Wales warned to act fast as damning report reveals staff trauma, delayed care and deadly gaps

THE UK’s healthcare system came perilously close to collapse during the Covid-19 pandemic, a major public inquiry has found, with Wales now facing pressure to act on urgent recommendations.

A landmark report published on Thursday (Mar 19) lays bare the scale of the crisis, concluding that hospitals across the UK – including in Wales – were pushed to “intolerable strain”, with some patients receiving lower levels of care and others left untreated altogether.

The findings come as First Minister Eluned Morgan welcomed the report and confirmed the Welsh Government will respond within six months.

System “ill-prepared” for pandemic

The inquiry found the UK entered the pandemic in a weakened state, with staff shortages, too few hospital beds, and ageing infrastructure already placing pressure on services.

Healthcare systems “coped, but only just,” the report states, warning that collapse was only avoided due to the “almost superhuman efforts” of NHS staff.

Many workers suffered severe mental health impacts, with burnout and post-traumatic stress widespread across the workforce.

Patients died alone

Among the most distressing findings was the impact of strict hospital visiting rules.

Thousands of patients died without family by their side, while relatives were often forced to say goodbye over the phone or by text.

The report highlights how restrictions, though intended to save lives, caused lasting trauma for families across Wales and the UK.

Missed treatment and cancer delays

The inquiry also exposes the devastating knock-on effect on non-Covid care.

Planned operations were cancelled, screening programmes paused, and patients avoided hospitals out of fear – leading to delayed diagnoses and, in some cases, avoidable deaths.

Cancer treatment performance worsened, with late diagnoses contributing to increased mortality.

“Fundamental flaws” in response

Investigators identified serious failings in how the pandemic was handled, including:

• Early guidance that underestimated airborne transmission
• Shortages of PPE, leaving staff exposed
• Poor communication with vulnerable patients
• Inadequate planning for emergency and critical care capacity

These issues, the report says, put both patients and staff at greater risk.

NHS 111 and ambulances overwhelmed

Emergency systems also struggled to cope.

Demand for NHS 111 surged beyond capacity, while ambulance delays increased – even for life-threatening calls.

The report warns future pandemics could see similar failures unless urgent reforms are made.

Long Covid and hidden impact

The long-term effects of Covid are still being felt, with inconsistent care for Long Covid patients and ongoing uncertainty around treatment.

Meanwhile, millions of people who needed routine care remain affected by the backlog created during the pandemic.

Welsh Government response

First Minister Eluned Morgan said the Welsh Government would respond “openly and constructively” to the findings.

She acknowledged the significant impact on patients, staff and families and confirmed Wales will address the inquiry’s recommendations within the required six-month timeframe.

Urgent warnings for the future

The inquiry makes ten key recommendations, including:

• Expanding hospital and emergency capacity
• Improving infection control guidance
• Strengthening support for healthcare workers
• Better data systems to identify vulnerable patients

It warns that without action, the NHS may not withstand the next pandemic.

“We may not be so lucky next time”

In one of the report’s starkest conclusions, Baroness Hallett warned that healthcare systems came dangerously close to failure.

If the crisis had lasted longer – or hit harder – the NHS could have collapsed entirely.

The message is clear: Wales and the UK must prepare now, or risk repeating the same mistakes.

Record progress claimed by Welsh Government as critics warn key targets are still being missed

THE NHS in Wales has recorded its biggest-ever monthly drop in waiting lists, according to new figures released on Thursday (Mar 19), but worsening cancer treatment times and a growing diagnostic backlog highlight ongoing pressure on services.

The latest data shows the waiting list fell by 27,900 in January — the largest monthly reduction on record — marking eight consecutive months of decline.

Average waiting times have now dropped to around 18 weeks, the lowest level since before the pandemic.

Cancer target slips further

Despite the overall progress, performance in cancer care has deteriorated.

Just 57% of patients began treatment within the 62-day target in January — down from 60.7% in December and well below the 75% target.

Diagnostic delays at highest level in two years

The figures also show growing pressure in diagnostic services.

Around 135,300 patient pathways were waiting for diagnostic tests in January, with more than 48,300 waiting longer than the eight-week target — the highest level recorded since January 2024.

These delays can have a knock-on effect on treatment, as patients often cannot begin care until tests and scans are completed.

Emergency care targets still missed

Performance in emergency departments remains well below national targets.

Only 63.7% of patients spent less than four hours in A&E, against a target of 95%.

Nearly 10,000 patients (9,817) waited more than 12 hours in January, despite a target of zero.

Ambulance response times for life-threatening “red” calls averaged 8 minutes 54 seconds.

However, separate February data shows some improvement, with faster response times and reduced handover delays at hospitals.

Long waits remain far higher than England

While long waits have reduced overall, they remain significantly higher than in England.

More than 5,200 patients in Wales are still waiting over two years for treatment, compared with around 200 in England.

The Welsh Government had previously pledged to eliminate these waits by March 2023 and again by March 2024.

West Wales focus: Hywel Dda sees progress — but pressure remains

In west Wales, Hywel Dda University Health Board is increasing activity to tackle waiting times, supported by additional Welsh Government funding.

Health Secretary Jeremy Miles is visiting Prince Philip Hospital in Llanelli as part of efforts to highlight improvements, including increased outpatient appointments and record levels of operations.

Across Wales, health boards have delivered an additional 187,000 outpatient appointments and 37,000 cataract operations.

