Health
NHS Wales workforce crisis: Audit Wales report highlights key challenges
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

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

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

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
‘We are on our own’: Unpaid carers forced to ‘beg’ for support
UNPAID carers are being left to “pick up the pieces” of a broken system due to a lack of respite, unsafe hospital discharges and carer’s assessments that result in “nothing at all”.
The warning came as the Senedd’s health scrutiny committee began taking evidence for an inquiry on access to support for more than 310,000 unpaid carers across Wales.
Chris Kemp-Philp, from Newport, who has been a carer for 33 years, gave up her career to become a full-time carer after her husband medically retired from the civil service in 1990.
Ms Kemp-Philp, whose husband died in April, told today’s (December 4) meeting: “I thought he’d been really badly treated… The last four months of his life were dreadful for both of us.”
She was only offered an updated carer’s needs assessment – a right under the 2014 Social Services and Wellbeing (Wales) Act – the day after her husband died.
Ms Kemp-Philp did not realise she had become a carer at first. “But, of course, having lost two incomes and to survive on a half civil service pension wasn’t great,” she said.
She told the committee how the couple “shielded” during the pandemic, saying: “For the past five years, basically, apart from going to a hospital or… a medical facility – I didn’t leave the house because if I’d have gone out, I could have brought something home.
“So, we spent five years literally avoiding people. The experience was unpleasant, I had two great-grandchildren born in that time and I only saw them on video.”
Ms Kemp-Philp said her husband was “pingponged” back and forth after unsafe discharges from hospitals in Gwent. He was put in a car by two nurses then she had to get him out on her own at the other end, with clinicians effectively telling her: it’s your problem now.
“Every time he was sent home, nobody came to help at all,” she said, explaining how she struggled to cope and her husband’s death brought a tragic sense of relief.
Judith Russell, who moved back to Wales to care for her mother 23 years ago, told Senedd Members the responsibility grew greater over the years.

Ms Russell, whose mother died last Saturday on the eve of her 102nd birthday, told the committee: “It’s been my privilege to care for her but I wish other people—I wish there had been more actual care for her. That’s it.”
Ms Russell also cares for her husband who has Alzheimer’s disease, acts as guardian for her disabled sister and cooks every week for her sister-in-law.
“It’s quite a responsibility,” she said. “My life is taken up with caring. I didn’t actually know I was a carer, I cared for my mother because she was my mother – I looked after her, of course I did – and it wasn’t until about three years ago that I identified as a carer.”
Ms Russell warned: “All through this last 23 years, I’ve had to fight and struggle to find things out… there’s very, very little help out there.”
She said she was given a carer’s assessment earlier this year but “there was nothing they could offer me, quite frankly – nothing at all”.
Ms Russell told Senedd Members: “We had a diagnosis [but] there’s no offer of help, there are no directions to find help, somebody to point you – you should be doing this, this is available, that’s available – nothing, you’re on your own completely.”
She joined the Bridgend carers’ group which opened a door to other people grappling with the same weight of responsibility and helped navigate the system. Ms Kemp-Philp added that joining a similar peer support group saved her life.
Ann Soley, who is originally from France and has been living in Wales for eight years, described how life was turned upside down when her British husband had a stroke.

She said: “We are stressed, we are lost. A lot of carers have lost their friends, that is just unbelievable for me because I realised society is not there – there is no compassion.”
Kaye Williams, who works at Bridgend carers’ centre and is herself a carer, warned the witnesses’ experiences are commonplace across the country.
Sue Rendell, from Caernarfon, has cared for her husband who has vascular parkinsonism for nearly 14 years and was waiting for a doctor to call as she gave evidence remotely.
She told the committee: “You go in in the morning to see if he’s still breathing to be honest. We’re at the later stages of his disease and it’s physically demanding, it’s mentally demanding and it’s administratively difficult as well… it’s just very wearing.”
Ms Rendell, who was shattered after a late night caring, said she has tried to get respite but has been told there’s nothing available in Gwynedd nor Anglesey for her loved one’s needs.
She told the committee unpaid carers in Wales are “expected to pick up the pieces” but “nothing much happens” after an assessment. “Fine words butter no parsnips,” she said.
Ms Russell added: “As carers, we save the government millions… and I asked for some help this week actually. I’m 258th on the list for a hip replacement… and I asked the doctor: as a carer, couldn’t I possibly go up the list a little bit? ‘No, we’re not allowed to do that.’
“It’s the only thing I’ve ever asked for.”
Education
‘Sink or swim’: Young carer sat exam hours after 3am hospital ordeal
A TEENAGE carer sat a GCSE exam only hours after getting home from a hospital at 3am following a family emergency, a Senedd committee has heard.
The warning came as witnesses highlighted a “sink-or-swim” reality where children as young as three are taking on caring roles while feeling invisible to schools and social services.
Elektra Thomas, 15, who cares for her autistic, non-verbal brother and her epileptic sister, was part of a remarkable and articulate trio of teenagers who gave evidence to a new health committee inquiry on access to support for unpaid carers today (December 4).
The teenager helps her brother Blake get ready for school in the morning and helps him communicate by acting as his voice, which she has done since about three years old.
Ms Thomas told Senedd Members her sister has two children, “so I’m either handling her having a seizure, running around with her medication… or I’m looking after her kids”.
She said: “I’ve been having school assessments at the same time she’s had a seizure. I’ve been in ambulances waiting for her to get into a hospital while also studying.”
Ms Thomas explained how she is unable to focus on her schoolwork if her brother has had an overwhelming day. “I can’t focus on myself and I don’t have time for myself,” she said.
The teenager, who is from Carmarthenshire, described how she was once in hospital until 3am then sat a test – which went towards her GCSE grades – that same day.
Ms Thomas warned young carers do not have time to manage their own mental health, saying: “I didn’t have time for myself, I had time for my brother and sister and that was it.”
She said: “As a young carer who wasn’t noticed for a decade, it was pure manic: I had no coping skills, I had no support – and this has been going on since I was about three or four.”
Ffiôn-Hâf Scott, 18, from Wrexham, who is working while studying in sixth form, has similarly been a carer since she was four years old.
“I used to care for my mum and my sister,” she told the committee. “My sister used to be in a psychiatric ward, she was there for seven years.
“And I care for my mum because she’s diabetic, classed as disabled, has a long list of mental health issues, she has in the past suffered a stroke and had cancer.
“I don’t know how she’s still standing.”

