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NHS Wales workforce crisis: Audit Wales report highlights key challenges

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A NEW report from Audit Wales has exposed critical workforce challenges in NHS Wales, citing gaps in workforce planning, recruitment and retention difficulties, and ongoing reliance on temporary staff. Despite some progress in reducing agency spending and sickness absence rates, the healthcare system remains under strain, with concerns over leadership, data collection, and long-term sustainability.

Workforce planning shortcomings

NHS staff: Under pressure and burning out, says report (Image: HDUHB)

Audit Wales identifies significant flaws in workforce data collection, making it difficult for NHS Wales to effectively plan for future demands. The lack of accurate, up-to-date data hinders efforts to address shortages and distribute resources efficiently.

The report also raises concerns over unclear national oversight, leading to inconsistent workforce planning across different health boards. There is no single entity fully accountable for ensuring a sustainable workforce, contributing to fragmented decision-making.

Persistent recruitment and retention struggles

Despite recruitment initiatives, NHS Wales continues to face staffing shortages, particularly in specialist medical fields and general practice. Doctors and nurses leave the profession due to stress, burnout, and lack of career progression opportunities. The retention crisis is worsening existing pressures on remaining staff, who are forced to work longer hours under increasingly challenging conditions.

Reliance on temporary staff still a concern

Withybush Hospital in Haverfordwest now uses less agency nurses, but is still reliant on them (Image: Herald)

While NHS Wales has reduced its reliance on agency workers, the expenditure on temporary staff remains substantial, putting pressure on budgets. Health boards are still heavily dependent on locums and bank staff to fill gaps, leading to inconsistencies in patient care.

Audit Wales Report calls for “collective action”

Audit Wales has published a report today detailing the workforce challenges at the heart of the Welsh NHS, calling for “collective action”, highlighting a reliance on “expensive” agency staff to “plug gaps in the workforce”.

Auditor General for Wales, Adrian Crompton, stated that “the NHS in Wales continues to face significant workforce challenges” and that service demand “is expected to grow further”.

The report highlights over 5,600 vacancies in NHS Wales, with over 10% of medical and dental posts currently unfilled. While agency staff expenditure has decreased, it still cost the NHS £262 million in 2023-24. The growing workforce is welcome but comes at a financial cost, with NHS staffing costs rising by 62% since 2017-18, reaching £5.23 billion in 2023-24. The report raises concerns over whether continued workforce expansion is financially sustainable in the long term.

BMA Cymru Wales criticism

In response to the report, BMA Cymru Wales issued a statement on February 18, 2024, emphasizing that workforce gaps have been highlighted for over a decade, yet progress remains slow.

Dr Iona Collins, chair of the BMA’s Welsh Council, said: “Despite highlighting the need for an all-Wales workforce strategy, we have yet to see the necessary improvements in data collection to inform an appropriate long-term plan.”

The BMA argues that staff shortages contribute to delays in surgery and lengthening waiting lists, causing avoidable harm to patients. They also point out that Wales has fewer doctors per head of population compared to the rest of the UK, exacerbating service pressures.

Welsh Conservatives criticise Labour Government

James Evans MS: Says Labour have ‘failed to deliver’

Welsh Conservative James Evans MS has criticised the Welsh Labour Government for failing to bring forward a substantial workforce plan to meet the needs of the Welsh NHS and the public.

Commenting, Welsh Conservative Shadow Cabinet Secretary for Health and Social Care, James Evans MS, said: “The Welsh Labour Government have comprehensively failed to bring forward the substantial workforce plan that the Welsh NHS needs to serve the public.”

“Without proper planning, we remain stuck in a perpetual cycle of less money being available to repair the foundations of the NHS, because disproportionate funding is going towards costly agency staff.”

“Welsh Conservatives will bring forward the recruitment and retention plan needed to fix the Welsh NHS, because Wales deserves better than this Welsh Labour Government.”

Impact on patient care

The consequences of the workforce crisis are already affecting patient care, with reports of longer waiting times, postponed surgeries, and staff shortages in key areas. The current workforce struggles are leading to avoidable harm for patients, as well as knock-on effects on their families and employers.

Calls for immediate action

The Audit Wales report calls for a comprehensive, long-term workforce strategy to address these challenges. Recommendations include:

  • Better workforce data collection and planning
  • Stronger leadership and accountability at a national level
  • More investment in training and retention strategies
  • Reducing dependency on agency staff through improved workforce stability
  • Developing a clear long-term educational and funding plan to ensure NHS Wales can retain the staff it trains
  • Creating a sustainable workforce model for social care to better integrate services

The report highlights the lack of clarity over system leadership arrangements, making workforce planning even more challenging. Health Education and Improvement Wales (HEIW) plays a key role, but its relationship with other NHS workforce organisations needs to be clarified. Workforce planning is also hindered by gaps in data and uncertainty about the future of health and care services.

With mounting pressures on NHS Wales, swift action is essential to prevent further deterioration in services. The Welsh Government is now under pressure to respond decisively to these findings and implement sustainable solutions to support the NHS workforce in the long term.

 

Health

Future hospital proposal raised as debate continues over west Wales services

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A MAJOR new hospital development in West Wales has been put forward as part of Welsh Labour’s proposed £4 billion “Hospitals for the Future Fund”, with Senedd Member for Mid and West Wales Eluned Morgan saying the region deserves “safe, sustainable hospital care for the future”.

Speaking at Welsh Labour’s campaign launch on Monday, Morgan said that if the party is returned to power at the Senedd election in May, the fund would be used to modernise ageing NHS buildings across Wales over the next decade, with West Wales expected to form a key part of those plans.

