The Wales Audit Office has published a report today that concludes that emergency care in the Welsh NHS is “disjointed and confusing”.
They conclude that too many people who have urgent reasons to access the NHS or social services encounter inefficiency, uncertainty and delays and they identify a “fundamental weakness” in a failure to plan for demand on services:
The report says: “The emergency department is commonly a bottleneck where people can face delays but only some of the delays are due to the management of the department itself.
“Very often, the delays in emergency departments are because of problems elsewhere in the hospital or at the interface between the hospital and community-based health and social care services.”
But at present, there are not enough community-based services for people to have genuine alternatives to acute care.
The authors are concerned that the unnecessary use of acute services leads to “avoidable hospital admissions” which put people at risk of infections which can result in loss of independence.
Crucially, they say that when ambulance crews are delayed at emergency departments, fewer crews are available to respond to 999 calls.
In the 12 months leading up to July 31 this year, ambulance crews spent 38,536 hours waiting at hospital emergency departments beyond the 20-minute target to complete the handover. These delays have an estimated direct cost of more than £2.9m.
This is a key conclusion in relation to the problems facing the Wales Ambulance Trust and needs some urgent action by the Minister and the health boards.
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