Merthyr Tydfil and Rhymney: The challenges facing the Welsh NHS

Hugh Pym visited the Royal Glamorgan Hospital to hear about hospital management improvements and found that the challenges facing A&E departments are the same nationwide.

The Welsh government had to defend its A&E records. "On the whole compared with England, Wales is doing worse on a number of indicators," said Nigel Edwards, chief executive of the Nuffield Trust.

Social change has had a big effect on the pressures on A&E teams, as patients visiting the departments require different treatment skills to those previously required.

Dr Ruth Alcolado, clinical director of acute medicine and A&E at Cwm Taf University Health Board, explained some of the issues faced:

"We now have large cohorts of frail elderly with multiple other illnesses that they carry with them, because medicine has been successful in keeping people alive for longer."