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, improvements in life expectancy have stalled and rates of adult obesity have risen. 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 Welsh Government has prioritised its healthcare outcomes on COVID-19 in its response to the pandemic, although the diversion of resource has led to reductions in service provision.  

• In January 2021, the Chief Medical Officer for Wales reported on the response in Wales to the first phase of the coronavirus pandemic, noting that the pandemic had directly and indirectly exacerbated existing inequalities. The report made eight key recommendations, including that the Welsh Government should do more to reduce health inequalities by taking steps such as routinely conducting impact assessments of health policies.
• The Wellbeing of Wales 2020 report notes that more deprived areas have higher rates of death involving COVID-19, as well as lower healthy life expectancy.
• The June 2020 report of the Socioeconomic Subgroup of the BAME Covid-19 Expert Advisory Group found that poor ethnicity data has led to poor health decisions, and people have reported experiences of racism in the healthcare system in Wales.
• The prioritisation of healthcare relating to COVID-19 during the pandemic has led to longer waiting times for other treatments.
• According to the National Survey for Wales results for 2019–20, 71% of adults reported good or very good general health, declining with age from 16–44 (80%) to 65+ (57%). Men reported good health more frequently (73%) than women (69%). The overall figure has not changed significantly since 2016–17.
• 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, with decreasing improvements in mortality rates from circulatory disease and increases in mortality rates for some other causes such as respiratory disease and dementia.
• The percentage of adults who are overweight or obese continues to rise, reaching 61% in 2020. Rates are highest among men and those living in more deprived areas.
• According to the National Survey for Wales results for April 2019 to March 2020, 89% of survey respondents who had recently used health services were satisfied with the care from their GP and ‘91% were satisfied with the care received at their last NHS hospital appointment’, similar to findings from the previous year.
• In 2020, the Delivery Unit was asked to manage the reporting process for patient safety incidents, partly to ‘improve shared learning across Wales’, but 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, including introducing a ‘duty of candour’ in respect of health services and making provision for a Citizen Voice Body to represent the interests of the public, but is not yet in force.
• Though the Welsh Government has published plans which include reducing health inequalities for different groups, there is little evidence on health outcomes in Wales for certain groups, including those sharing protected characteristics.

Read more about the UK and Welsh Governments’ actions on health outcomes and experience in the healthcare system.