Chronically ill being let down by fragmented and inconsistent community services

A report by the National Assembly for Wales’ Audit Committee found that health services don’t meet the needs of chronically ill patients.

The Welsh Assembly Government is spending £15million attempting to change the emphasis from treating patients with chronic conditions in hospital, to providing more services in the community.

But committee members found that there has been disappointing progress in achieving this rebalance in care

“As a result there is a continued reliance on the acute hospital sector to manage chronic conditions,” said Committee Chair, Jonathan Morgan AM.

“One in six emergency admissions are for patients with chronic conditions.

“It was clear to us that the factors behind hospital admissions are poorly understood and that community services, which are intended to reduce the reliance on the acute hospitals, are fragmented with gaps and inconsistencies in cover.

“Services are often poorly coordinated with many resources not used effectively.”

The main findings of the committee are :

• Services are not configured or co-ordinated effectively to meet the needs of patients with chronic conditions.

• The Welsh Assembly Government has invested in a wide range of measures to enable change but it is too early to assess their impact.

• Significant challenges remain in order to redress the balance of services for people with chronic conditions.

Other problems highlighted by the committees were that a lack of information and poor communication to patients played a central role.

And there was often very low awareness amongst healthcare professionals about the community and voluntary services available to patients.

As a result the committee wants the Welsh Assembly Government to:

• Provide an update report by the end of June 2009, setting out the outcomes of the community services information review and the progress made in establishing clinical, service, and financial indicators.

• Put in place a system to disseminate learning, from the demonstrator sites about what works, in order that NHS bodies can benefit well before the planned shared learning event in 2010

• Demonstrate robust monitoring arrangements are in place to track the impact of transitional funding.

• Ensure transition directors urgently review local plans for implementing the chronic conditions framework.

Audit Committee Chair Jonathan Morgan launches report at Diabetes Clinic in Cwmbran.

Jonathan Morgan with Sian Bodman and Dr David Millar.