Written Statement: Update on setting up an NHS Executive for Wales

This statement updates Members about our plans to establish an NHS Executive to drive improvements in the quality and safety of care across Wales.    

The decision to set up a national executive function was outlined in A Healthier Wales in 2018, and reconfirmed in the Programme for Government, and is based on the findings and recommendations of the OECD’s Quality Review and the Parliamentary Review of the Long-term Future of Health and Social Care. Both of these reviews called for a stronger centre, additional transformational capacity and streamlining of current structures.

Work to establish the NHS Executive was paused in 2020 to focus on the pandemic response. As we move beyond the emergency response to the pandemic, we can ensure the learning from the pandemic is built into the development of the NHS Executive.

I have decided to establish the NHS Executive as a hybrid model, rather than a standalone organisation. It will comprise a small, strengthened senior team within Welsh Government, bolstered and complemented by the bringing together of existing expertise and capacity from national bodies in the NHS, which will operate under a direct mandate from Welsh Government.    

Setting up the NHS Executive is an essential part of making our health system fit for the future. Its central purpose will be to support the NHS to deliver improved quality of care to people throughout Wales, resulting in better and more equitable outcomes, access and patient experience, reduced variation and improvements in population health. 

The NHS Executive will provide strong leadership and strategic direction – enabling, supporting and directing the NHS in Wales to transform clinical services in line with national priorities and standards by:

• Strengthening national leadership and support for quality improvement;
• Providing more central direction to ensure a consistent and equitable approach to national and regional planning based on outcomes;
• Enabling stronger performance management arrangements, including capacity to challenge and support organisations that are not operating as expected. 

It will bring together existing national capacity into a single delivery and accountability structure, operating to a mandate agreed by Ministers. 

Under these new arrangements statutory accountability mechanisms will not change. All NHS organisations are already directly accountable to Ministers and the Welsh Government and will continue to be. I will continue to set priorities, targets and outcome measures for the NHS, which will feed into the mandate for the NHS Executive to deliver with the wider NHS.  

The NHS Executive will provide additional capacity at a national level to oversee and support delivery of these priorities.  

An implementation programme to take forward the detailed work about how the NHS Executive will operate will be established. This will be led by Judith Paget, chief executive of NHS Wales and the Director General for Health and Social Services in the Welsh Government. As part of this programme there will be full engagement with NHS chairs and chief executives, the leads of national bodies, NHS and Welsh Government staff and wider stakeholders. 

I will update Members further as this work progresses.