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Eluned Morgan MS, Minister for Health and Social Services

First published:
30 November 2022
Last updated:

Today, I am publishing four new quality statements to guide NHS planning of clinical services. These quality statements set out what high quality clinical services should look like and reflect a consensus of expert and stakeholder opinion about vital areas of focus in the years ahead.

Well managed conditions are vital to delivering the best patient outcomes and delivering a sustainable NHS. These quality statements will address some of the big causes of the population’s ill health: respiratory diseases such as COPD and asthma; liver diseases such as viral hepatitis and fatty liver disease; neurological conditions such as epilepsy; and kidney disease, which includes chronic renal failure and other causes. Together these conditions account for a significant burden of ill health facing individual citizens – but also a large volume of healthcare demand facing our NHS. Therefore, it is important that NHS services are planned to meet this need, helping people to manage their condition as best as they can, reducing the risk of disease progression, and helping to avoid unnecessary healthcare demand.

Complex health systems need to ensure joined up care for patients. Health boards and NHS trusts plan services through many different settings, such as general practice or urgent and emergency care settings; as well as through different specialist outpatient teams, such as respiratory medicine or renal dialysis. Quality statements help to focus the planning of healthcare services according to clinical pathways – people’s individual journey through a complex healthcare system to treat or manage their condition. Looking at services along a patient pathway helps the NHS to ensure people are getting the recommended care they need and that services delivered by different teams along that pathway are arranged to be as seamless as possible. It also allows the NHS to monitor outcomes; those outcomes that are important to patients, as well as those that tell us the services and pathways are doing what they are intended to do. This provides opportunities to change pathways of care to improve patient experience and outcomes.

Healthcare services should give appropriate focus to quality of care, which is at the heart of our introduction of the Duty of Quality. Quality statements are an important part of this enhanced focus on improving quality by tackling unfair differences in how services are delivered or received. Our expectation is that NHS services in Wales are delivered in line with recommended clinical practice, for services to be delivered consistently across Wales, and care to be equitable for different groups of people. Delivering healthcare is a very complex task undertaken by many organisations and teams that are constantly interacting. Whilst it may be appropriate to have different ways of delivering healthcare services, what cannot be accepted is variation in the outcomes experienced by people receiving that care. Quality statements aim to address this by introducing nationally agreed clinical guidelines, pathways, and service specifications. This will support health boards and trusts to deliver higher quality, more equitable and more sustainable healthcare.

The imperative for greater quality and consistency of local healthcare delivery is overseen through NHS accountability mechanisms. We are strengthening how this is done in Wales through the establishment of an NHS Executive. This new body will absorb the national coordination and leadership teams that are in place for these conditions and integrate their expertise into how the NHS is held to account. This way of working will replace the national implementation groups that are currently in existence and include any national clinical leadership positions. The delivery plans in these areas will now be retired and the national funding associated with their work will be absorbed into the NHS Executive as it emerges.

These actions form part of the commitments we made originally in A Healthier Wales, and more recently, in the National Clinical Framework. The national leadership arrangements for these clinical areas, working from within the NHS Executive, will bring to life a system where reliable data will drive improvement in these clinical areas. This will allow better planning and delivery of services, as well as the ongoing quality improvement of these clinical services. This is the learning health and care system that the is described in the Clinical Framework.

These quality statements are part of a wider suite of ten documents that set out our high-level expectations of NHS services and require the NHS to respond through its local planning arrangements. They sit alongside other vital Welsh Government policies and strategies that focus on prevention of disease and good diagnostic care. This integrated set of policies reflects how NHS services are guided in Wales and how they will be held to account in the years ahead.

I look forward to working with all our partners in the months and years ahead to deliver the important commitments set out in the Quality Statements.

The quality statements can be accessed at: