Health outcomes and experience in the healthcare system – Welsh Government assessment

The Welsh Government has taken steps to promote equality in health outcomes, and reports of good general health and healthcare experiences in Wales have remained relatively consistent in recent years. However, life expectancy has declined and rates of adult obesity have risen. Waiting lists and emergency response times have also increased. There is a lack of disaggregated data for Wales and, where data exists, it shows inequalities in health for different groups, including those who share protected characteristics and those experiencing socio-economic disadvantage.

• The Chief Medical Officer for Wales’ annual report for 2021/22 highlights how the coronavirus (COVID-19) pandemic deepened inequalities and had a disproportionate impact on people in some of the most vulnerable situations in Welsh society.
• In July 2022, the Welsh Government allocated an additional £3 million to recruit emergency ambulance staff to improve response times. In the preceding three months, just over half (52.1%) of immediately life-threatening calls were reached within the target time of eight minutes.
• In April 2022, the Welsh Government published its programme for transforming and modernising planned care and reducing waiting lists in Wales. At the time of the programme’s publication, 707,098 patients were waiting to start treatment – equivalent to one in every five people in Wales – which grew even further by July 2022, to 743,229, a 62.7% increase since March 2020.
• The June 2020 report of the socio-economic subgroup of the Welsh First Minister’s Black, Asian and Minority Ethnic Covid-19 Expert Advisory Group found that poor ethnicity data had led to poor health decisions and people had reported experiences of racism in the healthcare system in Wales.
• According to the National Survey for Wales results for 2021/22, 72% of adults reported good or very good general health. The proportion of adults reporting good or very good general health was lower than in 2020/21.
• Research on life expectancy and mortality in Wales in 2020 found that there has been a ‘stalling’ of improvements in life expectancy and mortality since 2011. Life expectancy at birth actively declined for men and women in 2018–2020, compared with 2015–2017.
• The percentage of adults who are overweight or obese continues to rise, reaching 62% in 2021/22. Rates are highest among men and those living in more deprived areas.
• According to the National Survey for Wales results for 2021/22, 86% of survey respondents who had recently used health services were very or fairly satisfied with the care from their GP and 95% were satisfied with the care received at their last NHS hospital appointment.
• In 2020, the NHS Wales Delivery Unit was asked to manage the reporting process for patient safety incidents, partly to ‘improve shared learning across Wales’. However, there is no requirement for NHS bodies in Wales to appoint a Freedom to Speak Up Guardian.
• The Health and Social Care (Quality and Engagement) (Wales) Act 2020 includes welcome changes, such as introducing a ‘duty of candour’ in respect of health services and making provision for a Citizen Voice Body for Health and Social Care to represent the interests of the public, but this is not yet in force.
• Although the Welsh Government has published plans that include reducing health inequalities for different groups, there is limited direct evidence on health outcomes in Wales for certain groups, including those sharing protected characteristics.