Our full response can be downloaded below.
We welcomed the aims and ambitions set out in the Plan, in particular the recognition that delays can have a particularly significant impact on children as many treatments are age or developmental stage critical.
Welsh Government has now sent a clear statement that children and young people must be prioritised, with their needs and services considered and measured separately to adult services. However, member feedback indicates that a significant increase in workforce and funding in paediatrics and child health will be needed for this to be delivered and to achieve the stated aims.
Meeting people’s needs
- Waiting lists should be measured by age for reasons identified by the Welsh Government.
- To ensure transparency and make the most of this opportunity to effectively manage children’s services and to understand where resources need to be focussed and action taken, these data should be regularly published and communicated externally.
- Data should also be broken down by Health Board area to mitigate against geographical inequity within Wales.
- Welsh Government should consider how this data should be broken down to understand and take action on health inequalities.
- It would be helpful for the Welsh Government to set out how and when waiting times data will be published and communicated as part of this plan and its operationalisation.
- In terms of accelerating the embedding of virtual approaches and offer telephone and video appointments, we strongly recommend that that the Welsh Government and NHS services are mindful of our Principles for conducting virtual consultations with children and young people.
Targets and timescales
- This is a top line plan setting out principles and a vision and we accept that detailed targets and timescales for each service may be beyond its scope. There are also areas within that plan where further detail is needed, for example on dentistry and oral health.
- It is important that we have up-to-date data on the prevalence of tooth decay on children in Wales and what this means for hospital admission and waiting lists for children requiring dental extractions and other treatment.
- Given the ongoing disruption to dentistry services, the Welsh Government should provide a more detailed explanation of these ‘recovery phases’ and set out a plan for ensuring that its own targets and ambitions for children being seen by dentists are being met.
- Given the scale and impact of tooth decay, and the extent to which it is preventable, there was little in the plan on preventing tooth decay in children in the sections of the plan dealing with prevention of ill health. In State of Child Health and elsewhere we recommended ensuring sufficient funding and resource for Designed to Smile; and that Welsh Government should resource and support fluoridation of public water supplies, particularly for areas where there is a high prevalence of tooth decay.
Is it sufficiently clear which specialties will be prioritised/included in the targets?
- The Minister for Social Services has confirmed that she will publish the findings of the demand and capacity review of neurodevelopmental (ND) services and announce a series of actions to support medium to long term service improvements. We hope that these actions will be designed in partnership with clinicians enabling their views to be taken on board.
- We are not clear that ND services are prioritised and included in new targets but hope that publication of the demand and capacity review, will provide an opportunity to develop the plan for children and young people’s ND services.
- To make short term progress in tackling waiting lists, immediate investment is required by child health services including IT and digital infrastructure and estates. The need to specifically allocate or ringfence this funding for child health services has been fed back by members.
- We were encouraged to hear that the Health Education and Improvement Wales (HEIW) workforce strategy, part of the response to A Healthier Wales, made commitments to deliver the capability to provide reliable and comprehensive data; and robust modelling based on that data.
- Its success criteria include “Intelligence led workforce planning enabling us to change our workforce to meet our population need”. This will be needed if we are to develop a workforce that will be able to deliver the Welsh Government’s plan to transform planned care and tackle waiting lists.
- The Welsh Government plan signals a further strategic document in development: “We will develop in social partnership a Workforce Delivery Plan for Wales which incorporates these commitments and will enable the delivery of this plan as it is implemented”. If this is the document that sets out how the HEIW strategy will become a reality, this would be welcomed.
- However, the important thing will be the end result and the material reality of whether we have sufficient numbers of paediatricians along with the wider child health workforce in midwifery, nursing, allied health professionals, pharmacists, health visitors and school nurses.
- There is an increasingly busy strategic landscape around the health and social care workforce in Wales and we welcome this focus by the Welsh Government and HEIW. However, for the Welsh Government to reach the aspirations and meet the commitments made in the transformation plan, these will have to translate into appropriately staffed children’s services.
- The Workforce Delivery Plan for Wales will need to be consulted upon and delivered quickly; and will need to set out in detail how and when workforce commitments will be realised. It will also need to integrate seamlessly with HEIW’s mental health workforce plan, to set out how and when a mental health workforce to deliver the Welsh Government’s commitments in this space will be achieved.