Health boards activate ‘business continuity incidents’ to address exceptional pressure and challenges, notably affecting patient care and hospital operations. These incidents, signifying a critical level of alert, have a significant impact on the healthcare system in Wales. Swansea Bay University Health Board declared five business continuity incidents in 2024, with most linked to Morriston Hospital facing overwhelming pressures. The escalation to a BCI often garners public attention as it prompts advisories discouraging non-urgent visits to accident and emergency departments, prioritising severely ill or injured cases.
The process of declaring a BCI involves stringent criteria met by national standards, including assessing ambulance queues, critical care capacity, and resuscitation resources. The health board implements various strategies to manage escalating pressures before resorting to a BCI, such as reallocating resources, streamlining services, and enhancing coordination with other health boards. While postponing planned surgeries is a last resort during a BCI, efforts are made to segregate unscheduled and elective care to minimise disruptions to scheduled procedures and outpatient appointments.
Collaboration plays a crucial role in managing BCIs, with the Welsh Ambulance Service reallocating resources and neighbouring health boards assisting in patient transfers. The health board’s proactive measures also include reviewing major incident plans and ensuring continuous support for critical services during heightened alerts. Despite challenges, Morriston Hospital has not declared a formal BCI since October 2024, demonstrating successful management of demand and operational stresses.
To alleviate hospital pressures, the health board emphasises treating patients at home whenever feasible and expedient discharge processes. Services like urgent primary care centres, acute medical units, and surgical assessment units at Morriston Hospital facilitate rapid assessment and treatment, reducing unnecessary hospital admissions. Specialised community services, including virtual wards and acute clinical teams, address patients’ needs outside traditional hospital settings, promoting timely care delivery and reducing unnecessary hospital stays.
The establishment of the West Glamorgan Integrated Discharge Hub at Morriston Hospital exemplifies a collaborative approach involving multiple sectors to expedite patient discharges and enhance community care services. The hub’s success in reducing bed days and facilitating prompt discharges underscores the effectiveness of coordinated efforts in managing healthcare demands. By advocating for prudent use of unscheduled care options and promoting community-based services, the health board encourages public involvement in supporting efficient patient care delivery.
The Welsh Government’s oversight mechanisms mandate health boards to report escalation statuses regularly, ensuring swift responses to critical incidents like BCIs. The proactive collaboration between health boards, emergency services, and government agencies aims to mitigate risks during heightened alerts and enhance healthcare resilience. As healthcare providers navigate operational challenges, strategic initiatives and community engagement efforts play a vital role in maintaining quality care delivery and optimising healthcare resources.
In conclusion, the declaration of business continuity incidents by health boards signifies a critical response to escalating pressures within the healthcare system. By implementing stringent criteria for BCI activation, enhancing collaboration between health boards and emergency services, and promoting community-based care initiatives, health boards strive to ensure continuity of care and efficient resource allocation during challenging circumstances. Continuous monitoring, proactive interventions, and public engagement remain essential components in mitigating healthcare challenges and safeguarding patient well-being.