National Assembly for Wales

The Welsh Government has always been committed to the principle that higher education should be available to all with the potential to benefit – regardless of social and economic background. That is why I have ensured that every new student supported by the Welsh Government will have access to a minimum level of maintenance support linked to the national living wage – for the 2018/19 academic year that amounted to a maximum of £9,250 depending on their place of study.  

This means that our students will have support to meet their day to day living costs, whether that is travel costs, accommodation, or other expenses. This support is available to students wherever in the UK they choose to study.

As part of the student finance package, Disabled Students Allowances (DSAs) are made available to eligible students who have a disability, long-term health condition, mental health condition, Autism spectrum disorder or specific learning difficulty. DSAs are grants to help pay the essential extra costs they may have as a direct result of their disability, including reasonable spending on extra travel costs incurred as a result of the eligible student’s condition. Students need to apply for DSAs from Student Finance Wales: www.studentfinancewales.co.uk.

In addition the Welsh Government has also extended the Young Persons Discounted Travel Scheme, which is available to eligible 16 to 21 year olds living in Wales, providing a saving of around 30 per cent off bus travel costs (for education, work or leisure) in Wales. Further information about the discounted travel scheme can be found on the MyTravel Pass website: https://mytravelpass.gov.wales/en/.

In the event that students do suffer financial hardship, there may be alternative sources of funding to help students with their studies and most universities offer scholarships, bursaries and discretionary funding. Students will need to contact their university to ask about this funding.

We are not able to consider or make any decisions on applications to the Micro and Small Business Fund at this time. Officials are working closely with finance colleagues to try and secure additional capital finance to match fund the MSBF programme going forward and allow the scheme to be re-opened.

At present the Micro and Small Business Fund (MSBF), which has been very popular and successful, is currently closed.  Officials are working closely with finance colleagues to try and secure additional capital finance to match fund the MSBF programme going forward and allow the scheme to be re-opened.

The financial position of the applicant including the asset values is taken into consideration as part of the overall financial due diligence process.

My officials have been liaising with Newport City Council, who manage the road on our behalf, to determine the cost and delivery schedule for a number of improvement measures to the A4810 Steel Access Road.  These include signing and traffic light improvements, repairs to traffic lights and bollards following an accident, as well as an additional skid resistance survey at Glan Llyn roundabout.

Unfortunately the delivery of works has been delayed due to capacity restraints within the Council.  However, my officials are liaising with senior Council officers in order to ensure that works are carried out as soon as possible within the current financial year.

The Welsh Government has established a 3 stage new station assessment process. The assessment process aims to establish which proposals are feasible and warrant further detailed study work. This will ensure a pipeline of new schemes is available to take advantage of future funding opportunities that may come from UK Government.

From an original list of 46 possible new stations considered by the assessment process, twelve were prioritised for stage 2 assessment and four of these 12 have been selected to be taken forward to a Stage 3 assessment. This will include undertaking a WelTAG Stage One Report, business case and Network Rail’s Governance for Railway Investment Projects (GRIP) process. The four locations are:

• Mid Wales – Carno
• South East Wales – Ely Mill
• South West Wales – St Clears
• North Wales - Deeside Industrial Park/Northern Gateway

Holywell Junction has been added to the list of potential new stations. Subject to new station funding being obtained to deliver the stage 3 stations listed above, the intention is to review the list of outstanding stations to decide which of these should be taken through the next phase of the new station assessment process.

The Welsh Government is aware of potential reorganisation within some major bus operating companies operating in Wales and is monitoring these developments. Whilst there has been no Welsh Government assessment of Arriva Cymru’s bus service provision on the Island, we are taking steps to ensure a sustainable public transport system can be maintained across Wales.

As part of our bus reform in Wales, we will be working with authorities to review bus operations within their area including the potential to plan the services in a more effective way that better serves passenger needs. Discussions between Transport for Wales and North Wales Economic Ambition Board are ongoing about undertaking a review across the whole North Wales region. We are also proposing to support authorities to enter into partnership arrangements with operators and the Rhyl to Chester corridor is likely to be the first scheme. As well as looking at commercial and scheduled services, we are piloting an Integrated Responsive Demand scheme in the Llanrwst area that will cater for the demand in more rural areas.

Funding allocation for Active Travel is as below.

I am committed to increasing diversity within elected office and enabling individuals who wish to stand for election within their communities, to do so.  There are many reasons why people do, or don’t take part in local democracy. However, it is important that if people put themselves forward for elected office they feel their personal safety is not at risk. I will be considering this as part of the next phase of Diversity in Democracy.

