Welsh NHS facing ‘most challenging’ period during Covid pandemic, says chief exec

The Welsh NHS is facing the “most challenging period of time” during the pandemic as it works to tackle a growing backlog of operations and coronavirus.

That is the view of Dr Andrew Goodall, chief executive of the NHS in Wales, who was speaking on BBC Radio 4’s Today programme this morning.

He said that despite less patients being admitted into hospital with coronavirus, hospital capacity is now at its “fullest seen across the system in the last 20 months” as the health service continues to come under strain.

Data released last month revealed that waiting times had continued to grow, with 643,108 people waiting to start treatment in July 2021. This is the highest since comparable data was first collected in 2011.

In North Wales there are 135,398 people waiting to start treatment, up slightly from the 131,362 recorded in June 2021.

Demand has also continued to grow on emergency departments, which were the “worst on record” in August after the target of 95% of patients spending less than four hours in an emergency department was not hit.

Just 68.7% of the 61,281 patients attending Welsh NHS emergency departments spending less than four hours in the department from arrival until admission.

This is 1.6 percentage points lower than the previous month, 11.3 percentage points lower than the same month in 2020, and 8.8 percentage points lower than the same month in 2019.

Betsi Cadwaladr University Health Board was the worst performing in Wales, with 64.9% of A&E attendees spending less than the target time waiting to be seen.

Dr Goodall said that despite the extraordinary efforts of staff over the last 20 months of the pandemic, this “feels like the most challenging period of time.”

He said: “We are still responding to a coronavirus context, we still have significant numbers in our system and we have high community prevalence levels.

“Whilst the number of patients being hospitalised are much lower than we’ve seen over the last 20 months or so, and that is a positive development, it still means that we have patients who are affected by lots of the precautions that we take place within our hospital and our healthcare environments.

“Staff are still needing to PPE up, our physical environments still need to be protecting patients and staff as they move through.

“But the real thing that has changed over these last three or four months in particular, is the recovery of activity because NHS staff wants to ensure that patients are cared for and treated and we’ve actually seen months where high, if not record numbers of patients, are coming into our system from ambulances through to A&E.

“Of course, we’ve been wanting to restore planned operations across the system.

“So the numbers are increasing, we are probably at the fullest that we’ve seen across our system in the last 20 months at this stage.”

Earlier this month the Welsh Ambulance Service confirmed that it would be receiving military support as it faces increased demand following the easing of lockdown measures.

For the third month in a row, there was an average of more than 100 immediately life-threatening (‘red’ calls) a day.

The percentage of red calls receiving a response within 8 minutes was 57.6% in August 2021, down slightly from the previous month, lower than pre-pandemic levels and below the 65% target for the thirteenth consecutive month.

Dr Goodall was also challenged on why waiting times for routine procedures in Wales were longer than for patients in England.

He said: “We have been affected by the decisions that we took back in spring 2020 and the need to step away and ensure that the NHS was prepared, and that was a recognition that we needed to move and redeploy staff from routine activities.

“Our waiting list has been increasing probably around 3% a month at this stage, they are similar increases that has been seen in the English system.

“We have however, been able to show that more patients have been treated for elective operations since spring 2020 through to now.

“Before we were coming into the pandemic, we had some issues around our waiting times and we’ve been focusing on actions to improve that, there has been very significant investment.

“Irrespective of a range of examples of transforming our services in a different way and seeing the recovery happen at this stage, we have too many patients not able to access their services, for reasons that people will understand on the one hand but we have got a responsibility to ensure that we can speed up the access to care and make sure that we have other plans.”

He added: “As we have come out of the pandemic, we’ve really clear that if we look at the numbers that we are facing at the moment, it could take the whole of a government term actually to clear those areas.”

Speaking on Tuesday (12 October) Health Minister Eluned Morgan said that the Welsh Government’s winter plan for the NHS and social care service will be released next week.

However there has been criticism that such a plan outlining how the health system will be supported as it deals with a backlog of patients, the rollout of vaccines, an expected increase in cases of covid and other respiratory illnesses and winter pressures, has not been published sooner.

Commenting on today’s interview, Welsh Conservative and Shadow Health Minister Russell George MS said: “Although it is always a pleasure to hear more about Wales on UK-wide news outlets, it is a shame it is again in the context of the Welsh NHS’s leader admitting its experiencing its most challenging period.

“NHS Wales is right to say it is facing its most challenging time – we can see this in its worst-ever A&E waiting times, longest ever waiting list, and second slowest ambulance response times.

“The Labour Government has been responsible for running our Welsh NHS for quarter of a century and it is down to their mismanagement that we are seeing these problems now – do not forget that the NHS backlog doubled just a year before the pandemic hit, and now it’s out of control with one-in-five people in Wales waiting for treatment.

“Hopefully, Dr Goodall’s admission will mean his expertise in health will be better listened to when he becomes the Welsh Government’s permanent secretary in a few months’ time.”