Health
Patients in Wales waiting years for autoimmune diagnosis
Study led by Swansea University says long delays, limited specialist access and referral barriers are leaving some patients worse off than those elsewhere in the UK
PEOPLE in Wales with autoimmune and rheumatological conditions are facing long waits for diagnosis, poor access to specialist care and repeated obstacles when trying to secure treatment outside their local area, according to new research.
The study, led by Swansea University, examined the experiences of patients with illnesses including lupus and other autoimmune disorders. It drew on interviews, survey findings and Freedom of Information responses from health boards across Wales.
Researchers found that specialist provision remains limited in some parts of the country. Some patients reported having no access to a lupus specialist in their area, while FOI responses indicated there is only one NHS neuro-ophthalmologist in Wales for patients with neurological or visual problems linked to autoimmune disease.
The report also highlighted a lack of diagnostic services. None of the Welsh health boards that responded said they currently provide nailfold capillaroscopy, a test used to help identify conditions such as scleroderma.
Diagnosis in rheumatology can also be difficult because many of the conditions involved are complex and may develop gradually over time. Illnesses such as ankylosing spondylitis can be mistaken in the early stages for more common causes of pain, while autoimmune disorders often present with symptoms that overlap with other conditions.
Patients may require a combination of investigations before a diagnosis can be confirmed, including HLA-B27 testing, routine blood work, MRI scans, X-rays and detailed clinical assessment. Doctors also rely heavily on patient interviews to build up a picture of pain, stiffness, mobility and the wider pattern of symptoms.
There have also been local pressures on services in west Wales. At Withybush Hospital, delays were caused after the departure of a specialist consultant, and it took some time for that post to be filled. That consultant has now been replaced. However, it is understood the workload remained heavy, with the specialist working through a backlog of cases.
In some cases, patients may also feel rheumatology is treated as a lower-profile service. At Withybush Hospital, for example, the department has been based in a portacabin in the hospital car park, which it shares with the lymphoedema service — a setting that can give the impression that two important but often overlooked specialties are being accommodated on the margins of the wider hospital system.
Rheumatology also places a significant burden on the NHS because of the cost of long-term treatment and follow-up care, although that is not the main focus of the study. Biological drugs used to treat conditions such as rheumatoid arthritis and ankylosing spondylitis can cost around £500 for a pack of four injections, according to local hospital sources. Patients on those medications often also require regular blood monitoring, consultant reviews, specialist nurse support and physiotherapy. The Herald understands that more than 1,000 patients in Pembrokeshire are currently being managed through this treatment pathway.
Researchers said patients were also being held back by the referral system. Under current NHS Wales rules, doctors must apply to their local health board for permission to send patients for treatment outside the area or across the border into England. The study said decision-making around those requests was often inconsistent and unfair.
One patient with systemic lupus erythematosus told researchers he waited two years for approval to be referred to England, despite believing the process should only have taken weeks.
The study found that patients in Wales often face longer journeys to diagnosis than elsewhere in the UK. In the sample reviewed by researchers, the average time from first symptoms to diagnosis was around 11 years, compared with around seven years across the UK.
Patients described the effect those delays had on their health. One woman in her 30s said requests to see a specialist in a neighbouring health board had been turned down, and that her lupus had worsened as a result. Another patient said access to care became more difficult after moving from England to Wales.
The research was led by Rupert Harwood of Swansea University Medical School, who himself lives with several autoimmune conditions.
His own experience reflects the wider concerns raised in the report. After developing visual symptoms in 2016, he was advised to see a neuro-ophthalmologist, but no such service was then available in Wales. A referral to England was not successfully made until 2025, and he is still waiting for an appointment.
Mr Harwood said the present system can leave patients at a disadvantage if they cannot afford to seek private treatment outside Wales.
The study concludes that while NHS Wales rheumatology teams provide high-quality care, patients in Wales face additional barriers compared with those in England.
