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Deterioration in emergency NHS care in Wales, says auditor general Deterioration in emergency NHS care in Wales, says auditor general
(34 minutes later)
Unscheduled care services - such as accident and emergency units - are deteriorating across Wales, according to the auditor general.Unscheduled care services - such as accident and emergency units - are deteriorating across Wales, according to the auditor general.
A report says increased waiting times, staff shortages and problems with the flow of patients through hospitals are partly to blame.A report says increased waiting times, staff shortages and problems with the flow of patients through hospitals are partly to blame.
It highlights that too many patients, in particular older people, spend longer than 12 hours in A&E.It highlights that too many patients, in particular older people, spend longer than 12 hours in A&E.
The Welsh government will consider the recommendations made.The Welsh government will consider the recommendations made.
The auditor general, who has looked into the progress made in the Welsh NHS since a previous report on the issue in 2009, said A&E waiting times have generally increased in recent years.The auditor general, who has looked into the progress made in the Welsh NHS since a previous report on the issue in 2009, said A&E waiting times have generally increased in recent years.
Huw Vaughan Thomas also said that some of the key challenges raised in the previous report about unscheduled care - described as any urgent, unplanned treatment in a hospital emergency unit or at home - remained. Huw Vaughan Thomas also said some of the key challenges raised in the previous report about unscheduled care - described as any urgent, unplanned treatment in a hospital emergency unit or at home - remained.
The report highlighted problems including:The report highlighted problems including:
The Welsh government and NHS bodies have been asked to carry out continued "rigorous monitoring" to assess the impact of service pressures on quality and safety of unscheduled care services. The report said to help improve the situation, access to urgent same-day GP appointments during the working day should to be increased.
The report also wants to see more comprehensive feedback from patients who are facing a complex and confusing range of options. The skills of ambulance staff also needed to be improved to allow them to treat more patients at the scene or refer them to non-emergency services.
'Sensible recommendations' The planned development of community-based services offering alternatives to hospitals should be sped up.
Mr Vaughan Thomas said factors such as rising demand and problems with the workforce have put NHS services under pressure, despite a commitment to improve them. 'Problems enduring'
"The report makes several clear recommendations for all the agencies providing unscheduled care in Wales, which I hope will help the NHS build on the improvements suggested by the most recently available data," he added. Dave Thomas, director of health and social care at the Wales Audit Office, said the NHS faced a "struggle".
The Welsh government said the auditor general's report "makes some sensible recommendations". "A&E is actual front door of hospital but it'll actually be a symptom of many of the causes elsewhere," he told BBC Radio Wales.
A spokesperson said: "The report articulates the complexity of the unscheduled care system, and resolving the challenges described will require all key partners in hospitals, primary care, and local authorities to work creatively and robustly at a local and national level to ensure that we see sustainable improvement," a spokesperson said. "You'll find that if there are problems with patients flow through the hospital they then be manifest with back pressures in the A&E department.
"We are concerned that the problems are enduring.
"I think there's a clear focus by the Welsh government and the NHS. It's not from want of trying. I think the issues are complex.
"All the pressures are coming at a pace which is greater than the pace of changes made by the service."
The Welsh government said the report "makes some sensible recommendations".
A spokesperson said: "The report articulates the complexity of the unscheduled care system, and resolving the challenges described will require all key partners in hospitals, primary care, and local authorities to work creatively and robustly at a local and national level to ensure that we see sustainable improvement.
The spokesperson added that ministers would work with NHS Wales and social care to build on early improvements and respond to the report's recommendations.The spokesperson added that ministers would work with NHS Wales and social care to build on early improvements and respond to the report's recommendations.