The UK Government’s consultation on proposals to stem the tide of levels of intimidation in public life sought views on new electoral offences aimed at protecting candidates and campaigners; simplifying the offence of undue influence and extending the law so that it applies to digital elections campaigning. I support these proposals and I will seek to introduce similar measures in Wales.

In addition, in the forthcoming Local Government and Elections (Wales) Bill we intend to include a duty of political group leaders to promote appropriate standards of behaviour and require local authorities to publish the official address of its elected members rather than their home address. We will legislate to remove the need to publish a candidate’s address on the ballot paper.

As part of our ongoing work we will be looking at how we can all work together to promote the value and diversity of elected members and their unique contribution to society.

All national immunisation programmes in Wales and the rest of the UK, are based on expert advice from the independent Joint Committee on Vaccination and Immunisation (JCVI). The JCVI monitors developments in new vaccines and reviews the effectiveness of existing vaccines and vaccination programmes. To date, the Welsh Government has accepted the JCVI’s recommendations in full. Since 2013, a number of new programmes have been introduced in response to the JCVI’s advice. These include rotavirus, flu vaccination for primary school children, shingles, Meningitis ACWY, Meningitis B, pertussis (whooping cough) for pregnant women and most recently HPV for boys. We will continue to take the advice of the JCVI to inform our national programmes to ensure the maximum protection is offered to our population.

All programmes recommended by the JCVI have been fully funded. The majority of routine immunisation programmes offered by NHS Wales are funded from health boards’ core budgets and the Welsh Government does not hold information on this annual expenditure.

 The Welsh Government makes provision within its budget, where appropriate, to fund  new immunisation programmes or changes to existing programmes where recommended by the JCVI . Once these programmes become established, funding is transferred on a recurrent basis into health boards’ core budgets to continue  routine delivery. The amount of funding included in the Welsh Government’s annual budget for immunisation will vary, therefore, depending on the status of programmes at any given time.

Vaccines are supplied centrally at the UK level, not by the Welsh Government, and individual health boards are responsible for purchasing stocks directly. It is not possible to disaggregate the expenditure on vaccines and implementation costs for vaccination programmes.

Taking into account my comments above, immunisation funding transferred into health board allocations over the last 5 years totals £20 million. This funding is in addition to what already exists, but is not separately identified in core health board discretionary allocations. You should also note that this is supplemented by a centrally held immunisation budget in Welsh Government which in 2018-19 was £1.3 million. This budget covers in-year programme allocations.

All national immunisation programmes in Wales and the rest of the UK, are based on expert advice from the independent Joint Committee on Vaccination and Immunisation (JCVI). The JCVI monitors developments in new vaccines and reviews the effectiveness of existing vaccines and vaccination programmes. To date, the Welsh Government has accepted the JCVI’s recommendations in full. Since 2013, a number of new programmes have been introduced in response to the JCVI’s advice. These include rotavirus, flu vaccination for primary school children, shingles, Meningitis ACWY, Meningitis B, pertussis (whooping cough) for pregnant women and most recently HPV for boys. We will continue to take the advice of the JCVI to inform our national programmes to ensure the maximum protection is offered to our population.

All programmes recommended by the JCVI have been fully funded. The majority of routine immunisation programmes offered by NHS Wales are funded from health boards’ core budgets and the Welsh Government does not hold information on this annual expenditure.

 The Welsh Government makes provision within its budget, where appropriate, to fund  new immunisation programmes or changes to existing programmes where recommended by the JCVI . Once these programmes become established, funding is transferred on a recurrent basis into health boards’ core budgets to continue  routine delivery. The amount of funding included in the Welsh Government’s annual budget for immunisation will vary, therefore, depending on the status of programmes at any given time.

Vaccines are supplied centrally at the UK level, not by the Welsh Government, and individual health boards are responsible for purchasing stocks directly. It is not possible to disaggregate the expenditure on vaccines and implementation costs for vaccination programmes.

Taking into account my comments above, immunisation funding transferred into health board allocations over the last 5 years totals £20 million. This funding is in addition to what already exists, but is not separately identified in core health board discretionary allocations. You should also note that this is supplemented by a centrally held immunisation budget in Welsh Government which in 2018-19 was £1.3 million. This budget covers in-year programme allocations.

The Welsh Government does not collect data on seizures of illegal tobacco; Her Majesty's Revenue and Customs is the body responsible for this issue.