Researchers are calling for a review of the out-of-area referral system, better access to specialist services and greater investment in diagnostic testing to reduce delays and improve outcomes.
Health
Health row grows as Plaid urged to give clear timetable on two-year waits
PATIENTS must be given clear answers over when two-year NHS waits will be eliminated in Wales, opposition parties have said.
The row followed a statement in the Senedd by the Welsh Government’s Cabinet Minister for Health and Care, with questions raised over whether Plaid Cymru can maintain recent progress on waiting lists while delivering its own health pledges.
Welsh Labour said NHS waiting lists had fallen for ten consecutive months before the change of government, but warned that the new administration must not allow that progress to stall.
Ken Skates MS, Welsh Labour’s interim leader and spokesperson for health and care, said: “NHS waiting lists have now fallen for ten consecutive months and it’s now Plaid Cymru’s responsibility to ensure this progress doesn’t falter.
“We’re already hearing conflicting timelines from the Plaid Cymru First Minister and Health Minister on when two-year waits will be eliminated, with neither willing to answer the question. Patients deserve answers, not confusion.”
The Welsh Conservatives have also criticised the new government, claiming patients were being left with uncertainty after different messages were given about how quickly the longest waits could be cleared.
During the election campaign, the First Minister said two-year waits would be eliminated within months. However, the new Health Minister has since suggested the task could take longer.
The Welsh Government says reducing long waits remains a priority and that ministers are working with health boards to improve access to treatment, diagnostics and urgent care.
Plaid Cymru has argued that the NHS in Wales cannot be turned around overnight and says the new administration has inherited deep pressures across the health service, including demand on hospitals, delayed transfers of care, workforce shortages and financial constraints.
Health remains one of the most politically sensitive issues in Wales, with patients across the country continuing to face long waits for operations, appointments and diagnosis.
For families waiting for treatment, the political arguments in Cardiff Bay will matter less than whether appointments come through and whether the longest delays are finally brought down.
Health
Welsh Government calls summit after Herald reveals paramedic graduates left without jobs
THE WELSH GOVERNMENT is to convene an emergency summit after The Herald revealed that newly qualified paramedics in Wales had been left without paramedic jobs despite continuing pressure on the ambulance service.
The Herald previously reported that dozens of Newly Qualified Paramedic graduates were facing uncertainty after completing their training, with no available NQP posts within the Welsh Ambulance Services NHS Trust.
The issue has now been confirmed by Health and Care Minister Mabon ap Gwynfor in response to a written question from Welsh Conservative MS Darren Millar.
Mr ap Gwynfor said there are 82 graduates and no available NQP roles within WAST this year.
He said the situation reflected a “temporary mismatch” between the number of graduates and the availability of funded vacancies, driven by financial constraints and service redesign.
However, he confirmed that 62 of the graduates have secured Emergency Medical Technician roles within WAST, although not paramedic posts.
Of those, 42 have been allocated training courses in September and October, while a further twenty have been placed on a reserve list either to replace anyone who withdraws or to be allocated to a course in early 2027.
The minister said the issue was not limited to Wales, with restrictions on available posts being seen nationally.
He added that the Welsh Government was working with WAST, Health Education and Improvement Wales, universities and professional bodies to identify potential solutions.
A stakeholder summit will now be held later this month to consider immediate support for graduates who have not secured a post and longer-term action to stop the same situation happening again.
Pressure on ambulance services
The development comes at a time when ambulance services in Wales remain under sustained pressure, with delays, hospital handover problems and concerns over patient care continuing to affect communities across the country.
For new readers, the controversy centres on the gap between workforce training and actual funded jobs.
Paramedic students have completed their qualifications at a time when the NHS continues to face demand for emergency care, yet the ambulance trust does not currently have the funded vacancies to employ them as paramedics.
Welsh Conservatives said the situation demanded a full explanation.
Natasha Asghar MS, Shadow Minister for Health and Social Care, welcomed the summit but said it would be “of little comfort” to graduates who had expected paramedic jobs to be available.
