Oral - NHS Waiting Times And Emergency Pressures

I wish to report today on the progress that is being made in a number of key performance areas in the NHS, including progress against our waiting times targets and the service response in the face of emergency pressures.

The latest waiting times figures published show that the NHS is making good progress towards achieving the target that no-one will wait longer than eight months for in-patient or out-patient care. At the end of January 2007, 3,500 patients were waiting over eight months for in-patient or day-case treatment with no patients waiting over 12 months. That is a reduction of 3,700 compared with the end of March 2006. At the end of January, 5,700 patients were waiting over eight months for a first out-patient appointment with only five waiting over 12 months. That is a reduction of 13,500 compared with the end of March 2006.

Wales was the first of the home countries to publish waiting times for diagnostic and therapy services, in February last year. Those are an important part of the patient journey and our aim is to achieve the 26-week target by December 2009. This has previously been known as the hidden waiting list. At the end of December 2006, 2,500 patients were waiting over 36 weeks for diagnostic and therapy services. That is a reduction of 8,900 patients compared with the end of March 2006. Large reductions have been recorded in the numbers waiting over 36 weeks for key tests such as MRI and CT scans, and for therapy services such as speech and language therapy and physiotherapy.

There has also been a large reduction in the numbers waiting over 24 weeks for an echocardiogram, where the numbers have fallen from 2,900 to 1,200 people. These substantial improvements are due to the hard work of the dedicated NHS staff, and I congratulate them on this, given that they are also up against other pressures.

Moving on to the pressures faced in our emergency care services that have been well documented in recent weeks, the all-Wales performance against the 95 per cent target for waits of fewer than four hours in major accident and emergency departments has yet to be achieved consistently. However, it should be remembered that over 66,600 patients attended a major accident and emergency department in Wales in January, and nearly nine out of 10 patients were admitted, transferred or discharged within four hours. In those departments that are performing below the target levels, the regional offices and the delivery support unit are working closely with the relevant trusts to bring about improvements.

Along with demand for accident and emergency services, the demand placed on the emergency ambulance service has reached unprecedented levels. The number of emergency 999 calls received for the quarter ending 31 December 2006 was the highest ever, at 76,200. That is more than 4,500 additional emergency calls when compared with the same quarter the previous year, and it is a 34.8 per cent increase on five years ago. Despite this increase in demand, it is important to remember that more than 57,000, nearly 80 per cent, of responses to all emergency calls arrived within the target time, and nearly 18,000, or 55.8 per cent, of first responses to the immediately life-threatening calls arrived within eight minutes. The latest quarter’s figures on meeting the eight-minute response time show a small improvement. However, I would accept that one quarter’s figures do not constitute a sustainable trend.

There is much still to be done to improve the performance of our ambulance service. To facilitate its modernisation, I have recently announced more than £70 million in capital funding to provide new ambulances and to update telecommunications and vehicle location technology. We must remember that providing a better emergency service is not just about the modernisation of the ambulance service; it is also about ensuring that all services, including hospitals, accident and emergency, the ambulance service, primary and social care, work together to ensure that patients receive an appropriate response in line with their needs.

Our vision for the future of unscheduled care services in Wales is set out in our DECS policy—delivering emergency care services. It is to ensure that patients, no matter how or when they contact any of the emergency or unscheduled care services, are assessed and seen by a professional in the most appropriate care setting, at the most appropriate time.

Equally, in some parts of Wales, delayed transfers of care are a major problem, although, in other parts, significant progress has not only been made but also sustained. However, three to four areas have levels of delayed transfers of care that are well beyond the overall Welsh pattern. I intend to consult with the Social Services Inspectorate for Wales and the Welsh Local Government Association on undertaking a special review of these areas to establish any underlying reasons as to why their delayed transfers of care rates remain stubbornly high. This review will complement the outcomes of the wider review of delayed transfers of care, which the Assembly voted for before Christmas.

I recognise the importance that people attach to prompt access to general medical services and primary care. That is where 90 per cent of medical consultations take place, and that is why, in October 2003, we launched the access directed enhanced service. This service funded general medical services practices to reorganise their services to provide access to an appropriate member of the primary care team within 24 hours, or sooner in an emergency. By the end of March 2004, 93 per cent of practices reported that they were delivering that target, and that figure improved to 97 per cent by March 2006. General medical services practices have worked hard to deliver what patients want. These figures demonstrate a substantial improvement in access to general medical services primary care.

In response to feedback from patients, this year, we have introduced further initiatives to improve patient access. We have agreed with the General Practitioners’ Committee Wales that practices will also provide: booked appointments up to two weeks in advance, with the opportunity of being seen by a general practitioner of the patient’s choice within four weeks; a telephone answering system that is adequate to cater for reasonable patient demand; as well as a review of the access needs of patients with disabilities.