NHS Voices blogs

A month of change ahead of winter challenges

Darren Hughes, director of the Welsh NHS Confederation, writes about the the events of this month and highlights member concerns around social care.
Darren Hughes

30 September 2022

Along with NHS organisations in Wales, the Welsh NHS Confederation offered its deepest condolences to the Royal Family on hearing the sad news of the passing of Her Majesty Queen Elizabeth II. I was honoured to be invited, along with other public sector leaders, to the Service of Prayer and Reflection for the Life of the Queen at Llandaff Cathedral, attended by the King and the Queen Consort.  

In light of unfolding events, we made the difficult decision to postpone our annual conference and exhibition. It was not a decision we took lightly given the hard work of the team to prepare for the event, with all plans finalised. Thanks to Sandra and the team for rearranging so quickly. We really can’t wait for the opportunity to connect with you all and to hear from thought leaders during the postponed conference on Tuesday 1 November. 

I’d also like to take this opportunity to thank the outgoing chair of the Welsh NHS Confederation and chair of Powys Teaching Health Board, Professor Vivienne Harpwood, as she moves on to pastures new. Viv has been an invaluable support to me and the team and has been a great advocate for the organisation, both within Wales and as our trustee on the NHS Confederation Board. Her compassion, humanity and determination that we focus on what’s right for the Welsh NHS and the people that need it most is a great credit to her. She will be very much missed. We’d also like to thank Martin Woodford, chair of our Policy Sub-Group and chair of the Welsh Ambulance Services NHS Trust, who has been instrumental in guiding our policy and research asks and the surrounding work. We wish them both all the best for their future endeavours and I’ve no doubt they will continue to have an impact in whatever they choose to do next. 

NHS leaders in Wales painted a picture of a social care system struggling to cope with demand, with all respondents agreeing there is a crisis in the social care workforce with a subsequent impact on patient care and safety.

To this end, we’d like to formally welcome our new chairs. Emma Woollett, chair of Swansea Bay University Health Board, takes up the role of chair of the Welsh NHS Confederation and Jan Williams, chair of Public Health Wales NHS Trust, will become our Policy Sub-Group chair. The whole team look forward to working more closely with both Emma and Jan in driving our work forward as an organisation in order to achieve the greatest impact for our members. 

As we approach winter, concerns are increasing about the significant challenges in store for the health and care system. We published the results of our member survey on the impact of social care pressures on the NHS, setting out calls to Welsh Government for a long-term pay and funding strategy for social care and better integration between health and care services. Thanks to all who responded. 

NHS leaders in Wales painted a picture of a social care system struggling to cope with demand, with all respondents agreeing there is a crisis in the social care workforce with a subsequent impact on patient care and safety. Responses confirmed that said pressures are driving urgent care demand and impacting the NHS’ ability to tackle the elective care backlog, as well as impacting diagnostics, GPs, mental health services and community care. 94 per cent of those surveyed agreed the crisis is worse than it was 12 months ago, and almost all expected the situation to deteriorate over winter. 

If we don’t want the system to fall over this winter, we need immediate short-term intervention, as well as a sustainable plan and funding model in the long-term.

NHS leaders in Wales stand in support of their social care colleagues and are urging the government to increase investment in care services. Along with increases in pay, almost nine in ten healthcare leaders support an increase in investment to expand overall social care capacity and improve career progression opportunities to boost recruitment and retention, along with enabling better integration between health and care services. They say failure to act will leave more and more vulnerable people without the care and support they need, as well as adding further pressure on frontline NHS services. 

Actions are being taken, in partnership with local authorities and third sector organisations, to mitigate pressures across Wales, but without real system change, existing efforts will not go far enough. If we don’t want the system to fall over this winter, we need immediate short-term intervention, as well as a sustainable plan and funding model in the long-term. Decisive action is needed now to commit to making it attractive to work in social care and increase the numbers of social care staff. 

This is not a new problem, but one that has snowballed over the years to the point of crisis. We know steps are being taken to alleviate pressures, but these are not having a great enough impact. Of course, this is not the only challenge the NHS is dealing with but working together to improve patient flow and ultimately giving more patients the care they need and deserve is the top priority for NHS leaders as we head into winter.