Wales

The Welsh Government want to put rules in place for how care and support services are commissioned in Wales.
These changes would become part of a Code of Practice. The Code of Practice is made under a law called the Social Services and Well-being (Wales) Act. There is already Codes of Practice for other parts of the law, but this new one will say what the rules are for how care and support services are commissioned.

The Welsh Government plans to develop a national framework for social prescribing that would set a common set of standards and ensure consistent delivery.
They want to:

•    develop a common understanding of the language used to describe social prescribing
•    agree a model of social prescribing for Wales
•    understand what is already happening across Wales, what is working well and what isn’t
•    identify what action can be taken on a once for Wales basis
•    help embed social prescribing services in areas where they either don’t exist or need to be developed further
•    find out which technological solutions they need to develop

The Health and Social Care (Quality and Engagement) (Wales) Act 2020 places a duty of candour on NHS bodies in Wales. This Consultation sought views on the Regulations and Statutory Guidance needed to implement that duty.

The Welsh Government consulted on:

• how they introduce the Duty of Candour to NHS organisations through new statutory guidance and statutory regulations
• amending the 'Putting Things Right' regulations and guidance to enable the Duty of Candour to integrate with them

Link to Consultation

Members were asked to share their views on a new duty to improve disabled people’s access to communal areas of residential properties and how will this impact them and people requiring adaptations?

This consultation regards the commencement and implementation of the remaining parts of section 36 of the Equality Act 2010. This legislation places a duty on landlords to make reasonable adjustments to the common parts of let residential premises when requested by a disabled person. ‘Common parts’ include outside areas, entrances, hallways, landings and stairwells.

Disabled people can already make such requests but there is currently no legal duty on the landlord to make reasonable adjustments to common parts. Before commencement, regulations will be needed to set out how the new arrangements will work. The government proposed that guidance would be drafted to help landlords and disabled people to understand their rights and obligations.

Link to consultation: https://www.gov.uk/government/consultations/improving-disabled-peoples-access-to-let-residential-premises-reasonable-adjustments-to-common-parts-a-new-duty

July 2022

The Government launched a public consultation on proposed changes to the Mental Capacity Act (MCA) Code of Practice for England and Wales, which included guidance on the new Liberty Protection Safeguards (LPS) system. The consultation document and the Code of Practice were also be published in Welsh. This was a joint consultation published by DHSC, Ministry of Justice, Department for Education and Welsh Government.

July 2022

The Department of Health and Social Care (DHSC) and the Ministry of Justice (MoJ) consulted on the proposed changes to the Mental Capacity Act 2005 (MCA) Code of Practice, which includes guidance on the new Liberty Protection Safeguards (LPS) system. This consultation also sought views on the LPS regulations, which will underpin the new system.

The MCA applies in England and Wales, but some aspects of its application are devolved in Wales. The Welsh Government therefore informed this consultation.

The LPS will apply to people over the age of 16, and the Department for Education (DfE) has been involved in the development of this new system.

The government consulted on a number of documents:

• The Code of Practice
• LPS regulations
• LPS implementation products

Link to the consultation: https://www.gov.uk/government/consultations/changes-to-the-mca-code-of-p...

June 2022

As part of its inquiry into the impact of the waiting times backlog on people in Wales who are waiting for diagnosis or treatment, the Health and Social Care Committee sought written evidence from health and social care stakeholders on the plan for transforming and modernising planned care and reducing waiting lists published by the Welsh Government on 26 April 2022. published by the Welsh Government on 26 April 2022.

The Committee asked for views on the following matters:
•    Whether the plan will be sufficient to address the backlogs in routine care that have built up during the pandemic, and reduce long waits.
•    Whether the plan strikes the right balance between tackling the current backlog, and building a more resilient and sustainable health and social care system for the long term?
•    Whether the plan includes sufficient focus on:
o    Ensuring that people who have health needs come forward;
o    Supporting people who are waiting a long time for treatment, managing their expectations, and preparing them for receiving the care for which they are waiting, including supported self-management;
o    Meeting the needs of those with the greatest clinical needs, and those who have been waiting a long time;
o    Improving patient outcomes and their experience of NHS services?

