NHS Voices blogs

When resource is there, the NHS evolves and delivers

Director of the Welsh NHS Confederation, Darren Hughes, focuses on NHS and social care finances in this month's blog.
Darren Hughes

30 June 2022

This month, we’ve focussed on NHS and social care finances as the system prioritises and plans what’s needed for the future. As part of this, we’ve been proactively engaging with Members of the Senedd to discuss the NHS’ financial priorities and challenges. This includes meeting members of the Senedd’s Finance Committee and attending a stakeholder event to discuss the priorities for Welsh Government's future draft budget and what areas should be prioritised and scrutinised by the Senedd. We’ve been working with members to develop a paper on finance, which we look forward to publishing later this year.

The cost of providing healthcare continues to increase due to the Covid pandemic response, a growing and ageing population, developments in medical technology, inflation, pharmaceutical developments and recruitment and retention challenges.

As is well-documented, the COVID-19 pandemic is arguably the biggest challenge the health and care systems of the world have ever faced. The direct and indirect impacts of the pandemic have created unprecedented levels of demand and pressure on the system, resulting in worsening health inequalities and performance against targets, workforce pressures and funding shortfalls.

NHS leaders know the delivery of care must be transformed to address these issues. This requires future Welsh Government budgets to prioritise funding to both the NHS and its partners to improve patient outcomes, the quality and safety of services and reduce health inequalities.

The response from NHS Wales organisations to the challenges of the pandemic demonstrate the system’s ability to respond quickly and effectively to challenges when the resource framework supports the direction of travel and aims to achieve the same outcomes.

Like many healthcare systems across the globe, the NHS in Wales has reached a tipping point. The cost of providing healthcare continues to increase due to the Covid pandemic response, a growing and ageing population, developments in medical technology, inflation, pharmaceutical developments and recruitment and retention challenges. Just this week, the Census 2021 results revealed a two per cent increase in over 65s as a proportion of the population in England and Wales: this equates to one sixth of the population.

At the same time, both demand on, and expectations of, the service continue to increase, while patient safety and quality of services remains paramount, with the Health and Social Care (Quality and Engagement) (Wales) Act 2020 and the duty of quality coming into force in 2023.

NHS leaders are concerned that a lack of capital investment will impact the service’s ability to uphold quality and safety standards because they cannot sufficiently maintain their estate, embed digital innovations and, ultimately, reduce the elective backlog.

In view of the funding outlook, there is a pressing need for the Welsh Government to review the long-term funding model for health and social care to ensure future sustainability – this must be mapped against both demand and capacity. The response from NHS Wales organisations to the challenges of the pandemic demonstrate the system’s ability to respond quickly and effectively to challenges when the resource framework supports the direction of travel and aims to achieve the same outcomes. This clearly shows that when the financial and resource backing is there, the NHS can evolve to respond to the challenges it faces.

Long term investment in capital is also vital to the future of the NHS. NHS leaders are concerned that a lack of capital investment will impact the service’s ability to uphold quality and safety standards because they cannot sufficiently maintain their estate, embed digital innovations and, ultimately, reduce the elective backlog.

We need to maximise the benefits from the way our country spends available resources and enable greater collaboration and partnership working across sectors to minimise spending on treating ill health.

Healthcare leaders have highlighted numerous ways that investment in capital across all parts of the health and care system helps to provide better care and drive productivity improvements in the NHS. It also helps to support local communities and economies by providing jobs, skills and procurement opportunities.

We need to maximise the benefits from the way our country spends available resources and enable greater collaboration and partnership working across sectors to minimise spending on treating ill health. Alongside healthcare services, other public services play an essential role in supporting population health and wellbeing. It’s crucial that funding flows are designed so that organisations and systems meet their potential to improve overall population health and tackle health inequalities - the Well-being of Future Generations (Wales) Act 2015 is central to this vision.

NHS Wales organisations do not underestimate the significant challenges of public service budget-setting in these unprecedented times. NHS leaders across Wales are committed to doing the very best they can to deliver high-quality, timely and safe care. For the NHS to plan and deliver there must be clarity, certainty and sustainability across both health and social care so we can invest in the workforce needed to deliver for the people of Wales.