Good standard of care despite the unprecedented challenges of COVID-19

This review draws together the findings from all assurance activity undertaken since March 2020. More than 110 checks were conducted across Wales over the period, focusing on the extent to which healthcare services provided safe and effective care to patients during this time, as well as how the health and wellbeing of staff was supported.

Throughout the pandemic, HIW has continued to check that people in Wales are receiving safe, effective, good quality care.

To support healthcare providers to focus their resources on keeping people safe, we adapted our approach to assurance and inspection work by revising the focus of when and how we conducted our work. This included developing a new approach to gaining assurance remotely and using more traditional onsite inspection activity where the risk to patient safety was very high or where new models of care had been introduced at pace, for example field hospitals and mass vaccination centres. Throughout the pandemic, this work was supported by our ongoing review of intelligence, including information and concerns received via our first point of contact and notifications from healthcare organisations about incidents. We also worked closely with partner organisations.

Overall, we found that the quality of care provided across Wales during the pandemic was of a good standard.

We found that good arrangements had been introduced throughout healthcare services to adapt both the environment of care and the way in which care was accessed, enabling services to continue operating during the pandemic. These changes were often made within extremely short timescales and included changes to the environment to support social distancing requirements, and the provision of remote appointments to maintain healthcare services as safely as possible. Services have implemented innovative approaches to support patients’ physical and mental well-being during the pandemic.

The pandemic has, at times, rapidly evolved, and whilst on the whole we believe that infection control has been managed appropriately, the number of hospital outbreaks that we saw during the second wave illustrates the need to ensure arrangements are effective, reducing the risk of transmission as much as possible.

We noted the outstanding efforts made by staff working in healthcare services, who continued to demonstrate tireless commitment and flexibility during a time of such unprecedented challenge. However, the impact on the wellbeing of these staff was clear. As Wales begins its journey to recovery, the challenge faced by healthcare services to address treatment backlogs will undoubtedly bring with it a different type of pressure. Services will need to ensure there are robust arrangements in place to support their staff to deliver safe and effective care.

Alun Jones, Interim Chief Executive of Healthcare Inspectorate Wales said:

I want to commend the commitment, resilience and flexibility of staff across NHS Wales and independent healthcare services who have worked tirelessly to provide care to patients and to each other during the extraordinary challenges presented by COVID-19. Despite the unprecedented complexities of providing care during the pandemic, our overall finding, that good quality care was being provided, is testament to the dedication and resourcefulness of healthcare teams across Wales.