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Setting up an NHS executive for Wales

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31 organisations, including royal colleges, patient groups and third sector bodies have written to the Senedd Health and Care Committee in response to a request for views on the Welsh government’s proposed hybrid model for the new NHS executive for Wales.

Since the publication of the Welsh government’s national clinical framework (NCF) in March 2021, and before that, A healthier Wales in 2018, the parliamentary review of health and social care in 2017, and the OECD review of healthcare quality in 2016, patient advocacy groups, health and care professionals and other stakeholders have awaited further detail about the Welsh government’s plans to implement recommendations calling for a stronger central guiding hand, additional transformational capacity and the streamlining of current structures.

In November 2021, a number of third sector organisations in Wales came together to launch Ending the postcode lottery, which called for a clinically led, independent executive to deliver the NCF, while setting out some key examples of why this was needed.

Instead, on 18 May 2022, the Welsh government announced that they plan to ‘establish the NHS executive as a hybrid model, rather than a standalone organisation. It will comprise a small, strengthened senior team within Welsh government, bolstered and complemented by the bringing together of existing expertise and capacity from national bodies in the NHS, which will operate under a direct mandate from Welsh government.’

As a group of organisations, we have serious concerns about this direction of travel. There still seems to be no overall detailed plan or strategic national approach to addressing the growing sense of crisis in health and social care. There is still huge variation in the quality of services provided by different health boards and local authorities, especially in the context of growing waiting lists and the planned care backlog. Most condition-specific delivery plans have now (or are about to) come to an end, risking the loss of a coherent and joined up approach for the NHS bodies and clinicians responsible for delivering these services across Wales.