•    Whether the plan provides sufficient leadership and national direction to drive collective effort, collaboration and innovation-sharing at local, regional and national levels across the entire health and social care system (including mental health, primary care and community care)?
•    Whether the plan provides sufficient clarity about who is responsible for driving transformation, especially in the development of new and/or regional treatment and diagnostic services and modernising planned care services?
•    Are the targets and timescales in the plan sufficiently detailed, measurable, realistic and achievable?
•    Is it sufficiently clear which specialties will be prioritised/included in the targets?
•    Do you anticipate any variation across health boards in the achievement of the targets by specialty?
•    Is there sufficient revenue and capital funding in place to deliver the plan, including investing in and expanding infrastructure and estates where needed to ensure that service capacity meets demand?
•    Is the plan sufficiently clear on how additional funding for the transformation of planned care should be used to greatest effect, and how its use and impact will be tracked and reported on?
•    Does the plan adequately address health and social care workforce pressures, including retention, recruitment, and supporting staff to work flexibly, develop their skills and recover from the trauma of the pandemic?
•    Is there sufficient clarity about how digital tools and data will be developed and used to drive service delivery and more efficient management of waiting times?

Link to consultation

March 2022

Social Care Wales asked for comments on their plan for the professional mental health workforce for health and social care in Wales.

They developed the plan with Health Education and Improvement Wales (HEIW) to respond to the actions outlined in Together for Mental Health. To make sure they develop a full approach to supporting people, the plan includes all parts of the workforce who play a role in mental health services.

The actions they suggested in the consultation were a result of the engagement, research and analysis they have carried out.

Link to consultation

February 2022

The Health and Social Care Committee of the Welsh Parliament held an inquiry into mental health inequalities.
 
The Committee looked for views about:

• Which groups of people are disproportionately affected by poor mental health in Wales? What factors contribute to worse mental health within these groups?
• For the groups identified, what are the barriers to accessing mental health services? How effectively can existing services meet their needs, and how could their experience of using mental health services be improved?
• To what extent does Welsh Government policy recognise and address the mental health needs of these groups? Where are the policy gaps?
• What further action is needed, by whom/where, to improve mental health and outcomes for the groups of people identified and reduce mental health inequalities in Wales?

The committee wanted to ensure that their work is informed by experiences, needs, and views that reflect the diversity of the people and communities affected by these issues.

Link to Consultation

December 2021

During the Sixth Senedd, the Health and Social Care Committee explored how patient flow through hospitals can be improved. The first part of this work was a short inquiry focusing on hospital discharge and its impact on patient flow through hospitals.

The Committee considered in particular:

• the scale of the current situation with delayed transfers of care from hospital.
• the impact of delays in hospital discharge, both on the individual and the patient flow through hospitals and service pressures.
• the variations in hospital discharge practices throughout Wales and cross-border, and how they are meeting the care and support needs of individuals.
• the main pressure points and barriers to discharging hospital patients with care and support needs, including social care services capacity.
• the support, help and advice that is in place for family and unpaid carers during the process.
• what has worked in Wales, and other parts of the UK, in supporting hospital discharge and improved patient flow, and identifying the common features.
• what is needed to enable people to return home at the right time, with the right care and support in place, including access to reablement services and consideration of housing needs.

Link to consultation

September 2021

In order to help inform the Children, Young People and Education Committee strategic planning and forward work programme, the Welsh Parliament asked for views on what their main priorities should be during the Sixth Senedd (2021-2026). 

Link to consultation

The Health and Social Care Committee has been set up by the Senedd to look at policy and legislation, and to hold the Welsh Government to account on specific issues. This includes the physical, mental and public health and well-being of the people of Wales, including the social care system.

During autumn 2021, the Committee will be considering its strategic approach and forward work programme. To make sure that the Welsh Parliament can take account of what people think the most important issues are, they asked for views on:

The initial priorities for the Sixth Senedd identified by the Committee

• Public health and prevention
•  The health and social care workforce, including organisational culture and staff wellbeing
• Access to mental health services
• Evidence based innovation in health and social care
• Support and services for unpaid carers
• Access to COVID and non-COVID rehabilitation services
• Access to services for long-term chronic conditions, including musculoskeletal conditions

What other key priorities the Committee should consider during the Sixth Senedd in relation to: health services, social care and carers, and COVID recovery.

