Emerging from Covid: Time for a Preventative Health Approach

Darren Hughes outlines why prioritising population wellbeing and tackling health inequalities needs to be the Sixth Senedd’s priority.    

As we start the Sixth Senedd term, the immediate challenge facing the new Welsh Government is responding to the Covid-19 pandemic and longer-term recovery. 

There’s no question that the NHS in Wales has experienced the most challenging period in its history, and to think that we’re out of the woods is simply wrong. 

The efforts of staff working across health, social care and beyond, that saw us through this tumultuous time, have been nothing short of outstanding. 

Furthermore, the NHS in Wales is incredibly grateful for the sacrifices the public has made and continues to make. 

Without that support, our health service would have been under even more pressure and many more lives would’ve been lost.    

With Coronavirus cases, hospitalisations, and deaths at their lowest levels since last summer, there’s undoubtedly a renewed sense of optimism in communities across Wales. 

This, coupled with the remarkable progress of the delivery of the Covid-19 vaccination programme and the protection this provides people, makes for the right time to look to the future. 

“One of the key priorities… is to prioritise population health and wellbeing, including health inequalities, as part of a preventative approach.”   

This marked improvement in the public health situation means we can cautiously start to resume more services across the NHS in Wales, particularly in planned care, where it’s been well-documented that waiting lists are at record levels. 

Recovery from the Covid-19 pandemic is undoubtedly at the top of the priority list for NHS leaders and the care sectors. 

A core part of recovery will be providing the much-needed care and treatment to the many thousands of people on waiting lists, focussing on the outcomes that matter most to patients. 

The NHS is all too aware that patients are not just a statistic on a page, but human beings who might be experiencing daily discomfort and suffering, so it’s vital we provide care based on an individual’s needs and experiences.  

There won’t be many of us who don’t know of someone who has been negatively affected by the wider harms of Coronavirus, whether this be waiting for an appointment or surgery, or suffering with their mental health because of the unique circumstances many have found themselves in, including widespread social isolation.  

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While there are many challenges that the health and care system face, NHS leaders have united in putting forward solutions to the Welsh Government and political parties. 

We’ve engaged closely with our Members, the Chairs, Chief Executives and Vice Chairs of all NHS organisations across Wales, to find out what they think the direction for our health service should be over the next five years and beyond. 

NHS Wales leaders believe that one of the key priorities for the incoming Welsh Government is to prioritise population health and wellbeing, including health inequalities, as part of a preventative approach to healthcare.   

Society has changed dramatically since the creation of the NHS over 70 years ago, and the key challenge now is to set out how all sectors can work together to better anticipate and address current and future demands on the system. 

Improving population health and supporting the prevention agenda are key to achieving the change required across the whole system, supporting healthy behaviours and environments for current and future generations. 

Tackling issues such as smoking, drinking and obesity are essential to this approach, alongside confronting loneliness and social isolation.”

We need to invest in supporting and maintaining health, wellbeing and independence in our communities. 

It’s essential that we support and empower people to take responsibility for their health so they can shape their own care to meet their needs. 

We can do this by ensuring patients are involved in decision-making when it comes to their own health and care. 

Tackling issues such as smoking, drinking and obesity are essential to this approach, alongside confronting loneliness and social isolation, which can be multi-faceted in its impact on individuals. 

Social prescribing will be key here, ensuring these community links are strengthened for both the health system and the end user. 

One of the many issues that the Covid pandemic has shone a light on are the widening health inequalities in our population.

 Traditionally, we have looked to the health service to address these challenges in isolation, but the NHS alone simply doesn’t have the levers to make the changes we know are vital to creating the conditions necessary for good health and wellbeing. 

Covid-19 has shown us that the improvements required to revolutionise the health and social care system in Wales can happen.” 

Meaningful progress will require coherent efforts across all sectors to close the inequality gap. 

Our Health and Wellbeing Alliance joint paper, Making the difference: Tackling health inequalities in Wales, offers solutions for initial steps that an incoming Welsh Government could take in their first year to respond urgently to health inequalities and make the greatest possible impact by coordinating renewed commitment from all partners. 

The previous Welsh Government plan for health and care, A Healthier Wales, recognises that the NHS is only one small part of a much wider system that plays an active role in maintaining people’s physical and mental wellbeing. 

That’s why it’s so important to work across the public sector, to involve partners and patients in every decision that affects their care and treatment.  

As we emerge from the pandemic, we cannot let the relationships we have built with local government and the wider public, private and voluntary sectors fade away.

 It is crucial that we capture and continue these new ways of working for the benefit of the people of Wales. 

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NHS leaders want to see the new Government publish their plans to continue to improve partnership working across all sectors, with compassionate leadership at its heart, building on the progress made in implementing the long-term vision within A Healthier Wales and continue to transform the services we provide for the people of Wales. 

We also need to address the crisis facing social care, where once again the Covid-19 pandemic brought into sharp focus their unique challenges.

 Local authorities need the resources to adequately support the social care workforce to look after both the elderly and young people in their care, and to provide community and preventative support.  

The success of the NHS and the social care sector are intrinsically linked. We want to see commitment to developing social care services based around the needs of individuals. 

For a sustainable health and care system, the NHS has to work hand in glove with our colleagues in local authorities.   

We’ve seen some of the significant economic and social consequences of this outbreak. It hasn’t escaped NHS leaders that as Wales’ largest employer, the NHS will not only be key to the recovery of the health of the population, but to the economic recovery of the nation. 

It’s important to have a constructive debate around the solutions required to further implement the vision for the health and care system. 

We call for all political parties to play a role and ensure the debate focuses on quality-based outcomes, prevention, community services and whole-system collaboration. 

Covid-19 has shown us that the improvements required to revolutionise the health and social care system in Wales can happen. 

We look forward to engaging with all political parties to put forward solutions, on behalf of our Members, to tackle them.   

All articles published on the welsh agenda are subject to IWA’s disclaimer.

Darren Hughes is the Director at the Welsh NHS Confederation, the membership body representing all the organisations making up the NHS in Wales.

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