Each quarter, we share our latest news and highlight the key themes and learning emerging from our work. It is part of our commitment to better understand our stakeholders’ expectations, proactively engage, share our findings and report on our activity.
Welcome to our Mental Health edition of HIW’s Insight Bulletin!
Each quarter, we share our latest news and highlight the key themes and learning emerging from our work. It is part of our commitment to better understand our stakeholder’s expectations, proactively engage, share our findings and report on our activity.
We believe there is significant value in sharing learning and experiences from our work. We want healthcare services to reflect on our findings and measure their own services against these to drive service improvement. We hope the findings illustrated within this bulletin can be transferred between organisations, and across the wider health service to support improvements across the system.
In this bulletin we take a deep dive into our work in relation to mental health, with a particular focus on the following:
- findings from a joint review with Care Inspectorate Wales and Estyn of children and adolescent mental health services across Wales
- our latest Mental Health Monitoring Annual Report which outlines our assurance activities and findings for mental health and learning disability services.
- key themes from our joint monitoring review of the Deprivation of Liberty Safeguards regulations alongside Care Inspectorate Wales.
- a spotlight case study - Heatherwood Court Mental Health Services in Pontypridd
- follow up of mental health review of crisis care
As part of our ongoing commitment to continuous improvement, we have published a series of reports which highlight areas of improvement and good practice across the NHS and independent healthcare providers.
We hope you find the content within this bulletin informative and insightful.
Your feedback is crucial to us in improving how we communicate and share key messages with you, so please take the opportunity to provide your feedback to us via this survey.
Thank you.
Mental Health Work Updates
How are healthcare, education, and children’s services supporting the mental health needs of children and young people in Wales?
The joint review by Healthcare Inspectorate Wales (HIW), Care Inspectorate Wales (CIW), and Estyn explored how healthcare, education, and children's services in Wales addressed the mental health needs of children and young people. The report acknowledged progress in early support and prevention services but also highlighted significant gaps in providing timely and consistent specialist care. The demand for Child and Adolescent Mental Health Services (CAMHS) remain high, with many children unable to access the support they needed due to demand outstripping capacity and inconsistent eligibility criteria to access CAMHS. Neurodiverse and care-experienced children faced additional barriers as they attempted to access support from multiple services, and with often complex needs at the time of seeking support. Despite these challenges, the dedication of CAMHS, local authorities, education, and voluntary sector teams was evident. The report calls for improved systems and partnership working to ensure all children in Wales can access the mental health support they need, at the right time.
Mental Health Monitoring Annual Report 2023-24
Our Mental Health Monitoring Annual Report 2023-24 highlights inspection activities and findings for mental health and learning disability services across Wales. Monitoring of the Mental Health Act 1983 is a statutory responsibility delegated to HIW since 1 April 2009 by Welsh Ministers at which point responsibility for monitoring the functions of the Act was transferred from the Mental Health Act Commission.
The report identifies workforce shortages and increasing service demands as major challenges affecting patient outcomes. Despite positive feedback on staff professionalism and compassion, significant improvements are needed in areas like workforce recruitment, medicines management, patient observations, and governance. The report also notes an increase in complaints and requests for Second Opinion Appointed Doctors (SOADs). Chief Executive Alun Jones emphasised the need for continuous improvement to enhance patient care quality and safety.
Deprivation of Liberty Safeguards (DoLS)
Together with Care Inspectorate Wales (CIW) we have published the annual monitoring report on how the Deprivation of Liberty Safeguards (DoLS) are being used in Wales. The DoLS serve as crucial legal protections for some of our most vulnerable citizens and these safeguards exist to protect and maintain the human rights of people who lack mental capacity to make certain decisions about their care and treatment.
Our key findings highlight that health boards have seen a notable increase in DoLS applications whereas local authorities have experienced a slight decrease. The system continues to face significant challenges and many vulnerable people are experiencing lengthy delays in receiving their DoLS assessments, with statutory timeframes regularly exceeded. These delays mean many people across Wales are currently being deprived of their liberty without proper safeguards.
This report highlights both progress and persistent challenges in protecting vulnerable people’s rights.
