal services.

The Conservatives’ James Evans said the deeply distressing reports detailed serious failings, poor communication, a breakdown in trust, and avoidable harm.

He warned far too many women were dismissed, traumatised or left grieving.

The Tory shadow health secretary told the Senedd: “It is disappointing it took a family-led review, driven by those 50 families, to force the level of transparency that we’re now seeing – that should never, ever have to happen again.”

His Plaid Cymru counterpart Mabon ap Gwynfor paid tribute to families for exposing gross failings and clinical negligence, “something no new parent should ever have to endure”.

He told the Senedd. “And yet in many cases here in Wales, childbirth continues to present unacceptable risks – across a range of metrics, Wales is lagging badly.”

Mr ap Gwynfor said Wales has had the highest stillbirths rate in the UK since 2014, with neonatal mortality rates rising while falling in Scotland and England from 2010 to 2022.

He expressed concerns about pressures on workforce capacity, pointing to a 35% decrease in applications for midwifery courses in Wales since 2021.

Mr ap Gwynfor added: “The fact the family support group felt like they had no option but to undertake their own inquiry… speaks to serious issues with institutional accountability.”

Mr Miles assured Senedd Members the Welsh Government is committed to ensuring the contents of the reports inform improvement in maternity units across the country.

But Tom Giffard quoted families as saying: “Tomorrow the health minister will stand up in the Senedd and address the situation. He has only one option: remove control of the maternity service from the failed leadership of Swansea university health board.”

Asked why he had not done so by the Conservative, Mr Miles told the Senedd: “I don’t think that is the right way of making sure the service is strengthened.”

Giving a wider update on intervention arrangements on July 15, Mr Miles announced Cardiff and Vale health board would also move to level four due to an increasing financial deficit, breaching its duty to provide a three-year balanced budget.

He said: “It has the second largest number of people waiting more than two years for treatment and there have been a series of worrying cultural and leadership challenges which are indicative of an organisation which needs additional support.”

Mr Evans warned of a high-number of “never events” at the health board this year, “causing unnecessary harm and sometimes death”.

 “We need to make sure that’s rooted out,” he said.

Mr Miles said Cwm Taf Morgannwg health board has been de-escalated from level three to routine level-one arrangements for finance, strategy and planning.

The Labour politician told the Senedd that the Aneurin Bevan health board has been de-escalated from level four to level three – also for finance, strategy and planning.

Mr Miles said Hywel Dda has been de-escalated from level four to level three for cancer services, and from three to one for children’s mental health.

He confirmed Betsi Cadwaladr will remain at level five or special measures as it has for most of the past decade but said there have been signs of progress. Mr Miles brought in changes to allow health boards to be partially de-escalated from special measures in future.

He said Powys would remain at level four for finance, strategy and planning.