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Health

State of the NHS in Wales: Balancing challenges and progress

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THE NHS in Wales continues to navigate a complex landscape of challenges and achievements as it strives to deliver quality healthcare to its population.

Recent reports highlight both the pressures faced by the system and the initiatives underway to address them.

Healthcare professionals across Wales have expressed concerns over increasing workloads and resource constraints. Hospitals are grappling with high patient numbers, leading to extended waiting times for elective surgeries and specialist consultations. According to figures released by NHS Wales in September 2023, the number of patients waiting for treatment exceeded 750,000—a record high.

Emergency departments have reported surges in attendance, putting additional strain on staff and facilities. In August 2023, A&E departments across Wales recorded their busiest summer on record. Dr. Rachel Davies, an A&E consultant at the University Hospital of Wales in Cardiff, commented, “We’ve seen unprecedented numbers of patients this year. Our staff are working tirelessly, but the demand is overwhelming.”

In rural areas like Pembrokeshire, the situation is compounded by geographical hurdles. This newspaper has recently highlighted concerns over ambulance response times in the county, noting that residents in remote locations often face longer waits for emergency services. Local resident Sarah Jenkins shared her experience: “When my mother fell ill, it took over an hour for the ambulance to arrive. In critical situations, every minute counts.”

A shortage of medical personnel remains a significant issue. Recruitment and retention of doctors, nurses, and allied health professionals are ongoing concerns. The Royal College of Nursing Wales reported in October 2023 that there are over 1,800 nursing vacancies across the country. Many professionals cite burnout and limited resources as factors influencing their decision to leave or avoid joining the NHS workforce in Wales.

Eluned Morgan, the Welsh Minister for Health and Social Services, acknowledged these challenges during a recent Senedd debate. “We are acutely aware of the staffing shortages and the immense pressure our healthcare workers are under,” she said. “Addressing these issues is a top priority for the government. We’re investing in training and recruitment to bolster our workforce.”

Opposition parties have called for more decisive action. Plaid Cymru’s health spokesperson, Rhun ap Iorwerth, stated, “The staffing crisis in our NHS is not just a numbers problem; it’s about the wellbeing of those who dedicate their lives to caring for others. We need urgent measures to support and retain our healthcare professionals.”

In response to the mounting pressures, the Welsh Government has increased funding for the NHS, aiming to improve infrastructure and service delivery. The 2023 budget included an additional £425 million allocated to health and social services. Investments are being made in modernising hospitals, expanding digital healthcare services, and streamlining patient care pathways.

The then First Minister Mark Drakeford addressed the situation during a press briefing in September 2023: “Our commitment to the NHS is unwavering. We are working closely with health boards to tackle waiting times and ensure that everyone in Wales has access to the care they need.”

The government has also launched targeted recruitment campaigns and enhanced training opportunities to bolster staffing levels. “We are investing in our future workforce,” Eluned Morgan added. “By supporting education and providing incentives, we aim to attract new talent to the NHS and retain our valued staff.”

Despite the hurdles, there are success stories emerging within the NHS in Wales. Community-based health programmes are making strides in preventive care, focusing on wellness and early intervention to reduce the burden on hospitals. For instance, the “Healthy Pembrokeshire” initiative aims to promote healthy lifestyles through local events and education.

Telemedicine initiatives have been accelerated, particularly in response to the COVID-19 pandemic, enhancing access to care for those in remote areas. Dr. Gareth Thomas, a GP in Ceredigion, noted, “Virtual consultations have been a game-changer for patients who live miles away from the nearest clinic. It has significantly improved access to care and reduced travel times.”

Healthcare professionals are also embracing collaborative approaches, with multidisciplinary teams working together to provide comprehensive care. These efforts aim to improve patient outcomes and increase efficiency within the system.

Patients have offered mixed feedback on the state of the NHS in Wales. While many praise the dedication of healthcare workers and the quality of care received, others express frustration over delays and difficulties in accessing services.

John Evans, a patient awaiting hip surgery, shared his experience with Wales Online: “I’ve been on the waiting list for over 18 months. The pain limits my mobility, and it’s affecting my quality of life. I understand the pressures the NHS is under, but the delays are disheartening.”

Advocacy groups are calling for increased transparency and patient involvement in decision-making processes. The Patients Association Wales has urged the government to “prioritise patient voices in policy development and healthcare planning.”