Ms Scott said: “The main challenge right now is looking after myself and learning that you actually have to keep yourself afloat… to keep looking after someone else.
“I think for a very long time I ran on nothing because of my caring role or I didn’t think about the things I needed to do for me, so respite and things like that.”
The Welsh Youth Parliament member warned a lack of support for young carers has been normalised, saying she has had to explain herself 70 different times while aged 12.
Ms Scott said: “I remember going to my teacher and saying – we had a piece of coursework – look I can’t do this right now… you’re going to have to fail me…
“Their response was just ‘well, you have too much on your plate and you need to take things off your plate’ and I was like: it’s very bold of you to stand where you’re stood and say that to me because it’s not a choice to take on the things that we do take on.”
She recalled receiving a phone call about her mum collapsing moments before a maths test and expressed concerns about the prospect of mobiles being banned in schools.
Albie Sutton, 16, a young carer from north Wales, looks after his disabled mother by doing things such as cleaning the house, budgeting and cooking for the family every day.

Mr Sutton said: “It’s a real struggle for her to move around the house, to even do stuff like getting dressed or moving to the toilet by herself… so I’ve got to help her.”
The teenager estimated his caring role takes up about 25 hours a week and makes it difficult for him to pursue some of his hobbies such as competing in powerlifting.
“My mind feels like a hive of bees,” he said. “There’s so many things going in and out… I get home at the end of the day and I’m like ‘oh my God, I’ve got to do this, I’ve got to do that’.”
Warning of the mental stress, he added: “It’s also really difficult for me to socialise… I feel very isolated in my caring role, especially at home. I’m always housebound, I never get the opportunity even just to go out in my local town.”
Mr Sutton told Senedd Members it plays on his mind that his younger brother may have to take on responsibility. “It’s got me debating whether I can go to university,” he said.
He called for a Wales-wide campaign to raise awareness among educators and employers of the issues young carers face and how to recognise the signs.
Ms Thomas agreed: “I’ve had multiple teachers look at me and go ‘what’s a young carer, sorry?’. I’ve had pharmacists go ‘are you sure you’re a young carer?’ and it baffles me.”
Health
Fresh alarm over life expectancy in Wales as CMO warns of ‘prevention revolution’
WALES is living sicker for longer, the Chief Medical Officer has warned, as new figures show a worrying drop in the number of years people can expect to live in good health – with women hit hardest.
The findings, published today in Dr Joanne Absolom’s first annual report since taking over from Sir Frank Atherton, have prompted immediate calls for the next Welsh Government to overhaul its approach to public health after the 2026 Senedd election.
Dr Absolom says Wales must now move decisively away from a system that largely treats illness towards one that prevents people becoming ill in the first place. Her report warns that healthy life expectancy is falling across the country and highlights widening inequalities between communities.
Responding to the findings, Darren Hughes, Director of the Welsh NHS Confederation, said the message could not be clearer.
“NHS leaders in Wales welcome the report’s call for a prevention-first approach,” he said. “We have to move from simply treating illness to actively promoting wellbeing, and that means a proper cross-government strategy that tackles inequality and gives people the support to take control of their own health.”
He added that every pound spent on proven public health programmes delivers an average return of £14 – evidence, he said, that prevention “makes moral and financial sense” at a time when NHS budgets are under extreme pressure.
“It is deeply concerning to see healthy life expectancy falling, particularly for women,” he said. “Investment in prevention is vital if we are to make our health and care services sustainable.”
While health boards, councils and community groups are already working on preventative programmes, the Welsh NHS Confederation says Wales needs far greater ambition – and the NHS must be given the tools and flexibility to scale up what works.
The Chief Medical Officer’s report also raises serious concerns about NHS workforce shortages and urges significant investment in digital technology to improve productivity and patient outcomes.
Mr Hughes said all political parties should “take heed” as they prepare their manifestos for next year’s Senedd election.
“Those seeking to form the next Welsh Government have a clear blueprint here. We cannot keep doing the same things and expect different results. Prevention, workforce and digital transformation have to be top priorities.”
The Welsh NHS Confederation — which represents all seven health boards, the three NHS trusts, HEIW and Digital Health and Care Wales — has already outlined its detailed priorities in its own election document, Building the health and wellbeing of the nation.
With the Senedd election just over a year away, today’s report adds fresh, authoritative evidence that Wales needs a radical shift in how it approaches health if it is to secure a healthier future for all.
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