Annual Report: Healthcare Services in Wales remain under ‘sustained pressure’
Healthcare Inspectorate Wales (HIW) has today published its Annual Report for 2023-2024, highlighting key findings from the regulation, inspection, and review of healthcare services across Wales. The report provides insight into the quality of care delivered to the people of Wales, and outlines areas where improvements are needed to ensure services remain safe, effective, and patient-centred.
The report highlights the hard work and dedication of healthcare staff, but also brings to light the sustained pressure and challenges facing the system. Over the past year, HIW has conducted 172 onsite inspections across various healthcare settings, including hospitals and GP practices. It has found the system is still struggling with workforce shortages, increasing demand for services, and ongoing issues with patient flow that are affecting both planned and emergency care. We received over 600 concerns this year, and engaged with more than 8,200 patients, staff, and carers to gain valuable insights into their experiences with healthcare services. Their voices have been crucial in shaping our understanding of the challenges faced and the care being provided. HIW’s work this year has focused on identifying and addressing these challenges to check healthcare services in Wales are safe, effective, and accessible to all.
Key findings from the Annual Report include:
- Pressure on Emergency Departments: Our work has identified ongoing problems with overcrowding and long wait times in Emergency Departments across Wales. Patients often face delays in assessment and treatment, with many waiting longer for hospital admission due to bed shortages. Issues with patient flow, including delays in transferring patients from the emergency department to wards, further contribute to overcrowding and prolonged wait times. These challenges, along with staff shortages, continue to strain healthcare services as demand rises.
- Planned Care Delays: Many patients are facing significant delays in accessing planned care. HIW found that waiting lists for treatments and operations are too long, leading to frustrations for patients and additional pressures on healthcare staff.
- Mental Health Services: Access to mental health services remains a concern, particularly for children and young people. HIW identified gaps in services, long waiting times, and difficulties in accessing timely follow-up care after initial assessments.
- Innovative Responses to High Demand: Despite these pressures, the report highlights positive initiatives aimed at improving urgent and out-of-hours care. New systems, including alternative options for patients in need of urgent care, have been developed to ease the strain on emergency departments. HIW has praised these innovative approaches for their role in maintaining service quality during times of unprecedented demand.
- Independent Healthcare and Dental Services: Our work in regulating independent healthcare services, including private clinics and dental practices, highlighted issues around capacity and access. Patients are facing delays in accessing timely dental care, with many dental practices struggling to meet demand.
- Patient Safety and Discharge Delays: Our inspections of hospitals identified significant challenges around patient discharge. Many patients experience unnecessarily long stays in hospital due to delays in discharge, which not only puts pressure on hospitals but also places patients at increased risk of harm.
- Collaboration and Insight: We continue to prioritise listening to the people who use and work in healthcare services across Wales. Their feedback is critical to understanding the challenges patients face when accessing care. HIW also worked closely with partner organisations, leading two Healthcare Summits which brought together healthcare inspection, regulation, and audit bodies to discuss key issues and share insights.
Alun Jones, Chief Executive of Healthcare Inspectorate Wales, said:
Our 2023-2024 Annual Report highlights both the strengths and challenges within the healthcare system in Wales. We have seen many positive developments, particularly in areas like urgent care, but there are still significant pressures that need to be addressed, especially around capacity and patient flow. Our role is to ensure that healthcare services continue to deliver safe, effective care, and we remain committed to driving improvements where they are most needed. I want to thank all the healthcare staff, patients, and organisations who have contributed to our work throughout the year. Their insights are invaluable in helping us improve healthcare in Wales.