NHS body’s achievements ‘would cost too much to reveal’

Martin Shipton

A Freedom of Information request aimed at establishing the achievements of an important new NHS body since it was launched two years ago has been turned down because it would cost too much to compile the data.

The NHS Wales Executive (WE) was set up in April 2023 by the then Health Minister Eluned Morgan, who has since become First Minister.

At the time she said it would be an essential part of the NHS, playing “an important role in making our healthcare system fit for the future and [driving] improvements in quality and safety, resulting in better and more equitable outcomes, access and patient experience, reduced variation, and improvements in population health.”

However, a Nation.Cymru reader who has a sensitive political role and does not want to be identified, believes the body has not fulfilled its potential and that it has become just another layer of bureaucracy.

The source submitted a number of FoI questions intending to find out what it had achieved since coming into being and whether it had provided value for money.

Budget

One of the answers revealed that WE had a staff headcount of 274 on March 31 2024, while another established that the body’s annual budget amounted to £59.8m.

The amount spent on foreign travel amounted to £18,797.50, including trips to conferences in Denmark, Belgium, Portugal, Canada, Germany and the Netherlands. The trips involved 12 senior members of staff.

The source asked for details of actions taken by WE to improve NHS care, including a list of concrete actions or initiatives that WE had implemented or overseen to improve NHS care across Wales since its establishment, with solid data, including reports, evaluations, or assessments of the effectiveness of these actions or initiatives, particularly focussing on patient care, waiting times, or overall healthcare outcomes.

Public Health Wales, to whom the FoI questions had been posed, responded: “The work to collate this request has been assessed and is in excess of the 18-hour appropriate time limit. As a result, this request is refused in line with Section 12 of the Freedom of Information Act 2000 and this serves as a formal refusal notice.”

Streamlining

Explaining further the need for WE, Baroness Morgan said in a ministerial written statement: “The decision to establish an executive function was set out in [a report published in 2020 called 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 the 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 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.”

Resources

The political source who submitted the FoI questions said: “The NHS in Wales needs as much resources as possible to go to the frontline. Huge spends that go towards management are not the answers to the problems that the system faces.”

A spokesperson for the Welsh Government said: “The NHS Wales Executive plays 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.

“It has brought together multiple national teams that already existed in the NHS in Wales to work together on performance and improvement.”