NHS 75: Rapid staff additions needed, chief says – BBC News

The head of the NHS in Wales, Judith Paget, acknowledged the need for “rapid increases in staff numbers”, as well as fast-moving changes.

He also doesn’t rule out withdrawing from treatment until patients make lifestyle changes to improve their health.

Ms Paget spoke as the service marked its 75th anniversary.

On the issue of withdrawal from lifestyle treatments, he said: “If there’s good evidence to think about what that might look like, I think it’s a possibility.

“We know that when people are obese, their ability to respond well to surgical procedures and recover well is compromised. What we want to do is support people to lose weight before they have surgical procedures.”

But he is clear that he “will struggle with the concept of rejecting people’s medication based on some of their lifestyle choices”.

Ms Paget acknowledged the need for service changes as she faced growth in demand for services, with referrals alone having risen 13% in the past year.

That’s set against a backdrop of around 5,000 vacancies, according to Stats Wales, which also acknowledged this may be an underestimation.

He said progress on wiping out the pandemic’s backlog has been slower than he’d like, but insisted “we’ll get there”.

The waiting list for treatment in Wales currently stands at over 743,300 – approximately 582,000 individual patients – with the Welsh government’s goal of reducing waiting times still unfulfilled.

“I think we need to change what we do,” he said. “One of the things we really need to focus on is how we focus on keeping people healthy: preventing poor health; supporting our patients to make good choices around what they do.”

He pointed to the “big challenges ahead of us” posed by obesity and diabetes and the need for people to take good care of themselves.

However, the way services are delivered has changed, he said.

Ten years ago a controversial plan to concentrate some specialist services in south Wales was scrapped.

Different models are developing, but with the development of regional diagnostic centers and centers specializing in orthopedics and ophthalmic surgery all serving patients from multiple health boards, waiting times have reframed the discussion.

“I think it’s very important to have conversations with communities that may be affected by any change, but what we definitely need to do is focus our resources on providing the best health outcomes for patients.

“What we’re seeing right now is technology and research pulling us in both directions.

“There’s so much more we can do outside of the hospital in people’s homes; in the local community; in local doctors’ surgeries, GP surgeries; in other primary care settings.

“So we have something that attracts us like this — to decentralize. And then obviously we have another attraction, which is about the need to more centralize our highly specialized services.

“We need to provide opportunities for people to access diagnostics very quickly and the most efficient and effective way of doing that is in larger centers where we centralize everything together.”

Given low staff morale and patient frustration over access to care, is the 75th anniversary of the NHS a moment to celebrate, or take stock?

“I think we should celebrate NHS staff,” he said.

“They’ve been through a lot over the last few years. They are constantly being challenged.

“I think the constant criticism that they feel really takes a toll on their morale as well.

“So I think it’s time to yes, take stock and reflect. But, actually, I think there is a much stronger need to celebrate what staff in the NHS do every day to support us.”