Follow up of mental health review of crisis care
In March, 2022, we published a report following our National Review of Mental Health Crisis Prevention in the Community. The review identified several significant issues within the mental health support system, particularly the service gap for individuals requiring more than the standard General Practitioner (GP) support but not meeting the criteria for specialised services. GPs often lacked awareness of alternative support services, and the cumbersome referral processes result in delays, jeopardising timely support and potentially exacerbating individuals' mental health conditions.
Over the past two years, we have monitored health boards’ progress and it is encouraging to note that overall progress on completing actions was broadly positive. Health boards have begun to streamline referral processes for all services and health boards have begun improving their efforts to provide timelier and clearer advice and information to individuals with mental health needs.
Please visit our website to read the full findings.
Learning and Insight
Spotlight Case Study - Heatherwood Court Mental Health Services in Pontypridd De-escalated as a ‘Service of Concern’ Following Improvements
HIW inspectors completed two unannounced inspections of Heatherwood Court mental health services in June and September 2024 in response to incidents that occurred at the hospital.
During the inspection in June 2024, we were not assured the processes in place were sufficiently managing the risk of patients coming to harm whilst being under enhanced observations, and patient care plans were often generic and lacked personalised interventions. During the inspection in September 2024, it was positive to see significant progress since the first inspection. The actions taken by the service had resulted in a more organised approach to managing risks and making better-informed decisions for the benefit of patients.
We are encouraged by the progress made at Heatherwood Court, and keen to highlight as a case study within this bulletin. Please visit our website to view our full case study of this inspection
Activity Update
Assurance and Inspection Activity
We inspect NHS services and regulate independent healthcare providers against a range of standards, policies, guidance, and regulations to highlight areas requiring improvement. Following our inspection and assurance work we will publish a report outlining our findings and recommendations.
Latest mental health inspection reports include:
March 2024 - Coed Du Hall Hospital - Significant improvement required within a mental health hospital in Mold
April 2024 - Ty Glyn Ebwy Hospital - Inspection finds good standard of care at specialist eating disorder hospital in Ebbw Vale
June and September 2024 - Heatherwood Court Hospital - Heatherwood Court Mental Health Services in Pontypridd De-escalated as a ‘Service of Concern’ Following Improvements
September 2024 - Bryngolau Ward, Prince Philip Hospital - Improvement required at a specialist Mental Health Ward at Prince Philip Hospital in Llanelli
All published reports can be found here: Find an inspection report.
Want to find out when HIW reports are due to be published? Take a look at our Publication Schedule.
Important Update Recycling in Hospitals
From April 2026, hospitals will need to sort their waste for recycling in line with all other businesses, charities and public sector organisations in Wales.
Welsh Government introduced the workplace recycling law in April 2024 to improve the quality and quantity of recycling collected and the consistency of how it is managed.
Under the law, a hospital has been defined as:
(a) any institution for the reception and treatment of persons suffering from illness,
(b) any maternity home, and
(c) any institution for the reception and treatment of persons during convalescence or persons requiring medical rehabilitation, and includes clinics, dispensaries and out-patient departments maintained in connection with any such home or institution, and “hospital accommodation” must be construed accordingly.
If you fall into this definition, as of April 2026 you will be required to separate your waste. If you do not fall under this definition, you should be separating your waste by law already. If you are not, please act now. This is a crucial step in tackling the climate and nature emergency, by helping reduce waste whilst also helping the Welsh economy.
Details of how to comply can be found the Welsh Government’s Code of Practice: gov.wales/separate-collection-waste-materials-recycling-code-practice
Visit gov.wales/workplacerecycling to find out more.
Webinar: Workplace recycling law implementation for hospitals – Wednesday 19 March 2025, 2pm
This webinar, run by WRAP, will provide information to ensure all hospitals (both NHS and private) are fully aware of the requirements and the changes you will need to make. You can also submit questions when you register for the webinar.
Visit the WRAP website to register.
Need to register with us?
Looking to register with us or have any questions? Our registration FAQs may have the answers you need!
Please take a look before submitting your registration forms or making amendments to your current registration.
Need to register with us?
Looking to register with us or have any questions? Our registration FAQs may have the answers you need!
Please take a look before submitting your registration forms or making amendments to your current registration.
Have Your Say
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All open surveys can now be found on our surveys page.
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