The Royal College of Physicians (RCP) has today (Tuesday 27 September) released the latest in a series of video podcast interviews from Dr Olwen Williams, RCP vice president for Wales, in which she interviews senior leaders in the Welsh public sector about their vision for a healthier Wales.
Judith Paget is director general of health and social services at the Welsh government and chief executive of the NHS in Wales. She took up post in November 2021, and is responsible for around 800 civil servants who support ministers to deliver their priorities, as well as providing strategic leadership and management of the NHS and its resources. It is a dual role that combines developing government policy with the delivery of health services, and Judith calls it ‘a great job. I feel absolutely privileged. It's exciting, a huge opportunity.’
During their conversation, Olwen asks Judith about her plans for a long-term workforce plan for Wales, noting that recruitment and retention is one of the biggest challenges facing the Welsh NHS. Where there are frequent rota gaps, this increases workload and puts pressure on NHS staff and their wellbeing. In her reply, Judith talks about the Welsh government’s national clinical framework (NCF) – the published national guidance on how to plan and provide local and national clinical services – and the plans for a new NHS executive for Wales. She says:
"Making sure we've got the right people, in the right numbers, with the right skills, doing the right thing, at the right time is so important. I know how fantastic everybody has been over the past few years. People have worked above and beyond. In the next couple of months, we'll be publishing a more detailed NHS workforce plan. It's definitely on its way."
Moving on to the planned care recovery programme, Olwen describes the huge challenge of waiting lists facing the Welsh NHS and Judith talks about the potential for doing things differently, especially with new technologies and virtual appointments. Judith describes the rapid acceleration of digital working during the pandemic as a ‘huge positive that came out of the pandemic.’
Later in the interview, Dr Williams asks Judith about her vision for the future of the health service in Wales. Judith says:
"A healthier Wales is our long-term plan for health and social care. The pandemic has accelerated some things from the plan, and set us back on others. Nobody anticipated the planned care backlog when it was written, or the impact of COVID-19 on health inequalities. So we have to think about our response to these things, how we support our communities and develop integrated care and tackle inequalities. But we’ve also seen progress on digital transformation and a new focus on joined up health and social care, alongside changes to the way we support and develop our workforce. Now we need to deliver our recovery plan for planned care."
Picking up on Judith’s point about health inequalities, Olwen asks her what physicians can do to help improve population health and influence the social determinants of health, when traditionally they have focused on treating the symptoms and diseases that are often caused by ill-health. Judith told us:
"We need to make every contact count. Our public health teams are working with primary care to build capacity in our communities and provide support. We need a stronger focus on prevention and early intervention. Every health professional can play their role in delivering our public health messages and strategies to reduce ill-health."
The two healthcare leaders went on to discuss climate change, sustainability and the green agenda in the NHS, with Judith telling us:
"There’s a huge amount of work going on across Wales to tackle the climate emergency. We have some really ambitious targets. In the NHS, I think we’ve reduced some of our carbon emissions by about 5%. But there's so much more to do. We've now got the decarbonisation strategy, and we’ve made some small grants available to NHS organisations for grassroots work locally to combat climate change."
Olwen took the opportunity to ask Judith what she thought we should do to encourage women to put themselves forward for leadership roles in the NHS. Judith, as only the second-ever female director general for health and social care in Wales, said:
"What really helped me was having other women leaders around who actually supported and encouraged me, and created opportunities for learning. We need to spot people and signpost them because women often don't put themselves forward for roles. They find all the reasons why they shouldn’t – but it's beholden on us to say it is doable! HEIW are reaching out into the NHS in Wales to provide those opportunities. But certainly, those of us already in leadership positions should continue to lead the way and help people into those roles."
Reflecting on the interview afterwards, Dr Olwen Williams said:
"It was an absolute pleasure to interview Judith and hear about her vision for the Welsh NHS. I was delighted to hear that she is a big fan of crime novels, and I will be checking out her book recommendation, I am Pilgrim by Terry Hayes, which tells the story of an American former intelligence agent turned author who sets out to uncover a serial killer’s identity and instead becomes entangled in a terrorist conspiracy. When I asked her about how she relaxed during lockdown, she told me that her guilty pleasure was binge-watching crime boxsets and eating KitKats, which I loved."
Other interviews in the series, hosted on the RCP Player streaming service, include the future generations commissioner for Wales Sophie Howe, the Bevan Commission director Helen Howson and the older people’s commissioner Heléna Herklots.