This pilot scheme is one of a number of initiatives we are running to address holiday hunger in some of the poorest areas of Wales. The Holiday Hunger Playworks Pilot is testing community based initiatives and supporting children’s right to play as well as addressing hunger. Our School Holiday Enrichment Programme, which is a schools-based initiative that provides healthy meals, will be running in 21 local authorities over the school holidays including every authority in North Wales.

Under the Social Services and Well-being (Wales) Act, local authorities have a duty to assess whether a carer has needs for support and, if they do, to agree what those needs are or are likely to be.  The Codes of Practice underpinning the Act are clear on the requirements of local government to identify and record how personal outcomes will be achieved.

Published experimental statistics show that in 2017-18, there were 6,178 assessments of carers needs, resulting in 2,027 support plans. 6,891 carers refused the offer of an assessment. There are limitations to the data as not all local authorities were able to supply the required information.  Work is underway improve the quality of this data, and we will be increasing the amount of data that we collect on carers as part of our new performance framework – which is out to consultation until 5 August.  There are currently no plans to collect statistics on waiting times for assessments, nevertheless the Welsh Government will be collecting qualitative data from carers as part of the new framework to explore their experiences of social care.  We will also be considering the recommendations from the Health, Social Care and Sports committee inquiry on carers in the Autumn, as well the findings from Carers Wales’ Track the Act work.  It is of vital importance we listen to the experiences of carers and use their feedback to improve services and support for carers in Wales.

We know that not all carers are currently accessing the support that they may be entitled to, which is why we have a national focus on the needs of carers, to help make the rights in the Act a reality. The three national carers’ priorities were announced in November 2017 to help us achieve this. These are: supporting life alongside caring; identifying and recognising carers; and providing information, advice and assistance. We will be launching campaign materials this autumn to raise awareness among carers of their right to a carers’ assessment under the Act.  Funding to support the three national priorities for carers includes an additional £3m to local authorities in 2017/18 (which is now consolidated into their core revenue funding) to support additional provision of respite services and support for carers.  In 2018/19 and again this year, we have committed £1m to local health boards, local authorities and  third sector partners to improve awareness raising and support for carers in primary care.

The expenditure on NHS dental services in Wales per head of population in the years 2018-19 to 2014-15 is shown in the table below:

*Year estimates relate to 30 June of each year.

The Welsh Government does not hold this information and you may wish to contact the health board directly about this request.

The Welsh Government does not hold this information and you may wish to contact the health board directly about this request.

The Welsh Government does not hold this information and you may wish to contact the health board directly about this request.

The Welsh Government does not hold the information for the time period requested.  The Vascular Registry report is published each November and can be accessed via https://www.vsqip.org.uk/ . The latest report published last November contains data relating to 2017.

The Welsh Government does not hold the information for the time period requested.  The Vascular Registry report is published each November and can be accessed via https://www.vsqip.org.uk/ . The latest report published last November contains data relating to 2017.

The Welsh Government holds information on formally reported incidents of this nature.  Due to the low numbers involved, this information cannot be provided for reasons of patient confidentiality.

The Welsh Government does not hold this information.  Minimising medicines waste is an important element of the prudent healthcare approach we take in Wales and an extremely important element of our goal to secure an efficient and effective NHS.  Health boards already have local policies and procedures in place to reduce medicines waste within hospitals in Wales

In Wales, each Health Board is directly responsible for delivering all healthcare services within their geographical region. I expect health service professionals to deliver services based on clinical need and in line with current national guidelines.

Regulation of NHS services is overseen by the Healthcare Inspectorate Wales whose role is to regulate and inspect NHS services and independent healthcare providers in Wales against a range of standards, policies, guidance and regulations to highlight areas requiring improvement

Botox is classed as a prescription-only medicine in the UK, which means it can only be prescribed and given to a patient by a qualified prescriber. Only medical professionals can qualify as prescribers, so therapists can perform Botox injections only if they work alongside a prescribing clinician. The prescriber also has responsibility for the outcome of the procedure. We are aware that this does not always happen and that Botox may be being administered remotely. Dermal fillers are not regulated but patients should always ensure that the person carrying out the procedure has been trained. We have concerns about the risks associated with procedures such as dermal fillers and the administration of Botox.

Part 4 of the Public Health (Wales) Act 2017 will, when commenced, regulate four Special Procedures which will not initially include dermal fillers and Botox procedures. After giving time for the new licensing regime for the 4 Special Procedures to bed in, consideration will be given to whether to add to the list of Special Procedures to be regulated.  In any public consultation exercise, the question whether to regulate the practice of dermal fillers and Botox as Special Procedures will need to consider all the evidence including the potential harm to human health as well as the frequency at which they are carried out.

