PREPARATION FOR
1997-98
7. A a result of these various measures and the much
improved levels of co-operation which this strategic approach
has encouraged, health authorities and trusts in Wales have put
in place for 1997-98 arrangements which will provide extra capacity
in hospitals, particularly at times of peak pressure; built on
improved arrangements with social services departments to ease
the pressure of delays in hospital discharge; and improve phasing
of emergency/elective work over the year to avoid cancellation
of routine operations over the winter period.
8. In addition to stimulating the programme of co-operative
and strategic action, the department has supported this approach
by giving the treatment of emergency admissions top priority.
This has been enshrined in planning and purchasing guidance to
the NHS. As a consequence, the preparation for and the handling
of emergency pressures last winter has been markedly improved
and the prospects for 1997-98 are better than in previous years.
9. In November, an additional £9.5 million was made
available to health authorities in Wales, together with a further
£600,000 to improve cancer services. This was in addition
to a £2.5 million package of measures announced in July to
develop and improve primary care, which included £250,000
to provide for additional nursing home care over the winter. The
extra money has been targeted at easing the pressures on the health
and social care system during the winter period and restraining
the growth in waiting lists and waiting times. It is aimed at
both enabling hospitals to cope with the surge in activity in
emergency admissions over the winter period and reducing the need
for people to be admitted to hospitals by providing more community
and home care support; ensuring hospitals can better cope with
emergency pressures by improved staffing levels at times of peak
pressure; and avoiding delays in discharging patients. It is also
aimed at ensuring that non-emergency workloads are maintained
throughout the winter keeping any increases in waiting lists and
waiting times to a minimum.
10. The Department is also supporting a project to look
at the interface between the NHS and social services departments
in north Wales over the winter period. It will identify any bottlenecks
and differences in approach, explore the scope for better communication
between the NHS and other agencies, clarify issues around the
reasons for delayed discharge and "bed blocking" and
identify and disseminate good/best practice to ensure a seamless
approach to emergency patient care across organisational boundaries.
GUARANTEE
11. Health authorities and trusts in Wales have given
Ministers a guarantee about the treatment of patients over the
coming winter. This is a landmark commitment. Subject to a major
disaster or to the impact of natural events over which the NHS
can have no control, all patients needing emergency admission
will be admitted to their own appropriate local hospital or the
nearest one with available beds. Health authorities have pledged
to work to eliminate the unacceptable practice of patients being
referred to several hospitals which are closed to admissions.
This undertaking will require the co-operation of social services
departments, GPs and GP fundholders, trusts and ambulance services
as well as a recognition of the relationship which exists with
elective activity. The department will monitor NHS progress in
delivering the guarantee and in its ability to cope with emergency
pressures throughout the winter months. Regular weekly reports
will be sent to the department which will report issues of concern,
including any hospital closures to emergency admissions, operations
cancelled, bed shortages or increases in staff sickness rates.
