Right conditions must be in place to go further on prevention and long-term planning

Responding to both the Audit Wales report and the Future Generations Commissioner for Wales’ report on the implementation of the Well-being of Future Generations Act ten years on, director of the Welsh NHS Confederation Darren Hughes said:

“We welcome both the Audit Wales and Future Generations Commissioner for Wales reports, which contain plenty for NHS leaders and the Welsh Government to take heed of. The recognition of the ever-growing needs of our population and the focus on long-term planning, prevention and the wider determinants of health align with our calls ahead of the 2026 Senedd election.

“NHS leaders would not deny that the health system has some way to go in implementing the Act. However, this is not to say that there have not been extensive achievements across planning and delivery to do so. But we need to go further and scale up the good examples through more cross-sectoral action and long-term financial and delivery approaches.

“As Audit Wales rightly single out in their recommendations, there is only so far public bodies can go in making meaningful, coordinated progress in implementation of the Act without the right conditions in place. So often conflicting structures, legislation and processes can hinder implementation, which is why it’s positive, for example, that this year’s NHS Wales Planning Framework has a greater emphasis on prevention.

“As the Commissioner points out, the Welsh Government’s funding arrangements are short-term, inconsistent and unclear, adding pressure when capacity is already so stretched. NHS leaders share frustrations around a lack of long-term financial certainty, inhibiting their ability to plan for the future. Moving towards long-term funding arrangements is whole-heartedly supported by NHS leaders and is something we’ve been calling for.

“While there’s no doubt the NHS plays a role in prevention, when it comes to health, we know the NHS plays a relatively small role, with the majority impacted by wider socio-economic determinants such as the environment, the economy, transport, education, access to the arts and so on – this is where the focus needs to be.

“As a nation, we have an opportunity to make significant improvements to health and wellbeing in just five to ten years, benefiting millions of people, our economy and our health and social care system. This requires a whole-system, partnership approach to health and wellbeing across the wider determinants of health, as well as bringing the public with us to realise this transformation. But the government must initiate the drive for better health and create the conditions for all parts of society to work together to make this happen. 

“The Commissioner’s words that the challenges are significant but not insurmountable should be used to spur on collective action across government departments and sectors as we fight for a better future for the people of Wales.”