Wales

This consultation document from the Welsh Government seeks views on proposals to introduce new legislation to improve social care arrangements and strengthen partnership working to achieve the vision set out in the Social Services and Well-being (Wales) Act 2014 for people who need care and support and carers who need support. Proposals include setting out a clear national framework to support services to be planned regionally and delivered locally, and for the strengthening of partnership arrangements.

Link to Consultation

April 2021

The Mental Health Act White Paper (England and Wales) was out for consultation and members were invited to give their views on changes to the Mental Health Act to help put patients at the centre of decisions about their own care and ensure everyone is treated equally.
In 2017 the government asked for an independent review of the Mental Health Act 1983 (MHA), to look at how it is used and to suggest ways to improve it.  The review’s final report said that the MHA does not always work as well as it should for patients, their families and their carers.  The government is now proposing a wide range of changes to rebalance the MHA.
The changes are based on 4 principles that have been developed with people with lived experience of the MHA.

They are:

• choice and autonomy – ensuring service users’ views and choices are respected
• least restriction – ensuring the MHA’s powers are used in the least restrictive way
• therapeutic benefit – ensuring patients are supported to get better, so they can be discharged from the MHA
• the person as an individual – ensuring patients are viewed and treated as individuals

The document includes specific chapters for the criminal justice system, people with learning disabilities and autistic people, children and young people and experiences of people from BAME backgrounds.

December 2020

This consultation sought views on the Code of Practice on the Delivery of Autism Services under the Social Services and Well-being (Wales) Act 2014 and the NHS (Wales) Act 2006. It will support the delivery of the Welsh Government’s autism priorities as set out in the Autistic Spectrum Disorder Strategic Action Plan published in November 2016.

The Welsh Government consulted on: 

• assessment and diagnosis
• accessing health and social care services
• raising awareness and training
• planning, monitoring and stakeholder engagement

Link to Consultation: https://gov.wales/code-practice-provision-autism-services

November 2020

The Justice Committee conducted an inquiry into the future of legal aid.  The legal aid system in England and Wales was fundamentally changed by the Legal Aid, Sentencing and Punishment of Offenders Act 2012 (LASPO).  Since then, there have been a number of legislative changes and post-legislative reviews of LASPO.  The Justice Committee examined the changes to civil legal aid in 2014 and the changes to criminal legal aid in 2018.  This inquiry’s aim was to look ahead to the future of legal aid, to identify the major challenges facing clients and providers and how they might be tackled.  The inquiry was especially keen to hear about the sustainability of the legal aid market, the impact of Covid-19 and the increasing reliance on digital technology to deliver legal advice and court services. 

Link to consultation

July 2020

Consultation on the Welsh Government’s guidance on the management and accountability of transition and handover processes in healthcare services for children and young people as they move from children’s to adult services.

RCOT responded to the Welsh Government’s consultation on its guidance regarding transition processes for children as they move from children’s to adult healthcare services.

Background to the consultation

The aim of the Welsh Government guidance is to make the process of transition from children’s to adult services more transparent and easy to navigate.

Rather than take a strict age bound approach, the Welsh Government believes that the system must respond to the child or young person’s individual needs. A child’s experience of growing older into adulthood is a process, not an event, and may span a wide age range.

The focus of the Guidance is on what health services need to do to ensure that a well-structured, effective process is in place to meet the integrated healthcare needs of children, young people and young adults, promote quality and safety, access, autonomy and efficient care for better health outcomes.

RCOT questions on the guidance

• Do you currently support young people as they transition from children’s to adult services? What do you feel is the unique role and contribution of occupational therapy at this time?
• Have you or a member of your team been a named worked to coordinate the transition process? Do you think that occupational therapists have the skills, experience and time to fulfil this role?
• Do you use any specific documentation to support to hand over care? Do you use any particular occupational therapy tools/outcome measure to help inform the transition process? Will these be relevant for use with these guidelines?
• Please provide examples of how occupational therapists seek and incorporate the views of young people during the transition process.
• Will this document, in your view, improve the handover process?
• Would having an occupational therapist in GP practices improve the handover process at the primary care level? And if so, how?

Link to consultation

September

Health Education & Improvement Wales and Social Care Wales developed a set of principles earlier in the year and tested these with partners. However, the impact of COVID-19 meant that not everyone was able to provide feedback and so they suspended the consultation. In the interim, they took the opportunity to reflect on the feedback that they had received prior to COVID-19 as well as the learning during the initial phase of the pandemic. As a result, they refined the principles and are looking to test these with partners and stakeholders.

