Room for improvement

Auditor General Jeremy Colman, has today published a report entitled "Unscheduled care: developing a whole systems approach", which concludes that despite the strengths of the current system, there is work needed to improve the way which services work together.

The BMA has been calling for better service integration within the Welsh NHS for a long time - unscheduled care plays a key part in that agenda.

The report says that too many people who have urgent reasons to access the NHS or social services are encountering inefficiency, uncertainty and delays. Jeremy Colman says that a solution to this would be to show people how their needs can be met more effectively elsewhere.

It may sound obvious, but ensuring that patients are seen or treated in the right place at the right time will make a big difference to the efficiency of NHS services and so it is essential that we get that right.

The report recommends that the new LHB’s should take the lead in redesigning the structure of unscheduled care. I hope the Minister considers this and will take the appropriate action to address the issue. Of course, any changes must be backed by an effective channel of communication and better working practices.

In addition, universal targets for seeing patients in A & E Departments are skewing priorities – patients in more need should be prioritized and treated accordingly. That is just not happening at the moment. The use of smarter targets is a real solution to that and something we have been encouraging the Assembly Government to look into.

We must be careful not to undermine what we already have in Wales both in general practice and in secondary care. We need services that support and compliment each other – the danger which has become apparent is that unscheduled care has become a separate and isolated part of an already disjointed service.

At a time where NHS reorganisation is taking shape, it is crucial that the Minister acts now, so that the future benefits of the NHS in Wales can be fully realised. We would very much welcome the opportunity to work with the Assembly Government and the new LHBs on improving the service.

If you have any thoughts on the report, let me know.