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Response by the Cabinet Member: Thank you for raising this matter, and I hope you can accept my apologies for my delayed response. I had just finalised my reply when I learned that Powys Teaching Health Board [PtHB] had made the decision not to proceed with the proposal to extend waiting times for appointments and non-urgent operations. I sent a revised reply back to officers for checking, before sending to you, to ensure my understanding of the Health Board's decision was correct, and somehow that got lost in the email system and none of us realised this until now. You will have heard about the Health Board's decision long since, I'm sure, but I want to provide you with the reassurances you sought as to Adult Services’ focus on and capacity to prepare for proposals by Powys Teaching Health Board that might impact on the wellbeing of Powys residents. I recognise that the proposal in question was one which may have been leading to anxiety for people who already have care and support needs and may have felt additionally vulnerable to potential negative impacts should it have been realised. I agree fully with the points you raise about the importance of early intervention in supporting people to maintain or regain independence. As you set out eloquently, access to the right care at the right time is critical to a person’s wellbeing and also to the sustainability of services, ensuring that demand for services remains as low as possible so that we can continue to deliver those services within the increasingly constrained budgets available to us. Adult Social Care [ASC] plays a crucial and primary role in the community-based support that enables this approach, and ensuring and enabling access to this kind of support for people is a fundamental, driving priority for us. We are in continuous contact and discussion with Powys Teaching Health Board – several scheduled and unscheduled meetings every week – focusing on hospital admissions and discharges, and of course, as you point out, extending waiting times for routine operations may impact a patient’s strength and wellbeing while awaiting his or her operation, and/or the intensity of a patient’s care and support needs on discharge from hospital, and those impacts would in turn impact Adult Services and our budget. Between the two health board meetings, we maintained regular discussion with our colleagues in PtHB to ensure that we in ASC understood the proposal and were equipped with the necessary information to enable us to estimate its potential impact on the residents of Powys and on the social care budget, and to mitigate and plan. We have continued throughout that period to inform the health board’s decision-making process on the proposal and to highlight all of the potential impacts we identified. This relationship of insight-sharing and collaborative decision-making between the lead partners in health and care in Powys – PCC and PtHB, but also PAVO – is crucial if the best health and wellbeing interests of residents are to be served. We partners must work together as a whole system and we must strive continuously to improve and develop how we do that. I hope this provides some level of reassurance that Adult Services monitored the situation effectively, maintaining the appropriate level of focus on the proposal’s potential impacts and preparing to mitigate those if and when they arose. We will follow the same process for any future proposals PtHB may develop as it works to reduce its budget deficit.
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