Good quality care highlighted by Healthcare Inspectorate Wales’ latest Annual Report, however, significant challenges ahead for healthcare services

As the organisation with responsibility for checking that people in Wales are receiving good quality healthcare, we have had to adapt our work significantly to continuing discharging our duties whilst meeting the challenges of COVID-19. This involved introducing a new method for gaining assurance remotely and developing new styles of reporting which enabled us to share our findings quickly so that healthcare services could make improvements.

Overall we have found the quality of care provided across Wales over the past year has been of a good standard. We identified numerous examples of innovation and outstanding efforts from staff to ensure that care provision could continue during a hugely challenging period.

Significant changes had been made to environments in all healthcare settings, to reduce risks of transmission. Through our work we found evidence that zoning of areas, cohorting of patients, one way systems and social distancing had been quickly and effectively applied to help control risk of virus and infection transmission. A key area to have emerged from our work over the year, however, is the continued need for infection prevention and control arrangements to be strengthened, particularly in hospital settings, to reduce the risk of transmission.

We developed new approaches to consider the care being delivered at mass vaccination centres and field hospitals. Overall we found that appropriate arrangements had been put in place for the safe implementation of vaccination programmes, and to provide care in field hospitals which were mainly in new, temporary sites. We found evidence of extensive planning and preparation. We did recommend some improvements, for example better fire safety compliance and better arrangements for making sure resuscitation equipment is safe. We also recommended that patient admission criteria to field hospitals was reviewed to ensure appropriate care was being provided.

It is clear that many of the changes introduced to deal with the challenges of COVID-19 have altered the way patients access healthcare services beyond recognition. The fast pace in which these changes have been introduced is impressive and has only been made possible due to the dedication and innovation of staff leading and working within Welsh healthcare. There are risks and challenges associated with rapid change and services will now need to take forward the best of the innovation and change introduced during the pandemic, in order to tackle the unprecedented demand on services which has not gone away. Healthcare services will need to ensure effective consultation with patients and communities who may not have had the opportunity to input into changes introduced at the start of the pandemic to ensure they are inclusive and effective.

It is clear from our work that the pandemic has, and will continue to have, an impact on the well-being of staff who have worked tirelessly in highly pressured environments to maintain services for patients. Supporting staff wellbeing and recognising the continued impact on them as services recover and resume pre-pandemic activity will be of critical importance to the success of healthcare going forwards.

This Annual Report also sees us scrutinise our own performance as an organisation over the past three years. We have assessed progress against our priorities and commitments through engagement with staff, stakeholders and the public.

Alun Jones, the Interim Chief Executive of Healthcare Inspectorate Wales, said:

“For healthcare services, this has been a year like no other. Despite the unprecedented challenges encountered, I have continued to be impressed by the tireless dedication of staff throughout the healthcare sector in Wales. Individuals and services have demonstrated innovation and commitment which has led to the introduction of complex changes at a pace that would not normally be seen. Patients have continued to be treated by staff who have demonstrated time and again that they care about those they look after.

By adapting our models of working, I am pleased that HIW has been able to continue with our goal of checking on the care provided to people in Wales. We have made good progress over the last three years against our ‘Making a Difference’ strategy. As we set our strategy for the next three years we will continue to use our role to encourage improvement in healthcare, building on the best of what we have done to date to deliver the greatest impact.”