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New push for Welsh care shift from hospital to community

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The Welsh government has set out its first ever plan to integrate health and social care, as it attempts to treat more people in the community rather than in hospital.

The document – titled A Healthier Wales – is aimed at creating better care locally with support and treatment available across a range of community-based services.

“We have to move on from the idea that the hospital is the first or best place for you”

Vaughan Gething

The plan, which is to be implemented immediately, will see the development of new integrated prevention services and be backed by a £100m “transformation fund”.

The hope is that, by working harder to keep people fit and well, there will be fewer hospital admissions needed for seriously ill patients, said ministers.

The plan will focus on “seamless services” that are designed to fit around the individual. It also commits the Welsh government to increase investment in digital technologies and to support and develop the workforce, including unpaid carers and volunteers.

Welsh health secretary Vaughan Gething said that with increasing life expectancy and growing pressures on the NHS a “revolution” in thinking was necessary.

“We have to move on from the idea that the hospital is the first or best place for you to be when you are unwell,” he said. “That isn’t always the case, especially when there are a range of local services that will allow you to remain safely at home.”

“This is the first time Welsh government has produced a joint plan for health and social services”

Huw Irranca-Davies

The world had changed since the NHS was created 70 years ago, he said. “Today’s plan sets out our vision for the future – it looks at how we will adapt to meet these future challenges and transform the way we deliver health and social care.

He added: “We will deliver that change and remain true to the core values of the NHS to provide free healthcare for all.”

A parliamentary review of health and social care in Wales, commissioned by Mr Gething in 2016, found that the “current pattern of health and social care provision is not fit for the future”.

Mr Gething said the new plan had taken note of the review’s findings and was built on its recommendations.

“The parliamentary review found that much of what we are doing in health and social care in Wales is right, but that change needs to be made to secure services for the future and to ensure people continue to get the best care,” he said.

He added: “We are responding to that review. This will be a revolution from within the health service.”

Huw Irranca-Davies, minister for children, older people and social care, said: “This is the first time Welsh government has produced a joint plan for health and social services. It recognises the extremely important role social services play in promoting good health, keeping people independent for longer and reducing admissions to hospital.”

The Royal College of Nursing in Wales welcomed the plan. RCN Wales associate director Nigel Downes agreed with the vision to keep people active and independent in their own homes for as long as possible.

“To achieve this it is imperative that detailed workforce planning is undertaken for the transition from hospital to community care for patients,” he said. “This planning must include that there are sufficient qualified district and community nurses available to ensure the appropriate levels of care can be achieved.”

“As with all strategic documents, the devil remains in the detail of how this will be achieved”

Nigel Downes

He noted that the plan identified the need for a new NHS Wales executive and made it clear that the current frameworks for performance, governance and planning would not deliver the change needed.

“We expect to work in partnership with Welsh government and NHS in Wales as the actions in this plan are put into place, ensuring that the nursing voice is heard at every level,” he said.

He added: “This plan sets out a number of improvements for the health and wellbeing of staff, however as with all strategic documents the devil remains in the detail of how this will be achieved.”

He also cited the RCN’s campaign Rest, Refuel, Rehydrate as an example of where changes were needed. “[It] is a good example of where the NHS could make improvements, as many of our members tell us they don’t have time to have a break,” he said.

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