A ‘very challenging winter ahead” warns the Health Minister

SPEAKING yesterday in the Senedd Eluned Morgan MS, Minister for Health and Social Services spoke about “what is likely to be a very challenging winter period for the people in Wales as we face a cost-of-living and energy crisis and, of course, ongoing pressures within our health and care systems.”

The Health Minister went on:

“Our planning for winter for the health and care system has been developed over the past few months within our existing planning arrangements. Our planned care plan, developed in conjunction with clinicians, contains a number of challenging but achievable ambitions, and is supported by £170 million of recurrent funding. Health boards’ and partners’ plans to support resilient, urgent and emergency care services this winter will build on local six goals for urgent and emergency care programme plans. Priorities will focus on increasing emergency ambulance capacity, opening new urgent primary care centres, introducing seven-day same-day emergency care services, and increasing available community capacity to support timely patient discharge. I will shortly provide a further written statement on these plans.305

We’re also preparing for a third winter of living with COVID. However, the situation regarding respiratory viruses is more uncertain than in previous years, as seasonal patterns have been significantly disrupted due to the pandemic. We could experience spikes in both COVID-19 and flu, and we must ensure that our communities and health social care systems are as prepared as they can be, particularly in the context of the current cost-of-living crisis. Today, I will update Members on the current situation regarding COVID-19 and the approach we are taking to prepare for a potential spike in respiratory illnesses in the coming months.306

After an increase in COVID-19 cases over the summer, driven by the BA.4 and BA.5 omicron wave, community prevalence, thankfully, has continued to decrease, which has meant that pressure on our healthcare system associated with COVID-19 has also decreased, although other pressures remain. According to the latest Office for National Statistics coronavirus infection survey, the proportion of people in Wales testing positive for COVID-19 has once again decreased to one in 110 people, from one in 95 the previous week.307

This decreasing prevalence, combined with the protection provided by other interventions such as vaccination, has allowed us to reduce testing, including a pause on regular asymptomatic testing from 8 September. In line with our long-term COVID-19 transition plan and our objective to protect the most vulnerable, we’ll continue to provide symptomatic testing for patients, those eligible for COVID-19 treatments, health and care staff, care home residents and prisoners. And, we’ll continue to test patients on discharge from hospitals to care homes.308

While we are currently in a stable position, we know that seasonal flu and COVID-19 viruses have the potential to add substantially to the winter pressures faced by the NHS, particularly if infection waves from both viruses coincide. Therefore, we are adopting a joined-up approach across Welsh Government and Public Health Wales in our approach to respiratory viruses that will provide guidance to support health and social care colleagues and to our communities on preparedness and actions that can be taken.309

Vaccination continues to offer the best protection from COVID-19 and flu, and our winter respiratory vaccination programme, launched on 1 September, integrates the COVID-19 and flu vaccination programmes this year to maximise uptake of both vaccines. ONS antibody data indicates that the 2022 spring booster has successfully maintained high antibody levels in vulnerable, older populations. So, we go on encouraging all those who are eligible to come forward for their vaccinations to do so. Invitations for a COVID-19 vaccine will be issued to all eligible individuals by the end of November, and the flu vaccine will be offered by the end of December. A national winter respiratory vaccination communications campaign will be launched next week.

As I mentioned earlier, our testing and contact tracing teams are now focusing on targeting those who are most vulnerable to harm in our society. People who are at high risk of becoming severely ill due to COVID-19 are eligible for treatment with antiviral or antibody therapies. If those people who are eligible for treatment test positive for COVID-19 and report their lateral flow test result, they will usually be contacted by text or telephone call by the national antiviral service within 48 hours, and they will be offered treatment. We are also using multiplex PCR tests for our most vulnerable, including care home residents and others, and these tests test for other respiratory viruses alongside COVID-19 and can support treatment and manage outbreaks.

This winter, we will be strengthening our surveillance system to identify any deterioration in the situation, such as from new, harmful variants of concern and other respiratory viruses. A major purpose of the surveillance system will be to determine whether Wales has moved from a COVID-stable to a COVID-urgent state, either through the epidemiological—it’s difficult to say that word, isn’t it? Epidemiological indicators. Was that okay? Or from genomic surveillance indicating the presence of a more severe variant.

During this autumn and winter, we’re focusing on enhancing and establishing more robust community and hospital surveillance systems that will further enhance the information we receive from the Office for National Statistics survey, as well as the wastewater analysis and other intelligence. The continual assessment of these data sources contributes to our ongoing surveillance.

Despite all of our plans around vaccination, testing, treatment and surveillance, we know that COVID-19 has placed sustained pressure on the NHS in Wales, both from people being treated directly for COVID-19 and people testing positive but being treated for other reasons, along with staff absence due to infection, the requirement to self-isolate or family illness. Given the exceptional nature or scale of some of the potential risks faced this winter, particularly in relation to COVID and other respiratory viruses, and the system’s capacity and capability to respond to demand, additional winter operational planning guidance is being developed for NHS organisations. These NHS organisations will need to ensure that robust and resilient plans are in place, including joint action through regional partnership boards.

We are also acutely aware of the significant challenges faced by our communities this winter as a result of the cost-of-living crisis. We will be developing practical advice and guidance to support individuals and communities to keep well this winter. For example, we know that maintaining key protective behaviours—and we have all become familiar with them by now—can have significant benefits that go beyond COVID-19. Continuing with these behaviours will help to reduce impact of future waves of infection, and will also reduce the impacts from other respiratory infections. However, in the context of the cost-of-living crisis and fuel poverty, we recognise that these will be more challenging this winter and when we have cold weather. So, the key message to protect yourself, your family and others is to ensure that you are vaccinated and stay up to date with any COVID-19 booster vaccinations.

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