She said: “Vague references to financial pressures and service redesign have been cited as reasons for the situation, but this isn’t good enough.
“We need a proper explanation of how we got to this extraordinary situation where we have newly qualified paramedics, who are much-needed in the service, but there aren’t suitable jobs for them.
“This is unforgivable at a time when all efforts need to be focused on driving down waiting times, ending corridor care at A&E units and improving patient care.
“We look forward to the summit coming to clear conclusions about what actions the new government can take to ensure this doesn’t happen again.”
Health
New health minister sets out priorities for the Welsh NHS
WALES’ new health minister has laid out his priorities for the NHS, including tackling waiting lists, service modernisation, and a focus on preventative health.
Addressing the Siambr on Tuesday June 2, Mabon ap Gwynfor told colleagues he is “under no illusions” about the state of the Welsh NHS – and said his government has “inherited a health system beset by crises, and that is perhaps more precarious and more vulnerable than at any point in its history.”
The minister said his “immediate priority” was waiting lists, and said: “These [waiting lists], for too long, have been a debilitating millstone around the neck of the NHS and are imposing unacceptable strains on staff and patients alike.
“Having to wait years for treatment, with all the pain and anxiety that that entails, is an intolerable reality for far too many people the length and breadth of Wales, and I am determined to turn the page on this sorry legacy once and for all.”
Mr ap Gwynfor pledged to implement an “ambitious national programme” to expand surgical and diagnostic hubs across Wales, as well as a new approach to planned care that is “clinically-led, nationally-directed, and with a clear emphasis on service modernisation” to reduce waiting lists.
The Gwynedd Maldwyn MS said: “Through these measures, we will see two-year waits eliminated within a matter of months and the overall backlog reduced to pre-pandemic levels before the end of this Senedd term.”
He continued: “But this isn’t just a case of addressing the immediate pressures of long waits, as urgent as they are; it’s putting the foundations in place so that we’re never in this position again and to ensure that the NHS can sustainably manage demand.
“That’s why our plan for surgical hubs is predicated on reinforcing local capacity and expertise first and foremost, creating centres of excellence for long-neglected specialisms such as ophthalmology, and providing vital training opportunities for medical graduates.”
Promising a focus on prevention, Mr ap Gwynfor referred to First Minister Rhun ap Iorwerth’s decision to appoint a deputy minister for public and preventative health to his cabinet last month – fulfilling a Plaid Cymru manifesto pledge.
The cabinet minister pledged to act across the cabinet to address the “wider determinants of poor health” by tackling child poverty, healthy eating, physical activity, housing and employment.
He said: “We will move away from managing sickness to ensuring that people have the means to lead healthier and happier lives.
“And on my watch, I won’t measure success on the basis of the number of people in hospital, but rather by the number who didn’t have to go there in the first place.”
Concluding his speech to the Senedd, Mr ap Gwynfor said: “What I have set out today are the first steps along a long-term path of renewal.
“I’m under no illusions as to the scale of the challenge, and I won’t promise that the benefits of our agenda will manifest immediately, because I’m not here to indulge in quick fixes and easy answers, and nor should anyone who truly has the best interests of the NHS at heart.
“But, through our laser focus on the ultimate destination, I’m confident that, by the end of this Senedd term, we’ll have started to write a bright new chapter in the history of our health and social care system.
“With urgency, decisive action and ambition, we will protect the NHS and build a healthier, fairer Wales with a health and care system that puts people first and delivers the change our nation needs.”
Reform’s shadow minister for health and prevention, James Evans, challenged the health minister on his plans, noting “the Welsh NHS doesn’t need any more slogans; it needs delivery”.
Mr Evans described responsibility for health and care as one of the “greatest responsibilities” a minister can hold “because behind every statistic is a person, a family, and often someone who has waited far too long.”

He pressed the cabinet minister on his claim that two year waits will be eliminated “within a matter of months”, asking Mr ap Gwynfor for a “straight answer” on exactly how many months this will be.
