Health
Strengthening accountability and transparency in NHS Wales
CABINET SECRETARY for Health and Social Care, Jeremy Miles MS, has outlined further steps to improve accountability, openness and transparency across NHS Wales.
In an update following his October statement, Mr Miles said new measures are already making health services more accountable to the public, while improving access to meaningful performance data.
For the first time, Welsh Government has held a full round of public accountability meetings with all NHS organisations. The sessions were live streamed, allowing the public to see health boards, trusts and special authorities being questioned on their plans, finances, performance, quality and safety. Recordings and follow-up correspondence have been published online, with supporting evidence packs set to follow.
Over the past year, more NHS performance data has been released than ever before. This includes the introduction of a new Emergency Ambulance Performance Framework, which moves beyond simple response times to provide a fuller picture of patient care — from the initial call through to clinical outcomes.
The broader dataset is designed to give both the public and clinicians clearer insight into how services are performing. For example, publishing survival rates following cardiac arrest is expected to help improve outcomes by turning previously hidden processes into measurable areas for improvement.
However, a review by the Ministerial Advisory Group on NHS Performance and Productivity found the current accountability system to be overly complex, data-heavy and lacking transparency, with limited impact on driving improvement.
In response, the Welsh Government will introduce a simplified operating and accountability framework from April. The new system will focus on outcomes rather than processes, with a stronger emphasis on clinical leadership, earlier intervention and clearer consequences where performance falls short.
The reforms will include a more streamlined, risk-based oversight model and a single, shared dataset for performance reporting. Contact with Welsh Government will vary depending on an organisation’s level of escalation, with greater autonomy for those performing well.
As part of the changes, escalation frameworks for all health boards have now been published online, setting out expectations for improvement and criteria for de-escalation. Cwm Taf Morgannwg and Hywel Dda university health boards were de-escalated in February after meeting cancer performance targets.
Mr Miles also highlighted ongoing work to improve NHS productivity, including plans to develop a more comprehensive measure of system-wide performance.
He said the Welsh Government remains committed to improving transparency and accountability, using better data and oversight to drive improvements in patient care.
Health
Ambulance delays and blocked beds putting Welsh patients at risk, watchdog warns
AMBULANCE handover delays, long waits in emergency departments and delays discharging patients from hospital are continuing to put people at risk across Wales, Audit Wales has warned.
The public spending watchdog said urgent and emergency care remains under “constant pressure” despite extra funding and new policies aimed at improving joined-up working between the NHS, ambulance service, councils and social care providers.
In an article published today, Monday (Jun 22), Audit Wales said its work since 2024 had examined how health boards and the Welsh Ambulance Services NHS Trust manage demand for urgent and emergency care, as well as how health boards and local authorities support timely discharge from hospital.
It found that pressures across the system are increasing patient safety risks and driving up costs.
Key problems identified include ambulance handover delays, lengthy waits in emergency departments, underused new services despite extra funding, and delayed hospital discharges which continue to result in hundreds of thousands of lost bed days each year.
Audit Wales also said workforce problems across health and social care remain a major factor in delayed discharges.
The watchdog warned that data is still not being shared effectively across the system, making it harder for public bodies to make informed decisions and manage pressure.
The findings will add to growing concern about the state of urgent and emergency care in Wales, with patients, families and frontline staff repeatedly warning that delays in A&E and problems arranging social care packages are leaving people waiting too long for treatment or stuck in hospital after they are medically fit to leave.
Audit Wales said staff and leaders across the system had made clear that “something must change”.
It has set out six questions for the Welsh Government, NHS Wales and local authorities to consider as they look at how urgent and emergency care can be improved.
The Auditor General for Wales is the independent statutory external auditor of the devolved Welsh public sector and is responsible for auditing most public money spent in Wales.
The Herald has asked the Welsh Government and Hywel Dda University Health Board for comment.
Health
Wales most aware of alcohol addiction, but experts warn summer habits carry danger
MORE people in Wales recognise alcohol as addictive than anywhere else in Britain, new research has found, but health experts are warning that awareness alone may not be enough to prevent harmful drinking habits.