They welcomed views on these draft principles as part of their engagement process, specifically in relation to the following questions:

• Do the principles and compass capture the right things?
• Is there anything missing that you'd have hoped to see there?
• Would you be content to endorse these principles on behalf of your organisation so that they build the mandate for action?

HEIW provided links for examples of leadership resources hosted on the Gwella Leadership Portal

Social Care Wales provides leadership resources on their website

June 2020

The Welsh Parliament Health, Social Care and Sport Committee  undertook an inquiry into the impact of the Covid-19 outbreak, and its management, on health and social care in Wales.

The inquiry considered the impact of the outbreak, and its management, on health and social care services in Wales. As part of this, the Committee examined the response by the Welsh Government and relevant public bodies, as well as considered the impact on staff, patients and others receiving care or treatment in both clinical settings and the community. It also considered the Wales response in the wider, UK context.

Link to consultation

June 2020

Health Education and Improvement Wales (HEIW) has the responsibility to develop the Annual Education and Training Plan for Health Professional education and training which is considered by the Minister for Health and Social Services each year.  In normal times they engage with stakeholders through various routes usually in May to discuss the proposals for training of Health professional staff for the coming year, in this instance for 2021/22, however given the circumstances this year as a result of the COVID 19 emergency, a different approach was taken.

HEIW developed the Annual Education and Training Plan in light of the best evidence available and produced a brief presentation below summarising HEIW proposals which formed the basis of the consultation.

September 2019

This first workforce strategy was developed by Health Education and Improvement Wales (HEIW) and Social Care Wales, supported by the Institute of Public Care at Oxford Brookes University. Since January 2019, they have engaged with more than 1,000 people to help develop this consultation document.

Social Care Wales wanted to hear views about the themes and actions that have been developed as part of that engagement before a strategy is finalised in time to be launched next year in 2020.  It follows the publication of ‘A Healthier Wales’, the Welsh Government’s long-term vision for health and social care. This responded to a Parliamentary Review of health and social care in Wales, which published its findings in January 2018.

The ambition of ‘A Healthier Wales’ is for the health and social care systems to work together so that people using them won’t notice when services are provided by different organisations. A seamless system of health and social care will need a workforce that provides the best care, irrespective of who they are employed by and where they are based.

This has led the Welsh Government to commission HEIW and social Care Wales to develop a long-term workforce strategy in partnership with the NHS and local government, the voluntary and independent sectors as well as regulators, professional bodies and education providers.

The workforce strategy is an opportunity to change the conversation - to understand what matters to the workforce as they provide care and support to the population - as much as what matters to the people they care for.

Read the consultation

August 2019

The Welsh Government asked for  views on the revised code of practice on measuring the performance of social services.  They consulted on what should be included in the code of practice and the supporting technical guidance. This includes:

• how local authorities performance should be measured
• the quality standards that all local authorities should be working towards
• a new performance and improvement framework that local authorities will be required to collect.

Read the consultation

August 2018

This consultation from the Welsh Government sought views on future student support arrangements for health related education and training programmes in Wales including:

• the nature of future support
• the financial and other support received
• period of commitment to work in Wales after qualification

• Read the RCOT response

December 2018

The National Assembly for Wales Health, Social Care and Sport Committee welcomed views on the extent of the problem of suicide in Wales.

The Committee called for evidence about:

• The extent of the problem of suicide in Wales and evidence for its causes - including numbers of people dying by suicide, trends and patterns in the incidence of suicide; vulnerability of particular groups; risk factors influencing suicidal behaviour.
• The social and economic impact of suicide.
• The effectiveness of the Welsh Government’s approach to suicide prevention - including the suicide prevention strategy Talk to me 2 and its impact at the local, regional and national levels; the effectiveness of multi-agency approaches to suicide prevention; public awareness campaigns; reducing access to the means of suicide.
• The contribution of the range of public services to suicide prevention, and mental health services in particular.
• The contribution of local communities and civil society to suicide prevention.
• Other relevant Welsh Government strategies and initiatives - for example Together for Mental Health, data collection, policies relating to community resilience and safety.
• Innovative approaches to suicide prevention.

Link to consultation.

Read RCOT Response.