Eluned Morgan MS, Minister for Health and Social Services
This statement provides Members with an update about the establishment of the NHS Wales Executive. It comes into force on 1 April 2023 and will be an essential part of the NHS – it will play an important role in making our healthcare system fit for the future and drive improvements in quality and safety, resulting in better and more equitable outcomes, access and patient experience, reduced variation, and improvements in population health.
The decision to establish an executive function was set out in A Healthier Wales and based on the findings and recommendations of both the OECD Quality Review and the Parliamentary Review of the Long-term Future of Health and Social Care. Both set out the need for a stronger centre, additional transformational capacity and streamlining of current structures.
We paused the work to create the NHS Executive in 2020 as the focus was redirected to the pandemic. This pause has given us an opportunity to learn lessons from the pandemic and the way health and care services collaborated.
In May 2022, I decided to establish the NHS Executive as a hybrid model, giving us the opportunity to move more quickly and with agility to create an executive function without the need to transfer powers or large-scale staff transfers.
I have been clear that the creation of the NHS Executive must add value and be a key driver for improvements across the whole healthcare system. It should not disrupt patient care and clear lines of accountability to Welsh Government and to me, as Minister, should be maintained.
The NHS Executive brings together a number of existing national NHS organisations – the NHS Wales Health Collaborative, Delivery Unit, Financial Delivery Unit and Improvement Cymru. They will operate as a dedicated senior leadership team and will align with the proposed National Office for Care and Support, to reflect the health and social care integration agenda.
Ministers will continue to set priorities, targets, and outcome measures for the NHS in the form of the NHS Planning Framework. This will be translated by the Director General for Health and Social Services/chief executive of NHS Wales into a mandate to the NHS Executive, setting out its role, ways of working and functions.
Working on behalf of the Welsh Government, I expect the NHS Executive to provide strong leadership and strategic direction – enabling, supporting and directing, where necessary, NHS organisations to deliver national priorities and standards, and safeguard and improve the quality and safety of care.
Its core functions will include:
- Quality, safety and improvement, including reinforcing and refocusing national leadership for quality improvement, patient safety and transformation.
- Planning, including developing national and regional planning capability and support for national decision making alongside regional and local delivery.
- Oversight and assurance, including enabling stronger performance management arrangements, financial control, and capacity to challenge and support organisations that are not operating as expected.
This is not an exhaustive list and it will continue to be reviewed and refined as the NHS Executive matures and delivers its remit. Plans are being developed to scope the requirements for the delivery of further functions within the NHS Executive during 2023-24, including innovation and value, workforce planning and emergency planning.
The functions of the NHS Executive will be underpinned by the clinical networks and national programmes as key mechanisms to support improvement, change and delivery.
The planned care recovery and improvement and mental health programmes are already part of the Delivery Unit and NHS Health Collaborative, respectively. The Delivery Unit and NHS Health Collaborative work with NHS organisations and their partners, including all-Wales programmes, networks, and implementation groups, to achieve sustainable improvement, service transformation and a whole system approach to health and care within NHS Wales.
Hosting arrangements for the primary care and urgent emergency care programmes will be considered after April 2023, together with the incorporation of other programmes.
The coming 12 months will be a transitional year for the new NHS Wales Executive, I am confident that its creation will help us deliver real benefits for people throughout Wales.