The announcement comes amid strong public concern about the future of services at Withybush Hospital in Haverfordwest. A petition calling for certainty over local hospital provision has attracted thousands of signatures, reflecting widespread anxiety about potential changes to healthcare services in Pembrokeshire and surrounding areas.

Morgan acknowledged the strength of feeling locally, saying she understood why many residents were worried.

“I know how much Withybush means to people. I’ve had the conversations. I’ve looked people in the eye who are worried about what the future holds for their local hospital,” she said.

“And I want to be honest with people – this isn’t simple. If it was, it would have been solved years ago.”

She said the challenges facing hospital services in West Wales go beyond the condition of existing buildings and include difficulties recruiting and retaining enough specialist staff to ensure safe care.

“Buildings matter. But what really matters is whether you can staff services safely,” Morgan said.

“Patient safety and timely care must always come first – not politics, not headlines. No other party has offered any realistic alternative which is deliverable, which is why I hope people in West Wales will endorse this new hospital.”

Morgan said she would like Hywel Dda University Health Board to revisit options for a realistic hospital proposal in light of the new funding commitment.

“In light of this new commitment, I would like the health board to look again at a realistic hospital proposal that delivers safe, sustainable services for the future,” she said.

“For too long, people in West Wales have heard talk of a new hospital without seeing it become reality. Plans were drawn up in the past, but after years of Tory cuts, especially to the capital budget, the funding simply wasn’t there to deliver them. That’s the truth.”

She argued that the situation may now have changed following the election of a UK Labour government.

“Today, we are in a different place. After 14 years of austerity, we are now working with a UK Labour Government that understands Wales and is prepared to invest in our public services,” she said.

“Real investment is now possible if Welsh Labour leads the next Welsh Government. This is about securing the future – modern facilities, safer care and services designed around patients and staff.”

Morgan also warned against relying solely on older hospital buildings if staffing levels cannot be maintained safely.

“What I won’t do is pretend that patching up buildings from another era is a long-term solution if we can’t staff them safely,” she said.

The proposed Hospitals for the Future Fund would form a central part of Welsh Labour’s long-term NHS strategy, aiming to combine infrastructure investment with workforce planning and clinical safety.

However, debate over the future of hospital services in West Wales is likely to continue. Campaigners in Pembrokeshire have repeatedly called for key services to remain at Withybush Hospital, arguing that long travel times to other hospitals could pose risks for patients in rural communities.

Hywel Dda University Health Board has previously explored options for reorganising services across the region, including proposals for a new hospital to serve multiple counties. No final decision has yet been taken.

With the Senedd election approaching, the future of hospital provision in West Wales is expected to remain a major political issue.

 

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Health

Withybush Hospital ‘number one concern’ at Tesco pop-up surgery, says Kurtz

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RESIDENTS raised concerns about the future of services at Withybush Hospital during a pop-up advice surgery held by local Senedd Member Samuel Kurtz at Tesco in Pembroke Dock on Thursday (Mar 6).

The informal drop-in session gave shoppers and local residents the opportunity to speak directly with the Conservative MS about issues affecting the community, seek guidance, and raise personal concerns.

Several people stopped by throughout the day to discuss healthcare provision, local banking services, and other matters affecting the area.

According to Mr Kurtz, the future of services at Withybush Hospital dominated the conversations.

Speaking after the event, Samuel Kurtz MS said: “These drop-in surgeries are vital for ensuring open communication and staying connected to the day-to-day experiences of local people.

“The latest set of service changes at Withybush Hospital were the number one topic of conversation today. Everyone is talking about it, everyone is concerned, and people want to see action.”

Residents also raised questions about efforts to secure a banking hub for Pembroke Dock following the closure of several high street bank branches.

Mr Kurtz added: “Events like this are an important reminder that many issues affecting our community, from access to healthcare at Withybush to banking services, have a real impact on people’s daily lives.

“It is important that residents have the opportunity to raise their concerns directly and know that someone is listening.”

The MS thanked residents who took the time to stop and speak with him during the session.

“I am always grateful to everyone who comes over for a chat, whether it is to raise a concern, ask for help, or simply to share their views. These conversations help shape the work I do on behalf of our community.”

 

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Charity

Free London Marathon spaces offered by NHS charity

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Hywel Dda Health Charities is delighted to announce that it has secured three free charity places for supporters wishing to take part in the TCS London Marathon MyWay 2026 – the virtual version of the world‑famous marathon.

Taking place on Sunday, April 26, the TCS London Marathon MyWay gives participants the freedom to complete the iconic 26.2‑mile distance from any location. Whether running, jogging or walking, entrants have 23 hours, 59 minutes and 59 seconds to finish the challenge. The event must be completed outdoors, but participants can choose any route that suits them.

The virtual marathon is the perfect option for anyone who has always dreamed of taking part in the London Marathon but would prefer a more flexible timeframe, the chance to complete the distance at their own pace and the ability to take part without travelling to London.

Participants will receive a finisher’s T-shirt and medal (optional), a free trial with Coopah, the official training app of the TCS London Marathon and access to the official event tracking app.

In return for one of the limited free places, Hywel Dda Health Charities asks supporters to raise a minimum of £300 in aid of a Hywel Dda service of their choice.

Tara Nickerson, Fundraising Manager for Hywel Dda Health Charities, said: “We’re so excited to offer these special MyWay places to our supporters. The virtual marathon is a fantastic opportunity for people of all abilities to take on an iconic challenge in a way that works best for them.

“Every pound raised will make a meaningful difference to patients and staff across our local NHS services. We can’t wait to cheer on our amazing fundraisers as they take on the 26.2 miles their own way.”

Places will be allocated on a first‑come, first‑served basis. To request a place or find out more, please contact the Hywel Dda Health Charities team via email at [email protected] or by phone on 01267 239815.

 

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