Nesta Lloyd-Jones writes about the long-term vision for Wales, enabling an integrated health and social care system 

Welsh countryside

It’s been a little over a year since the Welsh government published their long-term plan for health and social care, A Healthier Wales.

Within the Welsh NHS we had been calling for a long-term vision, enabling an integrated health and social care system which keeps patients close to home and for as long as possible.

A Healthier Wales is an ambitious vision for how we do just that, transforming the way we deliver services for people in Wales. The long-term plan aims to take us from an acute service to a wellness service, and from hospitals into our communities.

You don’t need to be a healthcare professional to realise the level of demand we’re seeing across the system is increasing and is unsustainable. While 81,000 people visited our emergency departments in December 2018, the pressures on acute services are felt all year round in Wales.

Wales has also established a special health authority in Health Education and Improvement Wales which is developing a future workforce strategy in partnership with Social Care Wales

For 70 years we have followed the same model of treating people at the point they needed our care. It’s fair to say we didn’t just need to freshen things up a bit, we needed to fundamentally change the way we work to provide services which meet the demands of the Welsh population now and in the future.

People will rightly be asking the question, so what has changed?

Across Wales there are now a significant number of initiatives and services which are helping to change the culture and service delivery so we can enable people to live happier, healthier and longer lives.

We’ve seen patients being asked to get on their bikes in Cardiff to reduce the risk of heart disease. Older people in West Wales are involved in intergenerational IT training in order to bring the community together and reduce social isolation. And, “Community Connectors” in the most rural parts of Wales are helping people to access wellbeing services in their area.

Wales has also established a special health authority in Health Education and Improvement Wales which is developing a future workforce strategy in partnership with Social Care Wales.

Still More to be Done

While there are many positive stories to tell, we have only seen the green shoots of transformation within services so far. While organisations across the public and third sectors are now engaging with and collaborating like we never have before, we must not lose this momentum.

If A Healthier Wales is to be successful, responsibility cannot lie just at the door of the NHS. Multiple sectors must come together and overcome competing priorities and different agendas to deliver integrated services. This takes time.

And it’s not just in organisations where cultures and behaviours need to change, patients and their families also need to adapt too. Hospitals and GP surgeries are still seen as the first port of call for many, we need to ask people what they need in order to take ownership of their health and wellbeing.

Wales needs to improve the way we measure what really matters to people, so it becomes clear which services are working well, and which services need to be improved.

The challenge really is not in the plan itself, but in how we’re implementing it.

The direction of travel is set, but we need to shift progress up a gear so that everybody in Wales can benefit from the new services we are beginning to provide.

The projects we’ve seen piloted and developed over the last year now need to be scaled up and become the norm. What we’ve achieved so far is only a fraction of what’s required over the next few years.

Over the last year we’ve seen enough evidence to prove we’re on the right track but now it’s time for us to show the people of Wales what we can really do.