Written Statement: NHS Wales Annual Planning Framework 2021-22

Usually at this time of year the NHS in Wales is busy and preparing for the usual winter pressures. This year however, is like no other. Balancing the needs of those with urgent and emergency conditions, as well as those with elective and routine care, has always been a challenge in the colder months but this year we have COVID-19 to factor in as well.

NHS organisations would normally be developing their three year integrated medium term plans, IMTPs, providing a plan to move their organisations forward to improve outcomes for patients. The statutory duty to produce the IMTPs emanates from the NHS (Wales) Act 2006, further enhanced by the NHS Finance (Wales) Act 2014 for health boards to ‘break even’ over a three year accounting period. But times are far from usual.

We find ourselves now having to strike a balance, as we learn to live and work with COVID-19. The ‘four harms’ have become our strategic framework:

• Harm from COVID-19:

• Harm from an overwhelmed health and social care system
• Harm from reduced non COVID-19 activity, and
• Harm from wider societal action e.g. lockdowns

The NHS needs to balance the work appropriately to reduce the overall amount of harm, but it is a difficult balance to achieve.

Developing and issuing an Annual Planning Framework for 2021-22 today is an important step in recognising how to achieve that balance. It allows the NHS to start thinking about stabilisation and recovery, even amid the very operational environment we find ourselves in.

The Annual Planning Framework approach is a natural evolution from the quarterly planning arrangements supported in 2020-21. It would be challenging to move back to three year IMTPs immediately from what has been, and continues to be, a very fluid and changeable planning environment. The NHS Wales Annual Planning Framework 2021-22 sets the direction for the year ahead. It seeks to blend the needs for immediate operational focus with the need to maintain cognisance of the longer term objectives set out in A Healthier Wales, and other legislative requirements, for example Wellbeing of Future Generation (Wales) Act and the Health & Social Care Quality and Engagement (Wales) Act.  

I am, of course, aware that preparing a three year plan during a challenging winter period also risks diverting key staff away from the operational management of services during this time. Given that the position next year is likely to remain volatile across health and social care, I have decided to build incrementally on the quarterly arrangements by requiring an annual plan for 2021/22.  

By adopting this approach it does not negate the statutory duties of health boards to produce a plan setting out their strategic objectives nor their financial responsibilities. There is currently additional financial scrutiny and support in relation to NHS plans and I expect that to continue throughout the coming year. However, my intention is also to avoid any undue criticism of the service by setting a clear direction through publication of this framework.

This planning framework has been purposely kept short and succinct. While we need to plan, we have to be ready and able to flex plans as conditions within which we work change, often very rapidly. I understand the challenging environment in which we are all working, but it is important that we plan together for 2021-22 to ensure we can all benefit from a strong and sustainable health and social care system and to improve outcomes for the population of Wales going forward. 

I am immensely grateful for the work that staff across both health and social care continue to undertake. Working together to develop plans for 2021 will enable us to treat not only those with COVID-19 but ensure the NHS is available for everyone. This and everything that the public are doing will help ‘keep Wales safe’.