‘Faster change is needed for care to be sustainable’

HEALTH and social care in Wales is not sustainable in its current form and needs to change, experts have warned.

Health Secretary Vaughan Gething commissioned an independent review into the state of the NHS and the care sector in November 2016.

The review panel’s interim report describes the case for change as “compelling” and calls for new models of care to be trialled across Wales.

The experts claim caring for older people should be a priority because of the country’s ageing population.

They said the NHS needs to “speed up” how it adapts to changing needs and how it can operate in a more joined-up way.

“New models of care should be developed, trialled, evaluated and scaled up rapidly,” the report states.

“Faster change is needed if the health and social care system is to be sustainable into the future.

“Wales has very significant assets that can be used more effectively.”

Wales has the largest and fastestgrowing proportion of older people in the UK, the report states.

By 2039 there will be a further 44% more people aged over 65 compared to 2014.

As a consequence there is a projected 5% decrease of working-age adults in this period.

The report states: “This will mean a potentially shrinking tax base, increasing pressure on this cohort as carers, and a smaller pool from which to draw the health and care workforce of the future.

“Without effective action to reduce cost pressures, increase efficiency, or reduce the demand for services, NHS spending in Wales will need to rise by an average of 3.2% a year in real terms to 2030-31 to keep pace.

“Cost pressures for adult social care are projected to rise faster than for the NHS, by an average of 4.1% per year.

“Increasing effectiveness and efficiency is essential for future sustainability.”

It also highlighted “acute” staffing shortages in certain clinical fields including general practice, domiciliary and residential care staff.

“The uncertainty relating to how the UK will exit the European Union means that no easy assumptions can be made about drawing a health and care workforce from Europe and beyond,” the report states.

“The scale of these challenges mean the system is becoming unstable.”

The report states that certain hospital expertise and care needs to be centralised and utilised more effectively.

While major structural changes are not needed the report found that examples of good practice needed to be “scaled up rapidly”.

And new skills and career paths for healthcare workers needed to be planned on a larger scale.

The report also praised recent Welsh Government legislation, including the Social Services and Wellbeing (Wales) Act 2014 and the “prudent healthcare” message, which offer “powerful sets of principles” about how health and social care can be transformed.

Dr Ruth Hussey, the former Chief Medical Officer for Wales who chairs the panel, said: “In our independent interim report we have focused on the challenges to, and the opportunities for, improvement in the current services. The report defines the key issues facing health and social care services as we see them and outlines our initial proposals for a way forward.

“By the time our final report is published at the end of the year we aim to have a list of recommendations that command widespread support, are implementable, and give Wales the best chance of delivering the changes needed to achieve quality driven, sustainable, whole health and social care system and services that the population rightfully expects.

“We want to hear from as many people as possible to inform the next part of our work, especially on the case for change, new models, and the areas we have identified for action.”

The review panel has been asked to produce a full report by the end of 2017.