Review of data to measure progress against the ‘More than just words’ plan (2022 to 2027) in health and social care: summary

The Welsh Government’s More Than Just Words plan 2022 to 2027 sets out a national approach to strengthening the Welsh language provision in health and social care, including through the principle of the Active Offer. A major challenge identified in previous evaluations is the lack of consistent and robust data to monitor progress towards the plan’s aims.

In this context, the Welsh Government commissioned a review of the health and social care data landscape in Wales. The purpose of this research was to assess how far existing data can support progress monitoring, and to identify opportunities to strengthen the evidence base.

The project aimed to map and review relevant data sources, develop a practical indicator framework, identify gaps and limitations in the current data landscape, and recommend improvements to the evidence base going forward. 

The research was carried out in 3 main stages. First, a comprehensive mapping and review of data sources was undertaken to identify information relevant to Welsh-language provision in health and social care. This combined stakeholder engagement (including interviews and written input from organisations across the sector) with desk-based research. Each data source was assessed using a standardised framework, covering the information captured, population, data collection processes, accessibility, and limitations.

Second, a practical indicator framework was developed. This involved analysing Welsh-language data fields within each source and translating them into policy-relevant indicators. Indicators were designed to reflect the structure and coverage of the underlying data, and were assessed for feasibility, including whether they could be produced using existing published data or would require additional data sharing. The framework was organised around 4 thematic areas aligned with important dimensions of Welsh-language provision.

Finally, gaps and limitations in the data landscape were identified, and a set of potential improvements was developed. These were informed by comparative analysis across sectors and refined through stakeholder engagement, including an expert focus group.

Overview of the data landscape

The review identified a wide and diverse range of potentially relevant data sources across the health and social care sector. These include administrative systems, workforce data, regulatory returns, inspection evidence, surveys, and education and training data. Taken together, these sources provide a substantial evidence base spanning thematic areas relevant to monitoring progress towards the aims of the plan.

In some areas, data are collected consistently and at scale, providing a strong foundation for monitoring. This is particularly the case for workforce data in healthcare, regulatory returns in social care, and administrative data in education and training. However, the data landscape is also characterised by several limitations. Data are often fragmented across systems and organisations, with limited mechanisms for national-level aggregation. Recording practices are not always consistent, and data are not always available in a format that readily supports analysis and reporting.

There are also differences between healthcare and social care. These partly reflect the structure of the two sectors: while healthcare tends to rely on more centralised systems and more standardised data collection, social care data are often more dispersed. As a result, the overall evidence base is uneven and does not yet provide a fully coherent or comprehensive picture of Welsh-language provision across the system.

Indicator framework

Building on the review of data sources, the research developed a structured indicator framework to support monitoring of progress towards the aims of the plan. The framework comprises 39 indicators, organised across 4 thematic areas and presented separately for healthcare and social care to enable sector-specific monitoring. These cover:

• the delivery of the Active Offer and bilingual services
• demand for Welsh-language services
• workforce Welsh-language ability
• the future workforce

A major strength of the framework is its grounding in existing data sources. This demonstrates that it is feasible to construct a meaningful set of indicators using data already collected across the sector, without introducing additional data-collection requirements.

However, the analysis also shows that, while the data underpinning the indicators already exist, they are not always available in a form that directly supports their routine production. In some cases, data are not publicly accessible; in others, they are not aggregated or reported in ways that align with the proposed indicators. As a result, implementing the framework would, in some cases, require additional data processing and regular data sharing by relevant organisations.

Overall, the framework provides a practical and proportionate starting point for monitoring progress. At the same time, its feasibility assessment highlights where further collaboration among sector stakeholders will be needed to support implementation and ensure that indicators are produced consistently over time. 

Limitations of the data landscape and recommended improvements

The analysis identified several important gaps and limitations in the current data landscape that hinder consistent, comprehensive monitoring of progress towards the aims of the plan. These vary in nature and scale, reflecting both specific data quality issues and broader structural challenges across the sector.

To address these issues, the report sets out a series of potential improvements. These range from targeted enhancements to existing data collection and reporting practices to more exploratory actions aimed at strengthening the evidence base over time. The recommended improvements are summarised below:

• introduce a standardised approach to assessing the Active Offer in healthcare inspections, aligned with existing social care frameworks
• improve consistency in the deployment of the People’s Experience Survey across NHS Wales, including hospital, primary and community care settings
• develop a consistent, sector-wide approach to capturing service user experience in social care, including language-related questions
• extend NHS 111 data collection to capture whether Welsh-language requests are fulfilled
• promote more consistent recording of patients’ language, building on the rollout of the EMIS system
• establish routine aggregation and reporting of language data, subject to improved completeness and consistency
• explore patient self-reporting of language through digital platforms such as the NHS app
• explore regular inclusion of consistent Welsh language-related questions in the National Survey for Wales
• harmonise workforce Welsh-language ability scales, for example, by aligning with the Code to describe Welsh language ability, based on the Common European Framework of Reference for Languages framework
• introduce a more systematic approach to updating workforce language ability data
• add an introductory (pre-entry) level to workforce language ability scales to capture early-stage skill development
• promote the use of tools such as the Check-in-Cymraeg app to capture real-world language use
• build on the Welsh Language Commissioner’s pilot work to explore a more consistent approach to capturing Welsh-language use in workplace settings
• improve the capture and aggregation of Welsh-language requirements in social care recruitment
• strengthen approaches to linking workforce data to the plan’s priority groups, including refining definitions where needed
• increase completion rates for Welsh-language ability data in the Wales National Workforce Reporting System
• introduce more consistent reporting on Welsh-language training delivered outside the National Centre for Learning Welsh
• develop a Welsh-language education-to-workforce pipeline model linking education, training and workforce data

Taken together, these improvements provide a clear direction for strengthening the data landscape over time, while recognising that further work will be required by the Welsh Government and sector stakeholders to prioritise actions, determine appropriate implementation approaches, and clarify roles, responsibilities and timelines.

This research provides, for the first time, a consolidated overview of the data landscape relevant to Welsh-language provision across health and social care in Wales. By bringing together evidence from a wide range of sources and translating these into a coherent indicator framework, it establishes a practical foundation for more systematic monitoring of progress under the plan.

The findings highlight both the potential of existing data and the areas where further development is needed. While many of the building blocks for effective monitoring are already in place, realising this potential will depend on improving the consistency, completeness and accessibility of data across the sector.

In the short term, progress can be made by implementing the proposed indicator framework and establishing the data-sharing arrangements required to support it. Over the longer term, strengthening the evidence base will require continued collaboration to address identified gaps, improve consistency, and develop new approaches in areas where current data remain limited.

Ultimately, improving the quality and coherence of data will be important to enabling more effective monitoring of progress towards the aims of the plan, and to supporting evidence-based policy and service planning that promotes the Welsh language across health and social care.

Report author: Alma Economics

Views expressed in this report are those of the researchers and not necessarily those of the Welsh Government.

For further information please contact:

Welsh Language Policy Team 
Health, Care and Prevention Group 
Welsh Government
Cathays Park
Cardiff
CF10 3NQ

E-mail: hss.welshlanguagepolicyteam@gov.wales

Social research number: 75/2026
Digital ISBN: 978-1-80853-064-7