Health

NHS performance: Ambulances tied up as hospitals burst at the seams

Published

7 months ago

June 20, 2024

Jon Coles

A NEW set of Welsh NHS performance data was released today (Thursday, June 20), and it contains more bad news.

The Welsh Government described the data as “disappointing”.

WG “LACKS GRIP” ON FUNDAMENTALS

Sam Rowlands MS, the Conservatives’ Shadow Health Minister, said: “These atrocious statistics show that the NHS is going backwards under Labour.

“Two-year waiting lists have increased for the first time in two years.

“Keir Starmer has called Labour-run Wales his blueprint for what a UK Labour Government would look like: these figures are a stark warning for the whole UK.”

Mabon ap Gwynfor MS, Plaid Cymru’s health spokesperson, said: “Labour’s complete mismanagement of the NHS in Wales has left us with waiting lists at the highest on record, targets for diagnosis and treatment are being consistently missed, and people are getting stranded in A&E departments for hours on end.

“It’s no wonder that we have such astronomical waiting times when the government has failed to deal with problems in primary care and social care.

“Until the government gets to grip with these fundamental problems, then waiting lists will continue to climb.”

A Welsh Government spokesperson said: “We have made it a priority to reduce long waiting times, and today, the Cabinet Secretary for Health met with health board chairs to instruct them to redouble their efforts to tackle these.

“These figures show the NHS is continuing to manage incredible demand for urgent and emergency care – the number of immediately life-threatening 999 calls in May was 25% higher than the previous year, and demand is nearly two-and-a-half times higher than pre-pandemic levels.”

THE LOCAL PICTURE: HOSPITALS

Over 30% of patients waiting to start treatment in the Hywel Dda UHB area have been waiting for over 36 weeks.

The Health Board has the second-highest proportion of the population waiting to start therapy. In practical terms, that means that around 4,000 people are yet to get the therapy they need.

The number of patients told they did not have it fell. However, the number of patients starting treatment has remained stable for years.

With rising demand for cancer diagnosis and treatment and no improvement in the numbers starting treatment, performance against the target for treating cancer dropped.

At least 75% of patients should start treatment within 62 days of first being suspected of cancer.

Only 42% of cancer patients in the Hywel Dda UHB area started treatment within the target time. To meet a revised target of 80% by 2026, Hywel Dda UHB will have to increase its performance by almost 100%.

The Welsh Government’s performance target for patients waiting to start treatment for less than 26 weeks is 95%.

No Health Board is close to meeting that target, although Hywel Dda UHB is the second-best performer—just over 50% of patients start treatment within six months.

Despite a dramatic fall in the number of inpatient beds in Hywel Dda UHB’s hospitals over the last six years, the number of inpatient admissions rose sharply in April, placing even greater pressure on chronically overstretched staff and resources.

THE LOCAL PICTURE: AMBULANCES

The percentage of red emergency calls being met within eight minutes fell across Wales.

The ambulance performance target is for 65% of all red calls to be attended to within eight minutes.

Across Wales in May, there were 5,110 red (life-threatening) calls to the ambulance service, 13.9% of all calls.

45.8% of red calls received an emergency response within eight minutes, 2.2 percentage points lower than in April.

In the Hywel Dda UHB area, 47.6% of red calls received an emergency response within 8 minutes, compared to a sharply reduced number of calls in the red category.

Examining more detailed data for the Hywel Dda UHB area demonstrates the pressure on emergency hospital admissions and the knock-on effect on the ambulance service.

When an ambulance takes a patient to hospital, admission is supposed to take place within 15 minutes of arrival, with the ambulance returning to service 15 minutes after that.

In the Hywel Dda UHB area, ambulances were tied up beyond those markers for almost 4,000 hours beyond expected admission and return to on-call.

Fewer than 18% of patients conveyed to a Major Injury Department were admitted within 15 minutes. For Major Acute Units, that turnaround was even worse, at barely 15.5%.

Once cleared, however, well over 80% of ambulances were back out on call.

Diving deeper into the data, we see that just over 1,700 patients travelled by ambulance to major emergency, major acute, and maternity and mental health units.

By a very crude piece of arithmetic, we can calculate that if those 1700 patients accounted for the 4000 hours of “lost time”, the handover stats would be even more shocking, with an average turnover of over two hours.

Moreover, localised data shows that 35.6% of all people who are attended by an ambulance go to a hospital using other means of transport.

