This week, the long-awaited Parliamentary Review of Health and Social Care in Wales (“A Revolution from Within: Transforming Health and Care in Wales”) was published, making a number of recommendations on how change to the system can be supported and explains, in practical terms, how to meet the challenges facing health and social care services in the years ahead.
Building upon the interim report published in June 2017, the report recommends new models of care, with services organised around the individual and their family, as close to home as possible. It also emphasises that services need to be preventative, easy to access and of high quality, as well as being seamless, and delivered without artificial barriers: in essence, Wales needs a different system of care going forward. As stated by the Chair, Dr Ruth Hussey OBE (former Chief Medical Officer for Wales), in her forward:
Our Interim Report put the stark case that, in its current form, Wales’ health and care system will need to change. By a health and care ‘system’, we mean the way care and support is delivered by public, independent and third sector bodies rather than their underpinning organisational structures.
The review has framed its thinking around ten high level recommendations, across a number of key areas:
- Recommendation 1: One Seamless System for Wales
- Recommendation 2: The Quadruple Aim for All
- Recommendation 3: Bold New Models of Seamless Care —
national principles local delivery
- Recommendation 4: Put the People in Control
- Recommendation 5: A Great Place to Work
- Recommendation 6: A Health & Care System that’s always learning
- Recommendation 7: Harness Innovation, and Accelerate
Technology and Infrastructure Developments
- Recommendation 8: Align System Design to achieve results
- Recommendation 9: Capacity to Transform, Dynamic
Leadership, Unprecedented Cooperation
- Recommendation 10: Accountability, Progress & Pace
These recommendations will be increasingly contextualised by sustained public and political scrutiny of NHS performance, from funding and winter pressures, through to the potential impact of Brexit; but how much of this scrutiny focuses on short-term acute performance measures, rather than longer-term public or population health outcomes? As stated in the preamble of the report: if the case for change is compelling, then why hasn’t it compelled? With this year seeing the 70th anniversary of the NHS — born in Wales — does this review go far enough to drive change? I look forward to seeing how this develops.
[full disclosure: I am an independent member (non-executive director) of Abertawe Bro Morgannwg University Health Board]