Our commitment to digital transformation in NHS Wales is outlined in A Healthier Wales, our long term plan for health and social care. This includes significantly increasing the emphasis on, and investment in, digital infrastructure and technologies, supported by stronger national digital leadership and delivery arrangements.  The autumn budget confirmed an additional £50m investment in digital priorities which will accelerate information sharing and the use of new technologies.

Up to date information is available across NHS Wales, through national digital solutions such as the Welsh Clinical Portal (WCP).  Electronic referrals for outpatient appointments and specialist care can be made directly from GPs in primary care to consultants in secondary care. These digital patient referrals can be fully processed in less than an hour, in contrast to days or weeks for paper-based referrals. Summary information from a patient’s full GP medical record can also be viewed through hospital systems. 

Wales is one of the first countries to use a national test results service. In June 2019, over 750,000 distinct result reports were viewed in the Welsh Results Reporting Service. This is a 21% increase in the number of reports viewed in June 2018. Over 38,000 of these reports were viewed outside the originating health board area.  Clinicians in Wales can also view documents across Wales through the Wales Clinical Portal. In June 2019, over 250,000 documents were viewed, with 32,000 of them across organisational boundaries.

In primary care, community pharmacists also use national digital systems to access and share information. The Choose Pharmacy system has been rolled out to 703 of the 716 community pharmacies in Wales.  Pharmacists at enabled sites can view the patient’s GP record and supply prescribed medicines to patients in an emergency.

There are several digital projects in progress that will further improve the sharing of information. For example, community nurses in Swansea Bay are using mobile devices to access the Wales Clinical Portal remotely, reducing the number of times they return to base each day and enabling them to see patient demographics, blood results and GP record summaries at the point of care.  Pilot projects at Cardiff Prison and in the Air Ambulance allow healthcare professionals to access patient information from outside traditional healthcare settings, including GP records and test results.

In hospitals, the national patient flow management programme will provide real time inpatient care management information, both within and across health organisations in Wales. The programme will combine bedside technology with real time patient information to improve efficiency and quality, reducing length of stay, and providing better experience and outcomes for patients. The national programme will make use of local patient monitoring solutions across Wales, such as the early warning system currently being trialled on wards at Ysbyty Gwynedd, which I was able to see in operation on a visit to the hospital on 6 June.

The current waiting time targets for cancer are much shorter than the general referral to treatment target times as they reflect the need to urgently investigate suspected cancer, and if confirmed, to start treatment as early as possible.

Different types of cancer tend to present at different stages of development. Given the need to identify if cancer is present, the type of cancer and the stage at diagnosis before any prognosis can be determined, health boards and clinicians aim to complete the diagnosis phase for all suspected cancers rapidly and normally within 28 days. This approach gives people the best chance of accessing the appropriate treatment and ensures there is equity in the pathway between types of cancer.

The new Single Cancer Pathway, which I announced last year, will from this month start reporting the waiting time for all cancers from the point of suspicion rather than receipt of referral. This more consistent way of measuring cancer waiting times will result in better and more responsive management of patients through the care pathway. In order to support the implementation of the new Single Cancer Pathway, the Wales Cancer Network has been working with clinicians to develop and implement optimal pathways for all tumour sites, which aim to ensure that all patients start treatment within 62 days of suspicion of cancer.

The extraordinary meeting of the Persistent Pain Steering Group has been arranged for 6th September 2019.

The roll-out of SNOMED-CT across NHS Wales is being managed through two implementation programmes, for Primary and Secondary Care. The work is being undertaken in collaboration with NHS Digital who are the authoring and distribution centre for all UK countries.

The central server to support the application will be in place and commissioned by April 2020. The roll-out will be phased and technical elements, operational readiness and priorities in Health Boards will determine the timescale for completion of the complex implementation.

SNOMED-CT is a standardised way to represent clinical phrases as codes and so enables automatic interpretation of all conditions for clinicians in Primary and Secondary Care. Training will be provided for GPs and other users.

According to the  ASH Wales Cymru report The Economic cost of smoking to Wales: a review of the evidence published in 2013 https://orca.cf.ac.uk/89325/1/cost_of_smoking_to_wales_2013.pdf, costs to the Welsh NHS due to smoking were estimated to be  £302 million per year. Annual costs since 2015 are not available as no subsequent analyses have been undertaken. The cost provided in the Ash Wales report is a modelled estimate, based on a variety of factors such as hospital admissions, outpatient visits, GP and practice nurse consultations and prescriptions, and a range of assumptions.

Substantive Response

Substantive Response