Press release

"It's not just a crisis, it's a national emergency"

A Welsh NHS Confederation survey of 50+ NHS leaders in Wales paints a picture of a social care system struggling to cope and pressing need for funding

23 September 2022

  • 100 per cent of the 50+ NHS Wales leaders surveyed agreed there is a crisis in the social care workforce, with a subsequent impact on patient care and safety.
  • Many of the respondents said pressures in the care sector are driving urgent care demand, with a lack of social care capacity having an impact on the ability to tackle the elective care backlog.  
  • 94 per cent of those surveyed agreed the crisis is worse than it was 12 months ago and almost nine in 10 expect the situation to deteriorate over winter.

A recent Welsh NHS Confederation survey of over 50 NHS leaders in Wales throws up stark results, painting a picture of a social care system struggling to cope with demand and a pressing need for a long-term pay and funding strategy for the sector.

Social care services play a crucial role in care pathways –caring for people at home, keeping people well for longer outside of hospital and enabling faster, safer discharges home. The sector plays a critical part in protecting NHS capacity and its ability to deliver high-quality, safe care. 

However, social care services are facing significant challenges, including vulnerabilities in funding and market stability, growing unmet need and high levels of staff vacancies. The impact of these challenges means people are missing out on vital care and support, leaving them less independent and more likely to rely on healthcare services. 

This crisis is impacting every single part of the NHS from ambulance services and emergency departments to elective care, diagnostics, GPs, mental health services and community care.

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 supported an increase in investment to expand overall social care capacity and improve career progression opportunities to boost recruitment and retention. 93 per cent said this would be the most effective action that could be taken with 95 per cent of leaders surveyed felt it would be ‘very’ or ‘quite’ effective to have 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, to mitigate pressures across Wales, but without real system change, existing efforts cannot go far enough.

The Welsh NHS Confederation is calling on the Welsh Government to:

1. Provide sustainable funding for social care with a fully funded pay rise to enable recruitment and retention, alongside greater overall investment and career progression opportunities.

2. Support better integration between health and social services to achieve seamless care and support for the patient.

3. Provide sufficient, ring-fenced funding and longer-term investment to transform out of hospital care and allow and long-term service development.

4. Publish locality based delayed discharge data so there is clear information and evidence of the current issues in providing packages of care to people leaving hospital.

5. Introduce performance measures that focus on quality-based outcomes, prevention, community services and whole-system collaboration.

Director of the Welsh NHS Confederation, Darren Hughes, said:

“This isn’t just about the NHS and social care.  This is about empowering people to live the best lives they can.

“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 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.

“Without immediate action, both the NHS and social care could face an endless winter where people are being failed by the very systems that should be there to support them at their most vulnerable.”

Jonathan Griffiths, President, ADSS Cymru commented:

“All leaders across health and social care will need to work very hard this winter to find additional capacity in the system.

“However, delayed discharge is just one symptom within a wider set of challenges in the integration of health and social care support for people, and as such it cannot be considered in isolation. We must consider other factors and variables, including inappropriate hospital admissions, risk managed decision making and crucially, workforce supply.” 


*The survey was undertaken in August to understand how these system-wide challenges are playing out on the NHS frontline and asked members to describe the impact that staff shortages and a lack of capacity in social care are having on NHS services, as well as what effective solutions may look like. We received responses from over 50 NHS chairs, vice chairs, chief executives, executive directors and assistant directors from across Wales.

About us

We are the membership organisation that brings together, supports and speaks for the whole healthcare system in England, Wales and Northern Ireland. The members we represent employ 1.5 million staff, care for more than 1 million patients a day and control £150 billion of public expenditure. We promote collaboration and partnership working as the key to improving population health, delivering high-quality care and reducing health inequalities.