The Welsh Conservative health spokesperson, Russell George, commented, “Patients are bearing the brunt of systemic failures. The Welsh Government must take responsibility and implement effective strategies to reduce waiting times and improve service delivery.”

The NHS in Wales stands at a critical juncture. Balancing immediate demands with long-term strategic planning is essential to address the systemic issues at hand. Continued investment, innovative solutions, and collaborative efforts between the government, healthcare providers, and communities are key to strengthening the NHS for future generations.

As the nation navigates these challenges, the resilience and commitment of its healthcare professionals remain a beacon of hope. The path forward will require concerted efforts to ensure that the NHS can continue to uphold its founding principles of providing comprehensive, accessible healthcare to all.

Health

Major investment confirmed for GP services in Wales

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Government unveils £41m boost, but practices warn pressures remain acute

MORE than £41m in extra funding will go into general practice in Wales this year following a new agreement between the Welsh Government, NHS Wales and GP leaders. Ministers say the deal provides stability at a time of rising demand — but the settlement comes against a backdrop of sustained pressures, recruitment challenges and concerns over patient access.

The package includes a 4% uplift to the General Medical Services (GMS) contract for 2025-26, in line with independent DDRB pay recommendations, and a guaranteed 5.8% recurrent uplift from 2026-27. The Welsh Government says the multi-year commitment will allow practices to plan ahead, modernise systems and strengthen community-based services.

Health Secretary Jeremy Miles said the investment showed an “unwavering commitment” to general practice, adding: “The 4% pay uplift ensures fair recognition for GPs and practice staff who work tirelessly to deliver care for communities across our country. Multi-year funding gives practices the confidence to invest in the transformation primary care needs.”

However, the announcement comes at a time when many Welsh practices continue to report severe workforce pressures, rising demand, and longstanding challenges in recruiting new partners. GP numbers have fallen over the past decade, with some practices handing back contracts or operating list closures because of unsustainable workloads. Patient satisfaction with access has also declined, according to the latest Welsh GP Patient Survey.

What the deal includes

The settlement for 2025-26 comprises £37.9m of new investment and £4m in re-invested capacity funding, with the key elements including:

  • A 1.77% uplift in expenses, intended to help practices manage inflationary pressures in energy, staffing and running costs.
  • A recurrent £20m stabilisation fund to support practices facing immediate operational pressures and to prepare for wider reform under the incoming Sustainable Farming Scheme model for health.
  • An increased partnership premium, aimed at retaining experienced GPs and encouraging new partners into a model that some say has become less attractive due to financial and regulatory risk.
  • A full review of the GMS allocation formula — the first in more than 20 years — which determines how funding is distributed between practices. Some rural and deprived communities have long argued the current system does not reflect the complexity of local health needs.

Wider context

General practice remains the foundation of the NHS, accounting for around 90% of patient contacts, yet it receives a proportionally small share of the overall health budget compared with hospital services. Both the Welsh NHS Confederation and GPC Wales have repeatedly warned that without sustained investment, primary care risks being unable to meet increasing demand from ageing populations and rising chronic illness.

The Welsh Government’s own “community-by-design” programme relies on shifting more care closer to home, reducing pressure on emergency departments and supporting earlier intervention. For that to be achieved, GP leaders say investment needs to be matched with workforce expansion, improved digital systems, and clear strategies to retain experienced clinicians.

Working groups will now be set up to examine access standards, diabetes prevention and new service models.

Mr Miles said he was pleased that GPs would be “actively contributing to creating innovative care models that enhance access, improve outcomes and deliver care locally.”

GP representatives broadly welcomed the deal but have stressed that it is only one step in addressing the scale of challenge across primary care.

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Health

Welsh NHS leaders hail GP contract deal as “vital step” in strengthening primary care

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Agreement secures investment, digital upgrades and better patient pathways

WELSH NHS leaders have welcomed the successful conclusion of the new General Medical Services (GMS) contract for 2025-26 — and key elements of 2026-27 — describing it as a “positive example of social partnership” at a pivotal moment for general practice.

The deal, negotiated between Welsh Government, the Welsh NHS Confederation and GP representatives, sets out new investment and commitments for frontline primary care, including accelerated digital transformation through the NHS Wales App and strengthened support for population-level health management.

Darren Hughes, director of the Welsh NHS Confederation, said the agreement comes at a crucial time for GP services across Wales.

