Healthcare Inspectorate Wales
(HIW) has today published its Annual Report 2025-2026,
highlighting the need for faster progress in addressing
long-standing challenges affecting healthcare services across
Wales.
The report highlights the continued dedication of healthcare
staff across Wales, while identifying persistent challenges
including access to care, patient flow, workforce pressures, and
the suitability of some healthcare environments that continue to
affect the quality, safety and experience of care.
During the year, HIW carried out 216 on-site inspections,
received 783 concerns from the public, and heard from more than
4,400 patients, families and carers, as well as more than 1,600
healthcare staff.
Compassionate, person-centred care remains a significant strength
across Wales. Patients consistently described staff as kind,
respectful and committed, and inspectors found many examples of
healthcare professionals going above and beyond to support people
receiving care despite challenging circumstances.
However, HIW's findings show that healthcare services continue to
operate under significant and sustained pressure. Demand remains
high, delays in treatment continue to affect patients, and
problems with patient flow continue to reduce capacity across
urgent, emergency and planned care services. Workforce pressures
and reliance on temporary staffing are also affecting the
resilience and sustainability of healthcare delivery.
The report notes that many of these challenges are not new. They
are recurring themes identified through inspections, concerns
raised with HIW and wider system insight over a number of years.
While progress is being made in some areas, improvement is not
always happening at the pace required or being sustained over
time, meaning patients are not always seeing the lasting benefits
they should expect.
Mental health services remain one of the areas where the most
significant concerns are identified through HIW's work. Although
inspectors found many examples of dedicated staff providing
compassionate care, HIW continues to identify concerns about the
condition and suitability of some NHS mental health facilities.
The report highlights the impact that poor environments can have
on patients' safety, privacy, dignity and wellbeing, and the need
for sustained action to address long-standing issues.
The report also identifies continued growth and change within the
independent healthcare sector, including private healthcare,
medical agencies, weight management, wellbeing and aesthetic
services. While this brings greater choice for patients, HIW
continues to identify concerns relating to unregistered providers
and unsafe practice. It highlights concerns that current
regulatory arrangements may not provide sufficient oversight in
some rapidly expanding areas of healthcare, particularly laser
and aesthetic treatments.
Concerns raised with HIW continue to reflect the wider pressures
facing healthcare services, with people most commonly reporting
issues relating to waiting times, emergency care pressures,
access to GP and dental services, and mental health care.
The report reflects the breadth of HIW's work across healthcare
services in Wales, including NHS services, independent
healthcare, mental health services, primary care, and dental
services. It highlights both areas of good practice and areas
where improvement is required, while identifying emerging
challenges associated with changing models of healthcare delivery
and growing patient expectations.
Alun , Chief Executive of Healthcare
Inspectorate Wales said:
This report provides a clear and independent picture of the
quality of healthcare across Wales. Across the NHS in Wales we
continue to see dedicated healthcare staff delivering
compassionate care in often
meaningful and lasting improvement. HIW will continue to provide
independent assurance, highlight both good practice and areas of
concern, and use its voice to support improvement for the people
of Wales."