16th January 2018

Revolution in health and social care urged in Wales

A “revolution” is urgently needed in the way health and social care is delivered in Wales says a major review.

Without “significantly accelerated” change, services which are already not fit for the future, will further decline, the expert panel warns.

The NHS and social care will be expected to work “seamlessly” together to respond to a person’s needs and to deliver care closer to home.

Ministers say a new plan will take into account the review’s recommendations.

Nine leading international experts, chaired by the former chief medical officer for Wales Dr Ruth Hussey, have been looking at ways to try to put the health and social care system on a stronger footing.

Its findings propose 10 recommendations, including:

• Shifting resources away from big hospitals, investing in new technology and giving patients more choice about how and where they want to be cared for.
• Urgent action to address “critical” staff shortages.
• More to be done to protect the wellbeing of those working in health and care.
• “More sophisticated methods” of listening to patients and those being cared for and more shared decision making with those it affects.

Building on the many great examples of quality improvements at local level with “many driven by heroic individuals in isolation due to lack of support and coordination”.
But it warns that there is too much focus on narrow hospital targets rather than looking at the bigger picture.

It wants a new national transformation programme to drive forward changes.

However the panel warns this “won’t be easy” and will involve “significant test of leadership… at national, regional and local level”.

Without “faster” and “more widespread progress”, access to and the quality of services could decline in the next five years.

Dr Hussey said the scale of the challenge ahead should not be underestimated.

“It is clear that change is needed and even clearer that this should happen quickly,” she said.

“We have detected an appetite for change and a desire to ‘get on with it’. A strong commitment to transform not just how much is done, but what and how it is delivered is needed.”

The final report follows interim findings last summer calling for a much faster pace of change in the face of an ageing population.

Health Secretary Vaughan Gething said he would “carefully consider” the findings ahead of a new long-term plan for health and social care to be published in the spring.

“I believe that what we have seen today from the panel will set firm foundations for the future of health and social care in Wales for many years to come,” he said.

Dr David Bailey, chairman of BMA Wales, welcomed the review but said it did not have a lot to say on critical aspects like funding and workforce.

“What we really need is better staffing levels, we need enough funding to deliver the services people need – it’s around addressing winter pressures, addressing waiting lists.

“It’s a curate’s egg at the moment and we need to see how that goes.”

Vanessa Young, director of the NHS Confederation, which represents health boards, welcomed the review and agreed a “different pace and scale of ambition” was needed to move to a seamless system and one with new ways of working.

“This report is saying we need to be more radical and look at new ways of doing things and involve the patient and the public more in saying what matters most to them,” she said.

Helen Howson, director of the Bevan Commission think-tank, said: “We can’t afford not to make changes.

“When people are being challenged on their targets, on their resources and on the huge demand on the system, you can understand why we’re in the position we’re in – it’s like a rabbit caught in headlights.”