NHS Chief Exec says NHS services will continue through difficult winter ahead but “the higher the level of coronavirus in the community, the more difficult this becomes”

The spread of coronavirus is showing an “impact on our hospitals at the moment is similar to what we saw in March” according to the Chief Executive of NHS Wales.

The Chief Executive of NHS Wales, Dr Andrew Goodall, took the lunchtime briefing and gave a sombre update on the current situation, we have transcribed his full statement below:

“Since I last spoke to you in the summer, we’ve seen an increase in coronavirus cases across Wales. We’re now beginning to see the impact of this on our NHS and care services. I want to update you about how the virus is affecting the NHS across Wales and individual services.

“Yesterday, Public Health Wales reported 764 new cases of coronavirus. In some health board areas the levels of coronavirus and are higher than those we were seeing at the peak in April. This is because testing is more widely available.”

“Very sadly, we are seeing an increase in the number of people dying from Coronavirus. Every day this week Public Health Wales has reported deaths and the Office for National Statistics yesterday said deaths involving Coronavirus are at the highest level since the start of July. Behind every figure is a person and I want to pass on my personal condolences to all the families who have lost a loved one to Coronavirus.”

“We have four levels of escalation in the NHS which reflect pressures in the system. In July, I was reporting that most of our sites were green or level one status. Today, there are 12 hospitals reporting either level three or four, which show the increased pressure across the NHS as we balance emergency activity with rising numbers of people needing treatment for Coronavirus.

“Today, there are just over 700 COVID-19 related patients in Welsh hospitals. This is 49% more than last week. This is the highest number since late June.”

“The number of confirmed Coronavirus patients in most hospitals is currently 326 70% higher than two weeks ago. This is about half the number when we were at the peak in April. But I am concerned at the rising trend. The demand for beds for people with Coronavirus will continue to increase in the days and weeks ahead.

“About 15% of our acute and community hospital beds are vacant but some hospitals already have limited capacity in those parts of Wales where there are high levels of coronavirus. There are currently 25 people being treated in critical care for coronavirus. This has been stable over the last two weeks, but we expect to see this increase.”

“Our normal critical care capacity of 152 beds is full, mainly with people who do not have Coronavirus. Health boards who are already implementing plans to expand critical care, which will have a knock on effect on other NHS services, including unfortunately, planned surgery.”

“We know a lot more about the spread of the virus than we did earlier in the year. We know that an increase in community cases leads to an increase in hospital admissions and increase in critical care admissions, and sadly an increase in deaths. Inevitably, as we see increasing numbers of hospital admissions, it will impact on the NHS’s ability to maintain and deliver all aspects of service.”

“A range of services will need to change to manage Coronavirus. I will give you two examples of this. Around 10% of current 999 and ambulance calls relate to COVID symptoms. It can take paramedic up to six minutes to put on the necessary PPE they have to wear when responding to somebody with COVID symptoms. This has consequences for the speed of response to red 999 calls, where time is of the essence. It also has an impact on ambulance response time performance. Each ambulance must be thoroughly cleaned between calls taking that vehicle off the road.”

“The number of operations and procedures we can carry out is also affected by coronavirus. Every operating theater must be safe for patients and staff, which means a wide range of preventative measures must be put in place from enhanced infection control and decontamination between operations to PPE which must be changed between patients. Even for the most routine of operations, the time needed for each surgery has increased by 50% significantly reducing the number of operations which can take place.”

“I want to give you some insight into how NHS activity has been affected by the pandemic. In March we took the decision to postpone planned operations and appointments to enable the NHS to respond to Coronavirus while maintaining essential services including cancer, mental health and emergency services.”

“Restarting the NHS is a complex process, especially when there is still so much we don’t know about Coronavirus. We continue to provide essential and emergency care. We’ve seen gradual return to normal levels of activity in our emergency departments across well since June. The most recent operational data for September shows a small reduction in 999 calls and A&E attendances, which perhaps reflects the high levels of Coronavirus we are now seeing across Wales.”

“We have seen the number of people referred into the NHS for cancer treatment recover to expected levels. But treatment activity levels are 10% lower than normal. Demand for mental health support reduced significantly at the start of the pandemic. But they are close to what we would expect now for this time of year. We are expecting the demand will increase for mental health services.”

“We’ve seen the biggest impact on waiting times. The total waiting list has increased by around 10% over the last six months, but there’s been a five fold increase in people waiting more than 36 weeks because of the limited activity taking place. It will take time to address these weights. But we will do so using all means possible. About a third of outpatient consultations are taking place remotely by call or video consultation. We have agreements in place to use independent sector capacity in Wales.”

“As I said earlier, based on the current trends, I’m concerned about the impact of the current growth and coronavirus on our NHS and care services and the speed at which it is spreading across Wales. The impact on our hospitals at the moment is similar to what we saw in March. Our plan is to continue to respond to coronavirus pressures in the NHS, maintain emergency services and as much NHS activity as possible for as long as possible.”

“We want to balance essential services alongside the delivery of planned and routine services which have been reintroduced over the summer. But the higher the level of coronavirus in the community, the more difficult this becomes. I anticipate that this winter will be more challenging than any I have known in my professional career.”

“We have commissioned plans for an extra 5000 beds. This is 10 times the number of our usual winter plans.”

“The flu vaccination program is another important part of our winter protection plan. It’s been extended this year to protect more health and care workers and members of the public. I would urge everyone to have a flu jab to protect themselves and others. Demand is likely to be high the season and you will be called at the appropriate time for your risk group well ahead of the arrival of the flu virus to the UK.”

“We’ve also introduced COVID light zones or green zones in hospitals for emergency unplanned admissions and we are implementing enhanced infection control policies and practices, building on what we have learned from the first wave earlier this year. This is a virus which is easily transmitted in hospitals and can be invisible if people do not have symptoms when they pass through our services.

“Unfortunately, where there are high levels of community transmission, it’s highly likely we will see cases in hospitals and other care settings despite taking all possible steps to prove to prevent it.”

“We are facing a difficult winter ahead of us. We have seen an extraordinary response from our NHS and care staff over these recent months. They have been busy right through with little respite. It is a lot to ask more of them but I know they will continue to respond professionally and with care.”

“It’s important we all play our part and do everything we can to look after ourselves and each other.”

“It’s important we all follow the rules. We keep our distance from each other. Practice good hygiene, hand hygiene work from home where we can wear a face mask in indoor public places.”

“By doing this, we can support each other and our NHS and care services in the weeks and months ahead. together. We will keep Wales safe.