MEASURES to help the Welsh NHS cope with “unrelenting” pressure are not making a clear difference at the frontline, inspectors have said.

Alun Jones, chief executive of Health Inspectorate Wales (HIW), said services had suffered another “turbulent year” with the inspectorate itself increasingly having to scramble to address areas of high risk.

“Whilst there are initiatives in place to help support healthcare services cope with unrelenting demand, our work during this year did not find evidence of these making a clear and significant difference to services at the front line,” he said.

The HIW’s annual review for 2022/23, published Wednesday, December 6, found issues of overcrowding, long waits for triage, long waits for treatment, and ongoing delays in admission to the most appropriate beds in emergency departments across Wales.

GP practices are facing “unprecedented demand” with a range of issues including following up concerns, unsafe medicine storage, compliance with mandatory training and out-of-date equipment.

The HIW received 133 concerns from whistle-blowers in 2022/23 – an 85 per cent increase from 61 in the year prior.

Four of these whistle-blowers were based at Aneurin Bevan University Health Board, where there were 11 referrals of neglect and four of physical abuse. Across Wales, the number of referrals in Wales relating to abuse and neglect fell by 37 per cent.

‘One clear issue’

"We have found one clear issue throughout our work, which is, that at any junction in the care and treatment pathway of a patient, there is huge potential for delay, a pause in treatment, and an overall introduction of risk that is not there at other times," said Mr Jones.

“Our work within mental health, for example, has found that this is the case when patients with a diagnosis and care and treatment plan are moving from one part of the service to another.

South Wales Argus:

“Now, more than ever, healthcare in Wales needs continued innovation, and a vision and understanding of what works and what does not.”

The Welsh Government is pursuing a strategy of '3Ps' which aims to promote improved health behaviours, prevent cases of worsening health and prepare people for treatment and recovery.

‘Staff are number one’

Director of the Welsh NHS Confederation Darren Hughes, representing the seven health boards, said he welcomed the recognition that staff were implementing initiatives to cope with increasing and unrelenting demand.

“Unfortunately, this is not enough to mitigate the impact of the huge challenges, but evaluating what hasn’t worked is as valuable as learning from what has,” he said.

“It’s universally acknowledged that staff are the NHS’s number one asset. They don’t just care for patients; they also innovate and implement service change to improve outcomes for patients. Therefore, recruiting and retaining existing staff, including doing what they can to support staff wellbeing, is a priority for NHS leaders."

HIW's report, he said, rightly highlighted the challenges in primary care, including access to GPs, dentists and mental health services, while the media and politicians often focus on the challenges in secondary care.

He concluded: “We need health and social care regulatory bodies to work together to inspect and advise on necessary improvements in patient flow, due to the interdependent nature of health and social care services.

"These challenges cannot be looked at in isolation.”