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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

Welsh adults using harmful habits to manage mental health

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NEW POLLING shows more than two-thirds of adults in Wales are using potentially harmful coping mechanisms when feeling stressed, anxious or low.

The Mental Health Foundation said the findings, released for Mental Health Awareness Week, show a need for the new Welsh Government to prioritise prevention and action on poor mental health.

The survey found that 69% of adults in Wales had taken harmful actions to cope with their mental health in the past month.

More than a third, 36%, said they had spent time isolating themselves from others, while 34% reported spending more time scrolling social media or going online as a way to deal with anxiety, stress or low mood.

Other commonly reported behaviours included comfort eating or overeating, at 27%, and oversleeping or not getting out of bed, at 31%.

The Mental Health Foundation said these behaviours were concerning because evidence suggests they can make mental health worse over time.

However, the polling also found that many people in Wales are taking positive steps to support their wellbeing.

More than four in five adults, 84%, had taken at least one helpful action to support their mental health. The most common were accessing nature, at 41%, doing something enjoyable such as a hobby, at 37%, and taking part in physical activity or prioritising sleep and rest, at 35%.

The poll of 1,015 people in Wales was carried out by Opinium on behalf of the Mental Health Foundation. It was released to mark Mental Health Awareness Week, which runs from May 11 to 17.

Catherine Razzell, Policy and Public Affairs Manager at the Mental Health Foundation, said: “This polling tells us that, here in Wales, there is a concerning degree of harmful actions taken by people as a way of dealing with their feelings of poor mental health, such as doomscrolling or overeating.

“We are hopeful to see positive actions being taken by individuals to help maintain and improve good mental health. Tried and trusted activities such as connecting with nature, which many of us are fortunate to have access to in Wales, and taking part in physical exercise and rest, in equal measure, are all known to support our mental health.”

Calls for action

The polling found that nearly two-thirds of people in Wales, 64%, are using at least one harmful coping mechanism alongside positive actions.

Only one in five, 20%, reported taking only helpful actions to support their mental health.

The Mental Health Foundation said the results come at a significant moment following the Senedd election, with a new Welsh Government now in place.

Ms Razzell added: “Whilst it is good news people are finding ways to prioritise and protect their mental health and support those around them, more action is needed from our governments to create the conditions to support good mental health.

“We are seeing a once in a generation change politically in Wales. We are one year into the new ten-year mental health strategy for Wales and are keen to see how the new government will implement and resource this.

“In addition to a resourced focus on prevention, which we know has long-term economic benefits, we know that inequalities exist here that are huge barriers to good mental health, keeping people locked in poverty for generations.

“We want to see these issues tackled head-on by the new government for Wales. Now is the time for action and not talk.”

Mental Health Awareness Week is run by the Mental Health Foundation. This year’s theme is “Action”.

 

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Health

Hywel Dda health board celebrates International Nurses Day

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HEALTH chiefs are marking International Nurses Day by celebrating the vital contribution made by nurses across mid and west Wales.

Hywel Dda University Health Board said the day, held each year on May 12, is an opportunity to recognise the work nurses do for patients, families and communities.

This year’s theme is Empowered Nurses Save Lives, reflecting the role nurses play in delivering high-quality, compassionate care, often in challenging circumstances and at some of the most critical moments in people’s lives.

Nurses work across a wide range of settings, including hospitals, community services, primary care, education, research and leadership.

The health board said supporting and empowering the nursing workforce is key to enabling nurses to use their skills fully, continue to develop professionally, and lead improvements in care.

Sharon Daniel, Executive Director of Nursing, Quality and Patient Experience at Hywel Dda University Health Board, said: “International Nurses Day is an important opportunity to recognise the incredible difference our nurses make every single day.

“Empowered nurses save lives, and we see this through the skill, compassion and professionalism shown across our services.

“As we review our Nursing and Midwifery Strategic Framework, Empowered to Care, this is a timely moment to reinforce our commitment to supporting the nursing profession to grow, lead and shape services throughout their careers.

“When our staff feel valued, trusted and supported, teams are stronger and patient care is safer and more effective.”

The health board said nursing is founded on teamwork, with nurses working at the heart of multi-disciplinary teams alongside medical colleagues, allied health professionals and others to deliver joined-up, person-centred care.

It said the approach supports its wider ambition of improving health and wellbeing and providing care closer to home.

International Nurses Day is also being used as an opportunity to thank the nursing and midwifery workforce for their dedication, expertise and commitment to caring for others.

 

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Health

NHS Wales users share mental health support stories

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Two Welsh patients say free online programmes helped them manage anxiety and stress

TWO people who transformed their mental wellbeing with the help of NHS Wales’ online support services are encouraging others to seek help during Mental Health Awareness Week.

Kate, 39, from Cardiff, and George Ryley, 27, from Aberystwyth, both say free online self-help programmes helped them regain control during difficult periods in their lives.

The pair were supported through SilverCloud Wales, a suite of digital mental health programmes based on Cognitive Behavioural Therapy, managed by Powys Teaching Health Board.

The stories are being highlighted as part of Mental Health Awareness Week, which this year focuses on the theme of “Action”.

Parental anxiety

Kate sought help after her young son began suffering febrile seizures, triggering severe anxiety that quickly escalated.

“My chest would tighten and I’d get this feeling like a wave of nausea,” she said. “I couldn’t eat, couldn’t focus.”

She described becoming consumed by fear, constantly checking on her son and worrying about possible seizure triggers.

“I was so distracted at work that I had to stay behind after hours, and at home I didn’t feel I was always present with my son in the right way,” she said.

After speaking with her GP, Kate was diagnosed with parental anxiety and referred to SilverCloud’s “Space from Anxiety” programme.

She said the flexibility of the online course made it easier to fit around family life.

“I could do it in the evening when my son had gone to sleep, or during breaks in the day. It worked around me,” she said.

Kate says she still regularly uses mindfulness, breathing exercises and writing techniques she learned through the programme.

“I haven’t had a single anxiety attack since I started it,” she added. “I’ve not looked back.”

Stress and illness

Meanwhile, Aberystwyth resident George Ryley turned to the service after work pressures and illness left him physically and mentally exhausted.

“I was used to being busy and active,” he said. “Then suddenly, even having a shower would sap all my energy for the day.”

George said a period of poor health linked to mould toxicity left him bed-bound for several weeks and badly affected his mental wellbeing.

After contacting his GP, he was referred for counselling and encouraged to try SilverCloud’s “Space from Stress” programme.

“I didn’t have the most positive mindset at first,” he said. “But as I worked through it, I was amazed at how effective it was.”

Each SilverCloud user is assigned a dedicated supporter who provides encouragement and advice throughout the course.

“Having such lovely feedback on my progress was really motivating,” George said.

“I’ve recommended SilverCloud to so many people who I know have been struggling with stress.”

Taking the first step

Fionnuala Clayton, project manager for NHS Wales’ Online CBT Service, said the stories showed how small actions could make a major difference.

“This Mental Health Awareness Week reminds us that action doesn’t have to be dramatic or overwhelming – sometimes it’s simply about taking that first step to seek support,” she said.

“SilverCloud Wales gives people the tools to understand their thoughts, manage anxiety and stress, and build resilience in a way that fits around busy working and family lives.”

SilverCloud Wales is free to access through NHS Wales and can be used on phones, tablets or laptops.

The service is not intended as a crisis support platform or for those requiring high levels of intervention.

People can sign up at nhswales.silvercloudhealth.com/signup.

 

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