Delays with patients being discharged from hospitals in Wales affecting delivery of safe care

The issue of patient flow in Welsh hospitals has come under scrutiny following a revealing report published on Thursday by Healthcare Inspectorate Wales (HIW).

Focusing on the journey of stroke patients, the report underscores how delays in discharging patients from hospitals are posing considerable risks to safe care delivery.

Commencing in December 2021, the HIW study sheds light on significant disruptions in the efficient movement of patients.

Such inefficiencies have resulted in prolonged hospital stays, increasing the susceptibility of patients to various risks, and placing undue stress on crucial hospital services.

The report not only brings to light the operational challenges but also stresses the need for healthcare services to understand patient barriers.

Such an understanding is vital in ensuring patients access the right care platforms, potentially reducing undue pressures on GPs and Emergency Departments.

However, it’s not all grim. The review also acknowledged areas where the system has been efficient.

Stroke patients, for instance, are promptly prioritised for ambulance handover in line with the stroke pathway. Additionally, the presence of a Hospital Ambulance Liaison Officer (HALO) during patient flow meetings in certain health boards has proven beneficial.

HIW’s Chief Executive, Alun Jones, emphasised the importance of a unified approach, he said:

“Improving patient flow improves the patient experience, improves outcomes, and minimises waits and delays.”

“I am pleased that our work has enabled us to identify areas for improvement, and to highlight areas of good practice. Not just in relation to the stroke pathway, but for all patients. What is crucial now is that all parts of the health and social care sector work together as effectively as possible to address poor flow and achieve better outcomes for patients in Wales.”

“I want to take this opportunity to thank staff working within health and social care services who strive to provide safe and effective care. Their dedication and commitment provide a strong and positive basis upon which to improve.”

Reacting to the findings, Welsh Conservative Shadow Health Minister, Russell George MS, weighed in, he said: “Wales is a unique outlier, with extended ambulance and A&E waits compared to the rest of the UK,” Despite promises to eradicate two-year waits, such extended waiting times persist in the Labour-run Welsh health service.

George further highlighted pressing concerns regarding staffing. “Recruitment and retention, a lack of boots on the ground, is the key issue. With potential strikes on the horizon due to the Welsh NHS receiving the UK’s least favourable pay deal for doctors, the situation looks bleak,” he cautioned.

Mabon ap Gwynfor MS, Plaid Cymru’s health and care spokesperson, has pointed to Welsh Government “failure to invest” in community care, he said:

“Labour Welsh Government must heed the lessons from this extremely important report by HIW, and ensure further patients don’t suffer needlessly as a result of delays to movement through the health and care systems.

He said: “The issue of slow patient flow through hospitals due to a lack of community care is not a new one. Indeed, when I was elected two years ago, I raised it then. I welcome the fact that this report gives further credence to the concerns I raised then.

Gwynfor said: “Delays to patient flow through hospitals is complex issue, but there are fundamental issues at play: Wales has seen thousands of hospital beds closed over the last two decades. Each time we’ve been told that care is better delivered closer to home and whilst that is undoubtedly true, the Labour Government has singularly failed to properly invest in that community care.

“As a consequence of the lack of investment into that care ‘closer to home’, we are overly dependent on an army of voluntary carers. In turn, many of these carers are woefully under supported.” He said.

“Thanks to Plaid Cymru and our Co-operation Agreement, the Welsh Government is now seriously looking at closer working between health and social care, but this work needs to happen sooner rather than later. This report by the HIW will hopefully put some rocket fuel into this work so that we can see the vast improvements that are so desperately needed.” Gwynfor said.

The full report can be viewed here.