Welsh Government
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New five-year vision for NHS published

A new five year vision for the NHS, based around community services and placing prevention, quality and transparency at the heart of healthcare has been published by Health Minister, Lesley Griffiths.

Together for Health outlines the challenges facing the health service and the actions necessary to ensure it is capable of world-class performance.

It lists the factors driving the need for reform, including a rising elderly population, health inequalities, more people with chronic conditions, medical staffing pressures and some specialist services being spread too thinly.

The document sets out how the NHS will look in five years time, based around primary and community services playing a major role in delivery.

The main commitments in Together for Health include:

  • primary and community care services – such as GPs, community nurses and pharmacists – will play a leading role in transforming the way care is provided closer to people’s homes;
  • a focus on preventing ill health, to address public health challenges such as obesity and smoking rates;
  • all district general hospitals will retain an essential role, although some of the services they currently provide will change as new technology and treatments mean less people need to be admitted to hospital;
  • a number of centres of excellence – such as for cancer or stroke care – will ensure the very best skills and equipment are on hand round-the-clock for the most complex, life threatening conditions;
  • clinical networks comprising primary and community service staff will support local hospitals in providing care closer to home after patients’ discharge from specialist centres, and a greater use of telemedicine to increase 24/7 access to services in rural areas;
  • to drive up quality, information on NHS performance in terms of health outcomes and patient satisfaction will be published, including annual reports on each major service area; and
  • a compact with the public – an agreement between the NHS and its patients – will be drawn up, to ensure people have the information they need to take responsibility for their own health.

Lesley Griffiths said:

“Sustainability lies at the heart of the Welsh Government’s agenda, and there is an increasing consensus among clinicians that unless we take action now to address the challenges facing the NHS, that safe, sustainable, high quality services, delivering the best outcomes for patients, will not be achievable.

“There is, therefore, a compelling need for change with a rebalancing of how many services are delivered.  However, service change is just one aspect of this vision.  The bigger picture is the change in thinking and behaviour, with a focus on positive health and improving the quality of care and services based around people, not buildings.

“Overall, health outcomes are improving, with more people living longer.  Many of our existing local hospitals were built when life expectancy was lower and mortality rates from the likes of cancer and heart disease were much higher which meant patients needed to be cared for in a hospital setting.

“However, scientific breakthroughs and new treatments mean diseases that were fatal are now manageable and seeing improved survival rates.  As a result the number of hospital beds has been falling for some years.

“At the same time, a range of more complex clinical services for the most serious, life-threatening conditions have also developed over time within a number of hospitals.  

“However, because of the low numbers of patients with such complex conditions coming through their doors, patients do not receive the highest possible quality of care because staff treat relatively few numbers of such patients compared to patients with other conditions.  Maintaining thinly-staffed services is also not an option given current and future workforce pressures.

“I have made it clear health services need to be safe, sustainable and provide the highest quality of care.  That’s why it makes sense to centralise, where clinically justified, certain specialist services for more complex care that require a minimum number of patients on fewer sites to deliver the highest standards of care.

“The right local hospital and community services will be put in place to enable patients to continue their recovery closer to home.

“This document is not just our vision – there is growing acceptance of the need for change and Together for Health has been developed with clinicians and health unions.

“And as new opportunities for service improvements are identified, the NHS will explain the background and engage fully with local communities.”

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