Health Minister promises reporting is now correct as it is revealed a further 31 coronavirus deaths not disclosed in Wales

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This article is old - Published: Tuesday, Apr 28th, 2020

The Health Minister has said reporting systems are now ‘consistent’ as it emerged a further 31 coronavirus deaths in West Wales were also not disclosed, on top of the recent failure to report 84 deaths by the local health board.

Overall 115 deaths across Wales during the pandemic were not reported in the Public Health Wales information, with the public led to believe that the reason for non-reporting was that the figures were under five deaths.

A report released today says Betsi Cadwaladr University Health Board only became aware of the issue on the 18th of April once Public Health Wales started publishing localised information for the first time.

Yesterday the First Minister said he had commissioned a report into the matter, and was due to have a copy on his desk by the afternoon.

The Health Minister was asked if he had seen the conclusions of the report, he replied: “So I published a written statement on this particular issue, including the report that’s been commissioned.”

“It sets out a range of conclusions for areas for improvement, it sets out some of the challenges in communication between the North Wales health board and Public Health Wales, but also a smaller, but material underreporting issue at Hywel Dda health board where 31 deaths weren’t reported and included in the Public Health Wales figures.”

“Each family has been told at the time what’s happened with their loved one. So, for the individual family communication that hasn’t been affected. But it’s part of the national picture where it hasn’t been properly reconciled within the data that Public Health Wales published,
or that will have been within the one figures.

Yesterday we asked the First Minister if the report would be published in full, however was told publication would just contain ‘conclusions’. Today the Health Minister said, “So we published that report today, it is clear, it is transparent.”

“It does set out that we are absolutely clear now all the reporting systems are consistent, everyone is going to use the same reporting method. That should then mean from the figures today and tomorrow we will be fully up to date.”

“What I think is really important is it doesn’t change our understanding of the disease profile across Wales, there are certainly lessons to learnt as we progress through this and how each part of our system shares information with each other.”

We asked the Health Minister about the Betsi Cadwaladr University Health Board issue, and that as it is in special measures there is a direct link with Welsh Government, and himself.

With the previous comment pointing to the report and statement we asked him to simply explain how Health Board management, and his ministerial officials did not spot the huge discrepancy in figures. We also asked who decided the Health Board could use a different reporting system in the first place.

The Health Minister replied, “There are a couple of different pieces to unpack there from the series of questions.

“The first is that the statement that I published with the report sets out that when we started to report on a national level, so the Public Health Wales figures broken down by health board, Betsi Cadwaladr realised that there was a discrepancy in the figures that they thought they’d been reporting and providing, and what was then being published.

“They contacted Public Health Wales at the time and they were conversations between Public Health Wales and Betsi about how to reconcile those figures. They then came out and provided the corrected figures at the end of last week.

“We’ve now got every single health board into a position where they’re using the same reporting form. I would much that rather that happened earlier points, but the review of where we are has meant has absolutely been resolved across each and every health board.

“I just don’t think there is a link between what’s happened here, and special measures and I think it’s particularly unhelpful for people to try to suggest that special measures arrangements have played a part in the COVID-19 response in North Wales.

“Actually, the Health Board in North Wales and indeed, other health boards right around the country, deserve a significant amount of credit for the way they have changed the way they deliver healthcare, the way they’ve deliberately shifted their resources to tackle this once in a century threat that COVID-19 presents, and the tremendous hard work of not just leaders and managers, but of course our frontline staff run across our health care system. That applies just as equally in North Wales, it does in any other part of the country.”

With the written statement (or report / review) not public late this afternoon we requested a copy, and was promptly provided with a copy of the review paper by Welsh Government.

The review paper explains how a “Covid-19 mortality surveillance e-form Welsh Clinical Portal” has recently been created as a quick way to estimating the mortality burden in confirmed cases during the pandemic. It is clear that “it does not replace any of the official procedures around registration of deaths”.

The review paper states:

The report notes ‘inconsistent approaches’ across health boards, with those not using the specific e-form still are ‘providing data to the agreed definition’.

Other issues have been identified by Public Health Wales due to the lack of a single system across all health boards, including “delays by health boards in the reporting of deaths; reported ambiguity in the definition of what constitutes a death to be reported through surveillance and the inclusion of deaths occurring outside of a hospital.”

There appears to have been confusion over who was checking the figures, with “the roles and responsibilities for scrutinising the data have not been clear”, with it noted “there needs to be sufficient oversight in the system to reconcile the data being collected and made available through NWIS, ONS and PHW so that issues can be captured early and responded to”.

The report is specific to the local health board, although the actual reason for the issue is ‘unclear’, “It remains unclear what may have triggered this gap in reporting specifically to PHW other than an administrative oversight, occurring at a time of unprecedented change at the early stage of a pandemic, with several different reporting processes in place”.

The report states Betsi Cadwaladr University Health Board became aware of the issue on April 18th “when the discrepancy became clear upon the publication of local data for the first time on the PHW dashboard”

Once this was discovered the report says “extensive discussion and data validation between BCUHB and PHW occurred, leading to a robust data sharing process implemented from 24 April. BCUHB have also confirmed they will be using the e-form process from 28 April”.

It appears Welsh Government were aware of the issues being ‘identified’ 4-5 days later on the 23rd, and responded, “Public Health Wales were immediately instructed to contact all LHBs to obtain assurances about the processes in place and the data being reported”.

Solving the issue of who is checking the figures, the report states, “The Chief Statistician has been asked to provide a whole-system oversight role which includes requiring compliance with reporting protocols and quality assurance being given by Public Health Wales.”

A weekly call has also been setup between Welsh Government statistician the health boards in Wales to ‘discuss’ the figures, along with other data analysis work, to hopefully avoid a repeat of the incident.

You can view the full brief plus Q&A session from the Health Minister below…