Adding that while “’within months’ might sound good in a press release, it means very little to someone who’s waiting in pain at home for their operation”.
In response, Mr ap Gwynfor did not provide an exact timeline for when waiting lists will reduced, and instead focused on sharing how the Plaid government intends to tackle the backlog.
He said: “Absolutely, this is about delivery. That’s why we’ve spoken about delivering elective care hubs across Wales, making sure that we can get those people seen quicker, the high-volume treatments done, and people can go home on the same day.
“We know that there’s a lack of efficiency and productivity in the NHS in Wales. That’s why we will ensure that theatre space and theatre time is utilised to its maximum.”
Labour’s Ken Skates and Conservative Natasha Asghar also pressed Mr ap Gwynfor on his waiting lists timeline, but he did not provide a clear deadline.

Reminding the Siambr of the work Welsh Labour did in the previous Senedd to maintain the NHS, interim Labour leader Ken Skates told the minister “there is still more to do”.
Referring back to Plaid Cymru’s time in opposition, Mr Skates reminded the cabinet secretary that he once presented 29 recommendations in a document entitled, ‘The Welsh Health System: Accountability, Performance and Culture’.
Mr Skates told the Siambr that he sees “very few” of those recommendations in the minister’s statement, one of which was to establish pay parity between social care workers and NHS staff.
He pressed the cabinet secretary to confirm if he stands by these recommendations and to confirm when social care workers can expect pay parity.
In response, Mr ap Gwynfor said: “Yes, absolutely, we talk about pay parity, and that’s why, once again, I refer to the proud record that Plaid Cymru has of starting the process of merging health and social care, and that’s what we will be completing as a Plaid Cymru government.
“At the moment, my colleague Delyth Jewell will be looking at that and ensuring that that is delivered, and that we can see the fruits of that under a Plaid Cymru government.”
Welsh Conservative health and social care spokesperson, Natasha Asghar, described the Welsh NHS as being in a “perilous state” with waiting lists remaining “shamefully high” and “patients in all four corners of Wales languishing in pain”.
Describing improving access to care as “paramount”, Ms Asghar referred to calls for an A&E department at the Royal Gwent Hospital in Newport to be reopened.
Having raised the issue in First Minister’s Questions earlier in plenary, Ms Asghar called for the minister to engage with the Aneurin Bevan University Health Board and to look into opening the A&E.
More broadly, she pressed the minister to “shed a bit more light” on how the Welsh Government is going to reduce pressure on A&E departments across Wales.
Sharing that he and his officials have “regular engagement” with the Aneurin Bevan health board, Mr ap Gwynfor confirmed that he would be “happy to raise those issues” in discussions.

Welsh Liberal Democrats leader, Jane Dodds, also questioned the cabinet secretary, focusing on the government’s plans for social care.
She said: “1,275 people are stuck in hospital beds unnecessarily. They are waiting for social care, either for delivery of the services or for assessments.
“These people, the ones deteriorating in wards when they should be at home, are the ones that need urgent results.
“We know that the Welsh Local Government Association has projected a social care funding gap of over £200 million this year alone, yet the previous budget provided only £180 million across both health and social care.
“In November, your good self described social care as the most underfunded and overlooked pillar of Welsh healthcare, and you were absolutely right. So, could you please outline exactly what your response is to those people stuck in hospitals right now?”

Describing social care as “crucial”, Mr ap Gwynfor agreed the importance of social care and said: “If we are going to resolve the issues facing our health service, we need to resolve the issues facing social care, but the issues facing those who are being delayed from discharge, those who can’t get a care package, are more than just the social care, they’re also in primary care.
“It’s the whole-system approach, which is what we’re looking at here, ensuring that we invest, yes, in primary care, making sure that people don’t clog up the system on that front end, and then making sure that people can be discharged safely, so that there’s care in the community.
“And that’s what the plans we’ve put forward look at, ensuring that that care is in the community, closer to home, so that people are seen closer to their home.”
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