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At extreme risk – the state of our NHS

2011 Hydref 11 2:11 PM

Research by the Welsh Liberal Democrats has revealed that Local Health Boards across Wales are exposing patients to sub-optimal quality of care and safety to patients that can lead to "death, multiple permanent injuries or irreversible health effects."

LHBs assess the probability and likely consequence of risks in their own hospitals, categorising them from negligible (1) to catastrophic (5), Kirsty Williams indoor portrait July 2011 (Kirsty Williams)and likelihood of risk occurring, from rare(1) to almost certain(5).

Information gathered about LHBs' risk registers through Freedom of Information requests show that:

Hywel Dda LHB

- "Patients with myocardial infraction (heart attacks) presenting to any of the four hospitals will not receive treatment acutely because of a lack of availability for PCI (Pericutaneous Coronary Intervention) for the population." (Consequence 5 - Likelihood 5 = Score 25)

Hywel Dda LHB

- "Patients presenting with acute strokes out of hours in any of the four hospitals will not receive recommended thrombolysis treatment. Stroke thrombolysis available 9-5" (Consequence 5 - Likelihood 5 = Score 25)

Powys Teaching LHB

- "Acutely ill patients are not recognised as such and so do not receive appropriate care." (Consequence 5 - Likelihood 4 = Score 20)

Cardiff and Vale LHB - "

Insufficient Junior Doctors to support service provision. Risk of not being able to find cover at the right level of competence could compromise patient safety." (Consequence 5 - Likelihood 5 = Score 25)

Cardiff and Vale LHB

-" Inability to secure timely access to emergency beds due to discharge delays - leading to potential for risk to patients and provision of sub optimal care within Emergency Unit, Medical Assesment Unit, Surgical Assessment Unit, UHW and Medical Emergency and Assessment Unit, UHL. (Consequence 5 - Likelihood 5 = Score 25)

Aneurin Bevan LHB -

"Failure to maximise infection control performance to protect patients from hospital acquired infections and consistently reduce the levels." (Consequence 5 - Likelihood 3 = Score 15)

Abertawe Bro Morgannwg UHB

- "Failure to identify early signs of fetal distress leads to poor outcomes" (Consequence 5 - Likelihood 4 = Score 25)

Welsh Ambulance Trust -

That the Trust's arrangements for maintaining the highest reasonably practicable standards of cleanliness and infection control may not yet be such as to provide adequate reassurance, with particular reference to vehicle and equipment cleaning, laundry of bedding, the cleaning of staff uniforms and the safe disposal of sharps.  That operational staff currently do not have adequate time to clean vehicles and equipment to a satisfactory standard at appropriate frequencies.  (Consequence 4 - Likelihood 4 = Score 16)

Cwm Taf LHB -

"Impact on Safety. Re-configuring of core surgical training for junior doctors. Removal of posts in 2012 & 2013; risk to the service provided from that level (15-25 Extreme Risk)

Velindre NHS Trust replied to the FOI request.

Betsi Cadwaladr University Health Board has refused to disclose their risk register through FOI request.

Kirsty Williams, Leader of the Welsh Liberal Democrats said:

"These risk registers make for very uncomfortable reading for many people in different parts of Wales. I find it unacceptable that in many areas across Wales the NHS, under this Labour Government, is putting patients at extreme risk. This is the real state of our health service, as revealed by the people who deliver it.

"I understand that the risk registers of the LHBs are continually evolving documents and some LHBs have reduced the risks patients face while being treated, however these revelations do raise some serious questions about the standard of service that is being delivered in our NHS right across Wales.

"Neither the First Minister nor the Health Minister can hide from this and blame the Local Health Boards for their failures. They are happy to come out to take the glory when targets are being met however when things go bad under their watch, they are happy to pass the buck.  

"It is clear that many Local Health Boards across Wales have significant issues to overcome and while some progress is being made, it is wholly unacceptable that patients are faced with high and extreme risks when they are treated.

"I want the First Minister to explain to AMs and the people of Wales why this has been going on and what he intends to do about it. This is an issue he cannot run away from."  


Replies to FOI requests are available on request.

More examples of extreme risks across LHBs in Wales.