The Welsh NHS is facing a complex web of challenges, and the recent election in Wales provides an opportunity to assess the situation. While there are signs of improvement, particularly in planned care, the system is still under severe strain, especially in emergency and cancer care.
The Waiting Game
The waiting list issue is a critical concern for patients, and the recent figures show a positive trend. The number of appointments, tests, and treatments waiting to be carried out has decreased for the tenth month in a row, and the longest waits are falling. However, this improvement may not be felt by patients, as one person can be waiting for multiple appointments, tests, or treatments.
The Welsh government's focus on these targets is commendable, but it's essential to recognize that the recovery in planned care can significantly impact public health. Patients can experience less pain, uncertainty, and cancelled plans, and they may be able to stay in work or care for family.
Emergency Care: A System in Crisis
Emergency care is a critical area of concern. Despite the system's efforts, emergency departments are under immense pressure. In April, Wales recorded nearly 95,000 emergency department attendances, with only 66% of patients admitted, transferred, or discharged within four hours. This is a far cry from the target of 95%.
The issue is not solely due to the number of people attending A&E. It's a complex interplay of factors, including full wards, delayed discharges, and the inability of ambulances to hand over patients. This results in patients waiting 12 hours or more, causing frustration and highlighting the system's inefficiencies.
Cancer Care: Time is of the Essence
Cancer care is another area where the stakes are high. The Welsh target of 75% of patients starting treatment within 62 days is challenging to achieve. In March, the performance improved to 60.2%, but this is still a cause for concern. Delays in cancer treatment can lead to more advanced disease, complex treatment, and poorer outcomes, emphasizing the urgency of the situation.
Mental Health Services: A Different Kind of Pressure
Mental health services are also under pressure, with local support services receiving 7,568 referrals in March 2026. The system is managing to complete 84.9% of assessments within 28 days and initiate 92.7% of treatment within the same timeframe. However, the rising demand across different parts of the system indicates that the pressure is not limited to planned operations.
The Workforce: A Key Challenge
The NHS in Wales has seen an increase in staff numbers, with 100,224 full-time equivalent staff employed at the end of 2025. However, this does not guarantee sufficient capacity. The system is grappling with 5,652 vacancies and a 6.4% average sickness absence rate. Anxiety, stress, depression, and other psychiatric illnesses account for a significant portion of these absences.
The financial reality is also a challenge, with all seven Welsh health boards breaching their statutory duty to break even over the three years to 2024 and 2025. This financial strain impacts the ability to improve access, support staff, and redesign services.
Conclusion: A Journey Towards Safer, Faster, and More Humane Care
The Welsh NHS is making progress, but the journey towards a safer, faster, and more humane system is far from over. The test for patients will be whether the entire care journey feels improved, not just individual graph improvements. It's a complex challenge that requires addressing the workforce, financial, and operational aspects to ensure a sustainable and effective healthcare system.
