Mr. Damien McCallion:

We developed an annual plan this year that will encompass the winter rather than just recognise that pressures on urgent and emergency care are all year round. There are several elements. One is about avoiding admission. We know a proportion of patients will avail of alternatives if they have them. Traditionally, these have been the likes of local injury units, but also our enhanced community care programme, which is rolling about 2,500 staff out into the community for older people and those with chronic conditions.

Whereas the first aspect is focused on avoidance, the second is focused on emergency departments themselves and, as the Deputy referred to, how they are managed when patients come in. There are protocols developed for certain conditions. Obviously, there are protocols for the more extreme conditions, such as cardiac arrest, but equally there are protocols for other conditions. There are pathways for people that will assist. In paediatrics, for example, there is usually a direct pathway through. It is not the case in every hospital but it is being rolled out. It is partly limited by infrastructure.

The third aspect concerns the flow when a patient is admitted. It is about trying to maximise the flow to minimise the time spent focusing on the length of stay in hospital. We measure all our hospitals’ lengths of stay.