Health
One year to go: NHS leaders set out urgent priorities ahead of 2026 Senedd election
Health service calls for shift to prevention, long-term funding and cross-government planning as system faces growing pressure
WITH just one year to go until the next Senedd election, NHS leaders in Wales have issued a stark warning to politicians of all parties: without urgent and radical change, the Welsh health and social care system will face an unsustainable future.
The Welsh NHS Confederation, which represents all health boards and trusts in Wales, has published a new report setting out what NHS leaders want from the next Welsh Government. Based on responses from 95 senior NHS figures across the country, the report highlights the urgent need to move away from reactive, short-term measures and towards a long-term strategy focused on prevention, wellbeing, and coordinated action across government departments.
Key among the recommendations is a call for a cross-government strategy to improve health and reduce inequalities, with 87% of NHS leaders backing a national plan that would tackle the wider causes of poor health—such as poverty, housing, education, and employment.
The Confederation warns that without such action, the NHS will struggle to cope with rising demand, driven by factors including an ageing population, an increase in chronic and preventable illnesses, and ongoing workforce shortages. The number of people in Wales living with four or more long-term conditions is projected to double by 2035, placing even greater strain on already overburdened services.
Darren Hughes, director of the Welsh NHS Confederation, said: “There is only so far the NHS and other public bodies can go in making meaningful, sustainable progress if the right conditions aren’t in place.
“Short-term funding cycles make it extremely difficult for organisations to plan effectively, invest wisely, and build the kind of resilient communities we need. If we are serious about reversing the decline in the nation’s health, we must focus now on prevention, early intervention and addressing health inequalities at their root.”
He added that demographic trends paint a worrying picture, with the proportion of the population aged 80 and over expected to double between 2000 and 2038. This group already accounts for a disproportionate share of NHS activity.
The Confederation is urging the next government to embrace the principles of the Well-being of Future Generations (Wales) Act 2015, which it says are not being fully realised under current funding arrangements.
While the report has been welcomed by many within the sector, some observers note that successive Welsh Governments—both Labour-led and, in coalition periods, involving Plaid Cymru and the Liberal Democrats—have long acknowledged the importance of prevention, yet struggled to shift funding and policy at the necessary scale.
Critics argue that similar calls have been made repeatedly over the past decade, yet the reality on the ground remains dominated by crisis response and waiting list backlogs. In February 2024, the Welsh Government was forced to issue a £175 million emergency funding package to tackle pressures in emergency care and elective surgery.
Meanwhile, the latest statistics from StatsWales show that as of March 2025, over 750,000 patient pathways remain open—meaning more than one in five people in Wales is waiting for planned treatment or assessment. The British Medical Association Cymru has described the situation as “deeply worrying,” while acknowledging the immense strain frontline staff are under.
The Confederation’s report does not shy away from the scale of the challenge, noting that achieving a shift to prevention will require bold political choices, including long-term investment in public health, closer integration with local government and social care, and a reallocation of resources away from acute care.
Political parties are now beginning to shape their manifestos ahead of the May 2026 Senedd election. Welsh Labour, which has led the Welsh Government since devolution began in 1999, has pledged to maintain a publicly funded, publicly delivered NHS. Plaid Cymru has emphasised the need for a “National Health and Care Service” to integrate health and social care. The Welsh Conservatives have called for more choice for patients, greater use of technology, and a reduction in management bureaucracy.
The Welsh NHS Confederation said it would engage with all parties over the coming months to ensure that the voice of health and care leaders is heard in shaping the policy agenda.
Health
Hywel Dda Optometric Team wins at the Optometry Wales Awards 2025
HYWEL DDA UNIVERSITY HEALTH BOARD’S Optometric Team has been honoured with the Health Board Support Award at the Optometry Wales Awards 2025.
The award – sponsored by the Royal National Institute of Blind People (RNIB) – was presented by BBC Wales broadcaster Lucy Owen during a ceremony held in Cardiff on 29 November 2025.
Organised by Optometry Wales, the awards celebrate outstanding achievement across the eye-care sector in Wales. They recognise individuals and teams whose work goes above and beyond through clinical excellence, innovation, sustainability, mentoring, and service development.
Recognising leadership and support during major reform
Hywel Dda’s Optometric Team received the award for its significant support to practices across Carmarthenshire, Ceredigion, and Pembrokeshire during the rollout of the new national Optometry contract.
Their nomination highlighted the team’s strong leadership through the transition period and their commitment to ensuring practices were fully equipped to deliver high-quality eye health services under the new contract.
A key part of this work was developing new clinical pathways to ensure more patients could be safely managed in primary care. These pathways have improved access to timely local care and reduced the need for hospital appointments, ensuring people receive the right care in the right place.
Over 13,300 community appointments delivered
Since January 2024, more than 13,300 appointments have taken place in community settings using these enhanced pathways. Previously, many of these cases would have required referral to the hospital eye service. Now, an average of only 13.9% of patients require hospital referral — a significant shift demonstrating the positive impact of strengthened community-based care.
The team has also played a central role in developing Optometry Collaboratives, bringing together local practices to share ideas, improve services, and meet the needs of the local population.
“A fantastic achievement”
Rachel Absalom, Head of Optometric Services at Hywel Dda UHB, said: “We are incredibly proud to receive this award. It reflects the dedication of our committed team and the strong relationships we have built with practices across Carmarthenshire, Ceredigion and Pembrokeshire.
“The new pathways have made a real difference for patients, enabling more care to take place closer to home, and we are grateful to our colleagues in primary care who have worked with us to make this possible.”
Professor Philip Kloer, Chief Executive, added: “This is a fantastic achievement and recognises the vital work of our Optometric Team in supporting the rollout of the new national contract. Their leadership has strengthened local services and helped patients receive care closer to home.
“I’m also delighted to see several independent practices from our region recognised on the night, which demonstrates the exceptionally high standards of care delivered across Hywel Dda.”
Six regional wins on the night
A total of six awards were won across the Hywel Dda region. They included:
- Optometrist of the Year: Andy Britton (Specsavers Haverfordwest)
- Independent Practice of the Year: MN Charlton (Concept Eye Clinic, Fishguard)
- Dispensing / Contact Lens Optician of the Year: Samantha Houghton (Specsavers Haverfordwest)
- Sustainability Practice of the Year: Specsavers Haverfordwest
- Technology Practice of the Year: Specsavers Haverfordwest
Photo (left to right)
Lucy Owen (Presenter)
Sally Hodson (Optometric Advisor, HDUHB)
Rachel Absalom (Head of Optometric Services, HDUHB)
Hannah Rowlatt (External Engagement Officer, RNIB)
John Dixon (NHS Wales Engagement Manager, RNIB)
Jaynie Scourfield (Quality Assurance Manager – Primary Care, HDUHB)
Mary Owens (Head of Dental and Optometry, HDUHB)
Health
Major investment confirmed for GP services in Wales
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.
Health
Welsh NHS leaders hail GP contract deal as “vital step” in strengthening primary care
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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