However, hospitals serving Pembrokeshire, Carmarthenshire and Ceredigion continue to face sustained demand.

Emergency departments across the Hywel Dda area have been operating under “extreme pressure” in recent months, with winter demand, staffing challenges and delays in patient discharge continuing to impact performance.

Political row over NHS performance

Welsh Government ministers say the figures show “real, tangible progress” in reducing waiting times.

Health Secretary Jeremy Miles said: “The waiting list has fallen for the eighth month in a row, a new record reduction, and the longest waits are down yet again.”

However, opposition parties say the improvements are not being felt where it matters most.

Peter Fox MS, Chair of the Senedd’s Health and Social Care Committee, said: “Cancer waiting times are worsening, with fewer patients starting treatment on time and no sign of sustained improvement.”

Reform UK Senedd Member James Evans MS added: “The waiting list for diagnosis is the highest we’ve seen for over two years, with no credible plan to fix the NHS.”

Welsh NHS Confederation

Responding to the NHS Wales activity and performance statistics for December and January, director of the Welsh NHS Confederation, Darren Hughes, said: “It’s encouraging to see continued month-on-month improvements in NHS waiting times, now for the eighth consecutive month. We commend the hard work of NHS staff and leaders who are driving this noteworthy progress.  

“However, urgent and emergency care pressures remain. So, while targeted funding to boost progress in scheduled care is welcome, to achieve sustainable, long-term improvements across the breadth of health and social care, we need a more robust, whole-system approach that tackles the root causes of challenges.

“So far, what we’ve seen in party manifestos do not go anywhere near far enough to deliver the transformation needed to ensure the sustainability of our health and care services so they deliver for the people of Wales. It is not simply about having more beds, more diagnostic centres or more surgical hubs, we need a long-term commitment to deliver for the people of Wales.

“We need a long-term capital investment strategy to modernise NHS estates and infrastructure (including digital), an achievable plan to stabilise social care, an all-Wales long-term workforce plan for the NHS and social care workforce, joint performance and financial frameworks, and a cross-governmental shift towards prevention to drive down demand on health and care services.”

“It’s not easy but we need bravery and longer-term commitments from political parties – in line with the Well-being of Future Generations Act – so the people of Wales can live healthier, longer lives.”

Mixed picture across Wales

The latest figures present a mixed picture.

While waiting lists are falling and average waits are improving, performance in cancer care, diagnostics and emergency services continues to lag behind targets.

For patients across west Wales, the data reflects both progress and ongoing pressure as the NHS continues to recover while demand for services remains high.

HYWEL DDA Health Charities, the official charity of Hywel Dda University Health Board, is proud to announce a funding award to support Phase 2 of the Heads Up initiative, a unique service that provides expert, person-centred, holistic hair loss care for people affected by cancer treatment.

This funding will enable the continuation of the Heads Up service until 31 December 2027, following its successful launch in January 2024. The funding has been generously match-funded by two partner organisations: the Withybush Hospital Cancer Day Unit Appeal and Cancer Hair Care.

Hywel Dda University Health Board is the first Health Board in Wales to provide a comprehensive support service for chemotherapy-related hair loss. The service, which is delivered by Cancer Hair Care, connects healthcare professionals and haircare experts from local communities to empower patients to manage their hair loss journey with independence, dignity and choice.

Gina Beard, Lead Cancer Nurse, said: “We are incredibly grateful to our local communities for their generous donations, which have made this funding possible. Hair loss can be one of the most distressing side effects of cancer treatment, and this service helps patients feel heard, supported and equipped with practical tools and advice. Thanks to this funding, we can continue to offer inclusive, compassionate care that makes a real difference to people’s lives.”

The Heads Up initiative has already delivered thousands of touchpoints with patients, healthcare professionals and hairdressers across the Hywel Dda area. It offers tailored support for every stage of the hair loss journey, including headwear options, brow and lash care, and guidance on new hair growth. The service also provides training for nurses and local hairdressers, helping to build a community of informed professionals who can offer evidence-based support.

Nicola Llewelyn, Head of Hywel Dda Health Charities, said: “We are so thankful to everyone who has donated to Hywel Dda Health Charities. Your support enables us to fund projects like Heads Up that go beyond standard NHS provision and truly enhance patient care.”

Trish George, Treasurer of Withybush Hospital Cancer Day Unit Appeal, said: “Having funded the original pilot and Phase 1 of the Heads Up project in Pembrokeshire and witnessed its success, we are delighted to be able to fund the costs of delivering this exciting and beneficial project to many more Pembrokeshire residents over the next two years.”

Founder of Cancer Hair Care Jasmin Julia Gupta said: “So many of the service users have sent such heartfelt messages of thanks for the creative, compassionate and expert services they have received. We are delighted and privileged to continue this much needed service. It’s really a team effort and I would like to take this opportunity to thank all the patients, nursing and healthcare staff, funders and the dedicated hairdressers, who have supported this project in hospitals and within the community.

“We are looking for more hairdressers to join the project and would like to encourage hairdressers to contact Cancer Hair Care directly to show their interest via our website at www.cancerhaircare.co.uk or via email at [email protected].”

For more information about Hywel Dda Health Charities and how to support projects like Heads Up, please visit: https://hywelddahealthcharities.nhs.wales/

Pictured: NHS staff receive training in supporting patients with hair loss