A CRISIS ACROSS THE BOARD

The issue could not be clearer: delays at hospitals are keeping ambulances off the road.

The upward pressure on A&E services caused by the collapse of out-of-hours primary care (GPs, etc) is driving up attendance at all hospital A&Es.

The lack of beds is driving up a backlog of treatment. The lack of clinical staff means more junior staff fulfil tasks -including initial diagnoses- formerly taken by clinicians and registered nurses. Consolidating rural services on an urban model is making things worse.

Whatever the cure for the disastrous condition of the Welsh NHS, money will not be enough to turn around decades of decline.

Health

Hywel Dda Health Board announces Community Vaccination Centres

Published

2 days ago

January 28, 2025

Tom Sinclair

HYWEL Dda University Health Board is organizing pop-up community vaccine centres to make it easier for eligible individuals to access their flu and COVID-19 vaccines.

To check your eligibility for the flu and/or COVID-19 vaccine:

Visit: phw.nhs.wales
Contact the health board: 0300 303 8322 (Option 1)
Email: [email protected]

If you are eligible, you can either drop in at one of the centres listed below or book an appointment using the details above.

New clinics are being arranged for February. Stay updated by visiting the health board’s webpage:
Seasonal Flu Vaccinations

Vaccination Centres and Schedules

Carmarthenshire

Carmarthen Athletic RFC
Athletic Park, Johnstown, Carmarthen, SA31 3QY

Monday, January 27: 9:30am–4:45pm
Tuesday, January 28: 9:30am–4:45pm
Wednesday, January 29: 9:30am–4:45pm
Thursday, January 30: 9:30am–4:45pm

Llandeilo Fawr Civic Hall
17 Crescent Road, Llandeilo, SA19 6HW

Friday, January 31: 10:00am–4:45pm

Pontyberem Memorial Hall
Coalbrook Road, Pontyberem, Llanelli, SA15 5HU

Tuesday, February 4: 9:30am–4:30pm

Llandovery RFC
Church Bank Playing Fields, Llandovery, SA20 0BA

Thursday, February 6: 10:00am–4:30pm
Friday, February 7: 10:00am–4:30pm

Ceredigion

Tregaron Memorial Hall
The Square, Tregaron, SY25 6JL

Monday, January 27: 10:00am–4:30pm

New Quay Memorial Hall
Ffordd Towyn Road, New Quay, SA45 9QQ

Tuesday, January 28: 9:30am–4:45pm
Wednesday, January 29: 9:30am–4:45pm

The Pwerdy-Powerhouse Community Arts Centre
Chapel Street, Pont Tyweli, Llandysul, SA44 4AH

Tuesday, February 4: 10:00am–4:45pm
Wednesday, February 5: 10:00am–4:45pm

Pembrokeshire

Pembrokeshire Archives
Prendergast, Haverfordwest, SA61 2PE

Tuesday, January 28: 9:30am–4:50pm

Regency Hall
King George V Playing Fields, Milford Street, Saundersfoot, SA69 9NG

Friday, January 31: 9:30am–4:45pm

Neyland MVC
Unit 1, Honeyborough Retail Park, SA73 1SE

Monday, February 3: 9:30am–4:45pm
Wednesday, February 5: 9:30am–4:45pm

Llwyngwair Manor
Newport, Pembrokeshire, SA42 0LX

Thursday, February 6: 10:00am–4:30pm

Bloomfield House
Redstone Road, Narberth, SA67 7ES

Friday, February 7: 10:00am–4:45pm

Health

RCN demands urgent action and transparency on corridor care in Wales

Published

3 days ago

January 28, 2025

Tom Sinclair

THE RCN today issued a strong call to action to the Welsh government, urging them to take decisive steps to eradicate corridor care – a practice that is unsafe, undignified, and unsustainable. The most vulnerable in society, including many older people, bear the brunt of corridor care –where patients are treated in hallways and other inappropriate settings due to bed shortages.

Corridor care compromises patient safety and dignity by delaying timely treatment, reducing privacy, and increasing anxiety and stress. For the nursing workforce, it worsens workloads, contributes to burnout, and undermines their ability to provide quality care.

