RICHARD PUGH

COLUMNIST

ANYONE involved in health and social care will tell you that times are tough.

Increased demand and reduced budgets have placed huge pressure on these vital support systems, and there is little doubt that they are creaking under the strain.

Against such a backdrop, the vision of a “seamless” health and social care system outlined in the Welsh Government’s A Healthier Wales plan, is a welcome one.

But engineering such a shift from traditional hospital-based care, to a health, wellbeing and prevention approach within local communities, will not be easy.

Only recently a number of “nuts-andbolts” issues, which actively underpin the high-quality care aspired to in A Healthier Wales, have been found wanting.

There are areas of significant concern within cancer care in Wales which require far more urgent action than the Welsh Government’s long-term plan would suggest.

It starts with the cancer care workforce. The ability to offer high-quality care rests almost exclusively on having a highly trained workforce capable of delivering it.

Following our recent census of the cancer nursing workforce in Wales, the long-term viability and sustainability of this has been called into question.

Almost three-quarters of specialist breast cancer nurses in Wales are aged 50 or over, with many due to retire over the course of the next decade.

The number of whole time equivalent posts for breast cancer nursing have dropped by 14% since 2014, and more widely, vacancy rates among specialist cancer nurses also appear to have increased since the previous census.

This ticking time-bomb sits at the heart of the sustainability of Wales’ specialist cancer care workforce, and will directly limit Wales’ ability to offer cancer patients the seamless, high-quality treatment, care and support they need.

Another concern is the constant need to address variation in how early cancer is being diagnosed.

Whether it is variation by age, sex, area of disadvantage, or the significant challenges associated with delivering effective cancer care in highly rural areas – we need health boards and other organisations who design and deliver cancer care in Wales to look at this new data in depth to help shape local services and drive earlier cancer diagnosis.

By 2030 we expect around 250,000 people to be living with cancer in Wales, and that in the near future one in two of us can expect to receive a cancer diagnosis.

In light of this, the Welsh Government’s A Healthier Wales plan has much to commend it, not least its acknowledgement that people will have much wider wellbeing as well as purely clinical needs and concerns.

Charities have a huge role to play in delivering this vision and Macmillan Wales is firmly committed to working with our health board, local government and Welsh Government partners on delivering the transformative change that is needed.

But while the plan has huge potential for the future, we simply must not lose sight of the fact that urgent action is required to ensure current cancer patients receive the earlier diagnosis and more timely treatment that is needed in the here and now to improve outcomes for people with cancer in Wales.

■ Richard Pugh is head of services for Macmillan Wales