The Aneurin Bevan University Health Board

2. Questions to the Cabinet Secretary for Health and Social Care – in the Senedd at on 5 June 2024.

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Photo of Rhianon Passmore Rhianon Passmore Labour

(Translated)

7. How does the Welsh Government monitor the finances of the Aneurin Bevan University Health Board? OQ61208

Photo of Baroness Mair Eluned Morgan Baroness Mair Eluned Morgan Labour 2:50, 5 June 2024

Each NHS organisation submits its financial plan as part of the integrated medium-term plan process. Formal monthly monitoring by my officials is then undertaken throughout the year, with additional support by the NHS executive. This is further supported through regular meetings between my officials and senior finance staff from the health board.

Photo of Rhianon Passmore Rhianon Passmore Labour

Thank you. And I'll repeat, Cabinet Secretary, that Robert Holcombe, the Aneurin Bevan University Health Board's finance chief, told the board's main meeting that it has a worst-case scenario of a £60 million deficit and a best case of a £48.9 million deficit. He then went on to detail the board's month one report of just under £5 million, equating to the established worst-case scenario. Cabinet Secretary, the financial state of the health board of Gwent, with all of its industrial legacy and population acute demographic, will be of concern to my constituents in Islwyn. One aspect highlighted by the health board is the number of patients stuck in hospital beds, as there are no care plans in place for them to return home. This is a long-standing endemic issue across the UK, caused by a lack of UK focus on social care, but, across Gwent, there were 289 patients at the end of April, costing more than £1 million a month and around £15 million over the year. Cabinet Secretary, I know this is a strong focus for the Welsh Government, but what actions are the Welsh Government intending to take now to alleviate the pressing issue of delayed transfers of care? What urgent improvements to social care can be achieved now in a devolved setting to ease the pressure on hospitals, and will she commit to explore now the Scandinavian intermediate rehabilitative care model?

Photo of Baroness Mair Eluned Morgan Baroness Mair Eluned Morgan Labour 2:51, 5 June 2024

Thank you very much. You've put your finger on the button there in terms of where the problem is. Certainly, delayed transfers of care are absolutely in my sights constantly, as they are within Dawn's sights as the Minister responsible for social care. So, we're working together very much on that, and we're also speaking to the Minister responsible for local government. Delays in hospital discharge are not the sole factor that affects access to services, but they certainly are one of the key issues. Social care assessments are one of the largest reasons for delays in patients leaving hospitals. We've got a really comprehensive database now that tells us exactly why people are in hospital, why they are still there, who's chasing them down, whose responsibility it is, so that we can really hold people to account for that.

The truth is we have seen a significant reduction in these figures over the last year, but we have to go further. So, what we need is a joint approach to this, and you know that local government is also feeling the pinch as well as the NHS, but it is important, I think, that we don't take our eye off this particular issue. I can assure you that this is absolutely up there in the top four of our priorities, and certainly the performance relating to urgent and emergency care in the Grange is not where it should be. Some of that is as a result of the delayed transfers of care.

In terms of the intermediary model, I don't know what the Scandinavian model is, but I can assure you we've got lots and lots of examples of intermediate care. We have a £144 million fund that can only be used if the health boards co-operate and work with not just local authorities, but the third sector. So, we are very much in that space already.

Photo of Laura Anne Jones Laura Anne Jones Conservative 2:53, 5 June 2024

A great question from my colleague across the floor, actually—I'm glad you've asked that. I'd like to ask you a more general one, Cabinet Secretary, if that's okay. There can obviously be no one-size-fits-all approach to monitoring and aiding health boards. I just want to ask you: how do you and Welsh Government recognise the specific and often different and diverse needs of each individual health board?

Photo of Baroness Mair Eluned Morgan Baroness Mair Eluned Morgan Labour 2:54, 5 June 2024

We're monitoring each health board all the time. So, we have a team of experts, we have the NHS executive, and we're doing that on a regular basis. We are benchmarking, we are making comparisons on a whole range of areas. I now have monthly meetings with the chairs of the health boards to hold them to account for a whole range of things, where they can see how they're performing in relation to the others across Wales. It's not just me doing that, obviously; the chief executive of the NHS in Wales does the same thing with the chief executives of the health boards themselves. And then, officials are doing that at an operational level, as well. So, there is a lot of monitoring going on and we are seeing some movement. We do need to see a bit of modernisation, frankly, in some circumstances. We need people to follow the clinical pathways that are the optimum clinical pathways and not keep to the same old way that they used to do things; things move on in medicine and they need to move with the times. So, it's monitoring and making sure that that happens. And what's clear is that we are seeing real diversity across Wales, and that's not acceptable. It's not acceptable to the patients and it shouldn't be a postcode issue, according to where you live, which is why there is a responsibility on us, at the centre, to make sure that every single one of those health boards is performing to its optimum ability.