Welsh NHS failing to support people with chronic conditions – report

Emily Price

People living with long-term health conditions are not getting enough support from the NHS in Wales to effectively manage their conditions, according to a new Senedd report.

The Senedd’s Health and Social Care Committee has called on the Welsh Government to refocus efforts on delivering person-centred care for those living with long term illnesses like diabetes, endometriosis, chronic fatigue and autoimmune conditions.

In a report published on Wednesday (January 29), the committee said more needed to be done to prevent health deterioration in order to reduce the need for emergency intervention and hospital admissions.

46% of adults in Wales experience chronic conditions with 19% having two or more long-term conditions, and these numbers are expected to rise.

People living in deprived areas are more likely to develop chronic conditions at a younger age and are expected to have at least one condition by the time they are 50.

These people spend fewer years in good health, requiring more support from NHS services.

Tailored

The Welsh Government’s ‘A Healthier Wales plan’ published in 2018, focusses on coordinating tailored services to meet individual needs.

It aims to ensure better co-operation across departments, support from specialist nurses, ‘one stop shop’ clinics and advice on diet, exercise and wellbeing.

But the committee heard that this is far from patients’ current experience of the NHS in Wales.

It heard how people’s conditions are treated in silos, with no shared decision making, leading to delays and confusion as patients struggle to navigate the system.

The committee said there is also a “worrying lack of mental health support” especially at the point of diagnosis.

Painful

Phoebe Lewis, 26, from Cardiff was diagnosed with Endometriosis at 19, 7 years after first seeking help for painful periods.

She says the condition impacts every part of her life – but she only receives help on her worst days.

Phoebe said: “Proactive care and support for mental health is so important to live well and avoid problems in the future.

“Only getting help when you’re sick traps you in a cycle and it’s harder to recover each time: harder to go back to work, harder to live a normal life.

“After having surgery a couple of years ago, I am doing much better. I have done a lot of work to help myself by eating well and getting regular exercise, which is something I really struggled to do when my symptoms were worse.

“I’ve done this with little help from the NHS and had no idea if I was doing the right thing or if it was going to make a difference.”

Screening

Public health initiatives can reduce the probability of people developing chronic conditions, whilst regular screening for patients ensures early intervention to spot problems before they get worse.

But the committee found that preventative work is often not a priority.

Sylvia Penny lives in Dinas Powys in the Vale of Glamorgan. She has Type 2 Diabetes and several other conditions including Bilateral Bell’s Palsy.

The 74-year-old has become frustrated with the lack of communication and confusion in monitoring her conditions.

She said: “The care, when I receive it, has been exemplary, but the route of getting to it takes too long. You get sent from pillar to post, and there is a lack of communication between departments leading to more confusion to navigate.

“It’s a waste of time, effort and money for everyone involved.  Several times I have been prescribed the wrong medication, which has made me unwell, which means more time and effort to have it corrected. It makes it difficult to know who is responsible and whose opinion I should trust.

“A lack of diabetes monitoring has led to the development of a third nerve palsy, which has led to more tests, treatment and medicines. This continues and I am very grateful for the care I am now receiving from the hospitals.”

Chronic

Chair of the Senedd’s Health and Social Care Committee, Russell George, says the Welsh Government is failing to provide the support people with chronic conditions need to live well for longer.

He said: “This failure not only impacts individuals’ quality of life but also places an unsustainable burden on our NHS.

“While much attention has been concentrated on NHS acute care, there has been far less focus on people who rely on regular access to healthcare to manage one or more chronic conditions.

“We have made a number of recommendations to improve the situation, but ultimately, we are looking to Welsh Government to take immediate, decisive action to protect the health of the nation and the future of the NHS.”

The committee’s report includes 21 recommendations for the Welsh Government.

A Welsh Government spokesperson said: “We thank the Committee for their report. We will consider the recommendations in detail and respond in due course.”