Pwyllgor Cyfrifon Cyhoeddus                                   
Public Accounts Committee

Mark Drakeford AM Minister for Health and Social Services Welsh Government Cardiff Bay

26 June 2014

Dear Mark,

Public Accounts Committee – Unscheduled Care

The Public Accounts Committee considered the Welsh Government’s response to the recommendations contained in the Committee’s Report on Unscheduled Care on 24 June. Members were pleased to note that the Welsh Government accepted 16 of the 19 recommendations contained in the report, but the Committee would welcome further detail and clarity on the following responses you provided:

Recommendation 1: The Committee are still concerned that the Welsh Government's target for immunisation of NHS staff is insufficiently ambitious. While we appreciate that there will always be some resistance from a small minority of staff to accepting a flu vaccine, we believe that this should not be a barrier to increasing the immunisation target. Members were unconvinced by your assertion that increasing the immunisation target could potentially having a demoralising effect on staff and we would welcome some supporting evidence for this, should it be available.

Recommendation 2: The Committee notes your response that ‘Clear guidance on the use of the HAS [Handover Arrival Screens] system was issued to all organisations in 2010’ and that this is now under review. Given that this is described as clear guidance, Members would welcome an explanation as to why it is necessary to undertake a review to ensure that it is understood by all relevant staff.

Recommendation 3: The Committee welcomes your undertaking to develop a wider suite of performance measures for unscheduled care and we would find it helpful if you could provide details on both the timescales for the development of these indicators and how all aspects of ‘quality of care’ will be measured. Members would also welcome further information on any work the Welsh Government has undertaken with the other nations of the UK to enable data to be compared and benchmarked.

Recommendation 4: It is unclear to the Committee why this recommendation has only been partially accepted. We are aware that uncertainty over the future of services in some parts of Wales is continuing and wish to receive further information as to what specific action the Welsh Government is taking to encourage health boards to resolve any outstanding issues.

Recommendation 8: The Welsh Government response to this recommendation does not make any reference to the Committee’s specific recommendation that consideration should be given to systems adopted in the Republic of Ireland and Northern Ireland in reducing ‘did not attends’. Members would welcome confirmation that this will be considered as part of the Welsh Government’s review into ‘did not attends’.

Recommendation 11: The Committee would welcome further information on how the Welsh Government intends to monitor the effectiveness of different co-location arrangements to ensure better access is available in all areas of Wales.

Recommendation 12: The Committee would welcome information on your target dates for completing the short, medium and longer-term plans for ensuring there are sufficiently trained staff in relevant professional groups to deliver integrated primary and community care, particularly GPs. We would request that copies of the plans be made available to the Committee once finalised. Finally, we would welcome an update to the Committee in September 2014, in line with time scale you indicated in response to recommendation 10 for updating the Committee on out of hours work.

We look forward to receiving your response.

Yours sincerely,

Darren Millar AM

Chair

Public Accounts Committee