In open letters to the Welsh Government, NHS Wales, key watchdogs and advocates, the RCN has called for action on eight steps to end corridor care in Wales. The RCN’s eight recommendations include protecting patient safety and supporting the nursing profession by declaring care in chairs for over 24 hours a “never event” and fostering a culture where nursing staff can raise safety concerns without fear. Key steps include increase weekend staffing that can enable timely discharges, restoring District Nurse numbers to 2010 levels, and investing in social care to ensure patients can transition from hospitals to appropriate care settings promptly.

Additionally, the Government must pause hospital bed reductions and review capacity to ensure adequate care in both community and hospital settings. Investing in the nursing workforce and fully implementing the Six Goals for Urgent and Emergency Care programme is critical. NHS Wales must be empowered to divert patients to neighbouring services when necessary, easing pressure on overstretched facilities and improving outcomes.

Helen Whyley, Executive Director of RCN Wales, said: “Nurses are facing immense challenges in maintaining high standards of patient care amidst the growing prevalence of corridor and chair care in hospitals. The RCN’s recent report starkly highlights the stories of nurses who are striving to provide quality care in these difficult conditions. Despite the lack of proper facilities and the strain of overcrowded hospitals, nurses continue to demonstrate remarkable dedication and resilience. They often work long hours under intense pressure, ensuring that patients receive the best possible care even when resources are stretched thin.”

“Our recommendations provide a clear and achievable roadmap to ensure patients receive care in the right place, at the right time, and by the right professional. The nursing workforce is ready to lead the way – but we need the Welsh government to act now.”

The RCN is calling on the Welsh Government to engage all health care stakeholders, listen to the expertise of the nursing workforce, and prioritise patient safety above all else. The time to end corridor care is now.

Health

Leading pharmacies demand tougher regulation on online sale of weight-loss jabs

Published

4 days ago

January 27, 2025

Tom Sinclair

PHARMACIES are calling for stricter regulation of online sales of weight-loss injections, warning of risks to patient safety amid predictions of a surge in demand this year.

The National Pharmacy Association (NPA), representing independent community pharmacies, has urged the General Pharmaceutical Council (GPhC) to require more thorough consultations with patients before dispensing weight-loss injections and other high-risk medications online.

The NPA cautioned that existing regulations allow medicines to be supplied without adequate consultation or access to patient records, leaving patients vulnerable. They called for a mandatory two-way consultation process to ensure prescribers have a full understanding of patients’ medical histories before issuing such treatments.

Greater safeguards needed

Responding to draft GPhC guidelines, the NPA criticised the proposed safeguards, stating they “still leave the door open for medicines to be prescribed and supplied without appropriate two-way patient consultation or access to a full clinical picture, particularly with high-risk medicines.”

The association recommended prescribers engage in direct dialogue with patients—either in person or via telephone—before offering weight-loss medications such as Mounjaro injections. The NPA also stressed the importance of obtaining comprehensive medical histories, rather than relying solely on online questionnaires.

Nick Kaye, Chair of the National Pharmacy Association, said:
“Obesity is one of the biggest challenges facing our country, and pharmacies want to play their part in helping patients achieve and maintain a healthy weight.
“Weight-loss injections can be effective when prescribed as part of a carefully managed programme, but the current regulations allow some patients to access these medications inappropriately, without proper consultation or examination of medical records.”

Addressing rising demand

The call for tighter regulations comes as demand for weight-loss treatments is expected to rise, with the government planning to expand the rollout of such medications. Many pharmacies already dispense weight-loss treatments or include them in private weight-loss programmes, emphasising a need for best practices to prioritise patient safety.

The NPA highlighted cases of patients who had been inappropriately prescribed weight-loss injections, including individuals with eating disorders or those with body mass indexes (BMI) outside the licensed range. Such cases increase the risk of severe adverse effects.

Kaye added:
“Medicines are not like ordinary goods for sale; they must be handled with great care because they have the power to harm as well as to heal. We urge the GPhC to make a full consultation compulsory for high-risk medicines and ensure supply is prioritised for those with the greatest clinical need, including those with type 2 diabetes.”

Warning against unregulated sellers

The NPA and the Medicines and Healthcare products Regulatory Agency (MHRA) have also warned against purchasing weight-loss injections from unregulated sources, such as beauty salons or social media platforms. Counterfeit medications from these suppliers pose significant health risks.

The NPA advised patients to consult a pharmacist if they are unsure about weight-loss treatments, ensuring they receive safe and effective care as part of a programme to achieve sustainable lifestyle changes.