The findings come ahead of the busy summer period, when pubs, beer gardens, festivals, barbecues and outdoor events often lead to increased alcohol consumption.
According to YouGov data, 86% of people in Wales describe alcohol as addictive — the highest figure recorded across Britain and above the national average of 78%.
Only 14% of Welsh respondents said alcohol was either “not very addictive” or “not addictive at all”.
By comparison, London recorded the lowest level of awareness, with 69% of respondents recognising alcohol as addictive.
Health professionals say the results show that while many people understand the risks, regular drinking can still become habitual, particularly during periods of increased socialising.
Official figures suggest adults consume an average of 10.7 litres of pure alcohol per person each year, equivalent to around 21 UK units per week. That is around nine pints of beer or seven large glasses of wine, and is significantly above the recommended maximum of 14 units a week.
Nearly one in five adults are also said to drink at hazardous levels or above, with men more than twice as likely as women to fall into that category.
Dr Karen Faulkner, Associate Medical Director at Panthera Clinic, said alcohol occupied a “unique place” in British culture because it was both legal and socially encouraged.
She said: “What’s particularly interesting is that most people understand alcohol can be addictive, yet many still underestimate how easily regular drinking can become habitual. Dependence often develops gradually and doesn’t always fit the stereotypes people associate with addiction.
“During the summer months, drinking can become even more normalised through holidays, beer gardens, barbecues, festivals and sporting events.
“The challenge isn’t necessarily a lack of awareness about alcohol’s risks. It’s recognising when a socially accepted habit has crossed the line into something that’s beginning to have a negative impact on your health, wellbeing or daily life.”
Dr Faulkner said people wanting to cut back should consider planning alcohol-free days, alternating alcoholic drinks with water or soft drinks, setting limits before social events, and keeping track of their weekly intake.
She also urged people to watch for signs that alcohol may be becoming more important than intended, including finding it difficult to relax, socialise or enjoy an event without drinking.
Panthera Clinic has launched a free online Alcohol Health Calculator to help people assess how their drinking habits may be affecting their health and wellbeing.
Dr Faulkner added that low and no-alcohol alternatives had become more widely available, making it easier for people to reduce their intake while still taking part in social occasions.
Health
Welsh Government refuses to halt Withybush and Bronglais service review
Health Minister tells Paul Davies MS that decisions remain a matter for Hywel Dda University Health Board
THE WELSH GOVERNMENT has declined to intervene in controversial plans affecting services at Withybush and Bronglais hospitals, prompting fresh criticism from local Senedd Member Paul Davies.
In a letter dated June 19, Health and Care Cabinet Secretary Mabon ap Gwynfor said responsibility for planning and delivering NHS services rests with local health boards and confirmed that Hywel Dda University Health Board should continue its consultation process on proposed service changes.
The response follows concerns raised by Mr Davies on behalf of constituents in Pembrokeshire and Ceredigion over the future configuration of clinical services, including stroke care.
While acknowledging strong public concern about access to healthcare in rural communities, the Minister stopped short of offering any commitment to block or reverse the Health Board’s proposals.
Instead, he stressed that any changes must be supported by robust evidence, maintain patient safety and demonstrate improved outcomes.
The Minister wrote: “Responsibility for planning and delivering health services rests with local health boards, including decisions about how services are organised.”
He added that proposals must improve outcomes for patients, maintain safe and equitable access to care and be supported by thorough impact assessments.
Paul Davies MS described the response as disappointing.
Posting the letter on social media, he said: “This letter tells me that the Welsh Government is not going to stand in the way of the Health Board’s plans.”
He added that he would raise the issue in the Senedd chamber next week and continue pressing ministers to intervene.
The exchange comes as Hywel Dda University Health Board continues a public consultation on proposed changes to stroke services across west Wales.
The consultation, which opened on May 28, is due to run until July 26.
In his response, the Minister stated that anyone suffering a stroke should receive treatment “as quickly as possible in the most appropriate setting” and said the current model of stroke care in Wales must evolve if national standards are to be achieved.
The comments are likely to fuel concern among campaigners opposed to the proposed changes, who fear services could become increasingly centralised and further away from rural communities in Pembrokeshire and Ceredigion.


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