He said: “NHS leaders welcome this agreement as a positive example of social partnership in action. We also welcome the commitment to accelerating digital transformation for patients through the NHS Wales App and the measures agreed in the contract to enable enhanced population health management, such as diabetes management.”

Mr Hughes added that GPs and their multidisciplinary teams remain “the front door to the NHS,” and stressed that investment in general practice is essential if Wales is to treat more people closer to home.

“Evidence shows investing in primary and community care reduces demand on hospitals and emergency care and delivers returns of £14 for every £1 invested. To enable this shift ‘upstream’ from hospital-centred care to integrated services in the community, we must develop care pathways and joint performance measures that address the full needs of individuals,” he said.

Background: Why the GP contract matters

General practice forms the foundation of the Welsh NHS, handling millions of patient contacts every year. According to the latest official figures for 2023-24:

  • Over 29 million calls were received by GP practices
  • 18 million appointments took place
  • 11 million of these were face-to-face
  • More than 200,000 home visits were carried out
  • 78 million prescriptions were dispensed
  • Over 14,000 medication reviews took place

Demand has continued to rise while GP numbers have come under sustained pressure, particularly in rural areas such as Pembrokeshire, Ceredigion and Powys, where recruitment remains a long-running challenge. Practices in West Wales have repeatedly reported difficulties filling vacancies and increasing reliance on multidisciplinary teams, including nurse practitioners, pharmacists and physiotherapists.

The new GMS contract is therefore seen as a key mechanism for stabilising the sector, supporting digital access, improving chronic disease management, and helping to deliver the Welsh Government’s community-by-design programme, which aims to shift care away from hospitals and into community settings.

A recent survey by the Welsh NHS Confederation found that 74 per cent of NHS leaders support moving resources from acute hospital services into primary care, community-based services, mental health and social care, reflecting growing consensus around early intervention and prevention.

What comes next

The Welsh Government is expected to outline further detail in the coming months on how investment will be delivered at practice level, including support for digital tools, workforce development and shared performance measures with health boards.

With winter pressures mounting and hospitals facing record demand, NHS leaders say the success of the new GP contract will be central to improving access, reducing waiting times and ensuring patients in communities such as Pembrokeshire, Carmarthenshire and Ceredigion can receive timely, local care before conditions escalate.

The Welsh NHS Confederation represents all seven local health boards, the three NHS trusts, Health Education and Improvement Wales, and Digital Health and Care Wales.

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Charity

Motorcycle fundraisers transform children’s play area at Glangwili Hospital

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Long-running 3 Amigos and Dollies group marks 25 years of support

THANKS to outstanding fundraising by the Pembrokeshire-based 3 Amigos and Dollies Motorcycle Group, Hywel Dda Health Charities has funded a major improvement of the outdoor play area at Cilgerran children’s ward in Glangwili Hospital — a project costing more than £15,000.

The 3 Amigos and Dollies have supported Hywel Dda University Health Board’s children’s services for twenty-five years, with their Easter and Christmas toy runs becoming landmark dates in the local calendar, drawing hundreds of bikers and supporters from across west Wales.

The latest funding has delivered a full transformation of the ward’s outdoor space, including a re-sprayed graffiti wall, new toys and play equipment, a summer house, improved storage, and a moveable ramp to make the area more accessible for young patients. Members of the group even volunteered to help paint and refresh the space themselves.

Paula Goode, Service Director for Planned and Specialist Care, said: **“We are so grateful to the 3 Amigos and Dollies Motorcycle Group for their amazing support. Not only have they raised an incredible amount for the ward, but they have given their time to help make the outdoor space as special as possible.

“Outdoor play greatly reduces stress and anxiety for children, and it provides a vital opportunity to meet other young people going through similar experiences. It benefits both their physical and mental wellbeing, so we couldn’t be happier with the transformation.”

Tobi Evans, a volunteer with the fundraising group, said: “Because of the generosity of everyone who donates, we are able to give thousands each year. We are always humbled by how much people give, and it’s thanks to them that we’ve reached our 25th year.”

Katie Hancock, Fundraising Officer for Hywel Dda Health Charities, added: “We can’t thank the 3 Amigos and Dollies enough for their support for Cilgerran ward. You have put a smile on so many faces. Diolch yn fawr!”

Hywel Dda Health Charities funds items, equipment and activities that go beyond core NHS funding, making a meaningful difference to children and families across mid and west Wales.

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