Future Hospital update from Wales

Winter, for the RCP in Wales, like autumn, was occupied by a number of significant political events. As controversy takes hold in north Wales over the reorganisation of consultant-led obstetrics and gynaecology services, and hospitals continue to recover after a particularly difficult winter at the front door, the NHS in Wales remains in the headlines. The team in Wales, led by the RCP vice president for Wales, Dr Alan Rees, has been out and about, promoting the need for a patient-centred, clinically-led model of care, based on the Future Hospital report.¹

For example, the RCP Wales team, made up of physicians and patient representatives, attended the Welsh Labour, the Welsh Conservative and the Plaid Cymru political party conferences in February and March. Our key messages were taken from the Future Hospital report and the RCP Wales policy paper, Rising to the challenge.² We urged all political parties to support the Future Hospital vision and allow clinicians to lead change, and we called on them to commit to an electronic patient record and a national workforce and training strategy for Wales.

This work takes on a greater significance with the 2016 National Assembly for Wales elections on the horizon, and so the RCP Wales team has developed an action plan for the next Welsh Government with input from physicians, trainees and patients. We also hosted a round-table discussion with specialty leads and speciality society representatives in Wales, including physicians with a special interest in cardiology, gastroenterology, diabetes, respiratory medicine and neurology. The group agreed that workforce and training issues and the need for integrated care should be prioritised.

The vice president for Wales has also recently had meetings with a number of key decision-makers in Wales, including the minister for health and social services, Professor Mark Drakeford AM, and the deputy minister for health, Vaughan Gething AM. They were both keen to discuss a range of issues, especially Rising to the challenge,² which they warmly welcomed. The minister was especially interested in the RCP Future Hospital development site in Betsi Cadwaladr University Health Board. He also welcomed RCP involvement in the recent mid-Wales healthcare study which was published in September last year.

In fact, the challenge of rural medicine continues to be a recurring theme in Welsh politics. The RCP Wales team was substantially involved with the mid-Wales healthcare study and was the only royal college invited to deliver one of the keynote speeches at the recent mid-Wales rural healthcare conference in March. Other speakers included representatives from the Wales Deanery, NHS Scotland, Central Michigan University and Northumbria NHS Trust, and delegates travelled from across Wales. The RCP Wales presentation on ‘New Thinking from the RCP’ developed the idea that the Future Hospital is ‘more than a building’ and promoted the need to develop rural and remote medicine training pathways in Wales.

Meanwhile in Westminster, the House of Commons Welsh Affairs Committee has urged the governments in Cardiff and London to work together to remove ‘deterrents’ to GPs working on either side of the Wales-England border. The committee also found that patients living near the border face ‘a worrying lack of information’ about the impact of growing differences in the organisation of health care since devolution.

In legislative news, the Safe Nurse Staffing Levels Bill is proceeding through the National Assembly for Wales. The RCP recently gave oral evidence to the health and social care committee, highlighting our calls for effective enforcement, the importance of reporting transparent, accurate staffing outcomes, and the need to publish real-time medical and nursing staffing data in a prominent place on every ward.

In an excellent example of collaborative working to develop the Future Hospital, the RCP Wales team, the Wales Deanery and health board clinical leads came together to discuss progress on the chief registrar project in Wales and how it fits in with the RCP London project. The group aims to develop a standardised role description in order to develop a business case for a national chief registrar programme in Wales, focusing on leadership skills.

Finally, our local conversations with hospitals in Wales continue, with recent visits to Glan Clwyd Hospital and the University Hospital of Wales. Glan Clwyd Hospital also hosted the North Wales Future Hospital Symposium 2015 in February, which was attended by members of the RCP Wales team along with Dr Mark Temple, the RCP's future hospital officer. The day was full of positive and constructive debate, with a strong focus on finding solutions to the challenge of rising admissions. The RCP team is now looking ahead to planned visits to hospitals in Wrexham and Swansea.

• © Royal College of Physicians 2015. All rights reserved.