MS, Cabinet Secretary for
Health and Social Care: In October, I made an oral statement about
the work I have put in place to deliver our ambition for a more
accountable, open and transparent NHS. This statement provides an
important update about how we are making the health service more
accountable to the public it serves and making meaningful and
transparent data about services more available and accessible.
I recently concluded the first round of public accountability
meetings with all NHS organisations. Each of these
were live streamed, enabling people to watch – for the first
time – the Welsh Government hold health boards, NHS trusts and
special health authorities to account about their plans,
finances, services, performance, quality and safety. The
recordings of these meetings, together with the post-meeting
letters, are available online. We will be publishing the evidence
packs supplied by each organisation this week.
Over the course of the last 12 months, more data has been made
available about NHS performance than ever before. The
new Emergency Ambulance
Performance Framework means there is more meaningful data
about how the ambulance service is performing and about patient
outcomes. The introduction of the framework has moved the Welsh
Ambulance Service beyond a single response‑time measurement to a
more transparent picture of the entire patient journey, from call
handling to clinical outcomes.
Publishing this broader set of measures allows people to see how
the ambulance service – and their partners – are delivering care
where, and when, it matters most. For example,
publishing data about return of spontaneous circulation rates
enables clinicians and the ambulance service to focus on
improving people's outcomes after a cardiac arrest because it
turns cardiac arrest care from a hidden clinical process into a
measurable, learnable system, focused on the chain of survival
and the role of wider society in its delivery.
The Ministerial Advisory Group
(MAG) on NHS Performance and Productivity, which carried out
a thorough review of the health service in Wales, reflected that
the accountability environment in Wales is complex, data‑heavy,
burdensome for NHS organisations lacks transparency and does not
drive improvement.
I am grateful for the group's insight and support. I have taken
action to rectify this. From April, the operating and
accountability framework for NHS Wales will be simplified,
aligning the system to the MAG's recommendations about
productivity and performance to strengthen accountability. The
NHS will move to a streamlined, risk-based oversight approach
with stronger clinical leadership and clearer consequences for
non-delivery. This will simplify the system and sharpen lines of
accountability, while improving the way Welsh Government holds
the NHS in Wales to account. It strengthens Ministerial
oversight, focuses on outcomes rather than processes, and
supports a culture of early intervention and improvement.
These arrangements will be implemented during the first quarter
of 2026/27. They will reduce the number of direct interfaces
between Welsh Government and NHS organisations with NHS
Performance and Improvement providing an operational assurance
interface. There will be a single, governed dataset and narrative
shared for assurance and performance reporting. The frequency of
meetings with Welsh Government will be dependent on an
organisations level of escalation meaning there will be earned
autonomy for those in lower levels of escalation.
As an initial step towards improving accountability,
all health board escalation
frameworks are now available on the Welsh Government website.
These set out the expected actions for improvement and
de-escalation criteria for each health board in escalation. The
automatic de-escalation was triggered for Cwm Taf Morgannwg and
Hywel Dda university health boards in February when they met the
cancer performance delivery requirements, which were set out in
their respective frameworks.
Finally, I set out in a written statement last
month, the action we are taking to improve NHS productivity.
This also responds to a recommendation made by the
Ministerial Advisory Group on NHS Performance and Productivity to
develop a holistic measure of system productivity.
We are committed to strengthening transparency and accountability
in the NHS and will continue to act on all opportunities to use
data and information to improve and transform services for the
public.
