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Health service calls for shift to prevention, long-term funding and cross-government planning as system faces growing pressure
WITH just one year to go until the next Senedd election, NHS leaders in Wales have issued a stark warning to politicians of all parties: without urgent and radical change, the Welsh health and social care system will face an unsustainable future.
The Welsh NHS Confederation, which represents all health boards and trusts in Wales, has published a new report setting out what NHS leaders want from the next Welsh Government. Based on responses from 95 senior NHS figures across the country, the report highlights the urgent need to move away from reactive, short-term measures and towards a long-term strategy focused on prevention, wellbeing, and coordinated action across government departments.
Key among the recommendations is a call for a cross-government strategy to improve health and reduce inequalities, with 87% of NHS leaders backing a national plan that would tackle the wider causes of poor health—such as poverty, housing, education, and employment.
The Confederation warns that without such action, the NHS will struggle to cope with rising demand, driven by factors including an ageing population, an increase in chronic and preventable illnesses, and ongoing workforce shortages. The number of people in Wales living with four or more long-term conditions is projected to double by 2035, placing even greater strain on already overburdened services.
Darren Hughes, director of the Welsh NHS Confederation, said: 'There is only so far the NHS and other public bodies can go in making meaningful, sustainable progress if the right conditions aren't in place.
'Short-term funding cycles make it extremely difficult for organisations to plan effectively, invest wisely, and build the kind of resilient communities we need. If we are serious about reversing the decline in the nation's health, we must focus now on prevention, early intervention and addressing health inequalities at their root.'
He added that demographic trends paint a worrying picture, with the proportion of the population aged 80 and over expected to double between 2000 and 2038. This group already accounts for a disproportionate share of NHS activity.
The Confederation is urging the next government to embrace the principles of the Well-being of Future Generations (Wales) Act 2015, which it says are not being fully realised under current funding arrangements.
While the report has been welcomed by many within the sector, some observers note that successive Welsh Governments—both Labour-led and, in coalition periods, involving Plaid Cymru and the Liberal Democrats—have long acknowledged the importance of prevention, yet struggled to shift funding and policy at the necessary scale.
Critics argue that similar calls have been made repeatedly over the past decade, yet the reality on the ground remains dominated by crisis response and waiting list backlogs. In February 2024, the Welsh Government was forced to issue a £175 million emergency funding package to tackle pressures in emergency care and elective surgery.
Meanwhile, the latest statistics from StatsWales show that as of March 2025, over 750,000 patient pathways remain open—meaning more than one in five people in Wales is waiting for planned treatment or assessment. The British Medical Association Cymru has described the situation as 'deeply worrying,' while acknowledging the immense strain frontline staff are under.
The Confederation's report does not shy away from the scale of the challenge, noting that achieving a shift to prevention will require bold political choices, including long-term investment in public health, closer integration with local government and social care, and a reallocation of resources away from acute care.
Political parties are now beginning to shape their manifestos ahead of the May 2026 Senedd election. Welsh Labour, which has led the Welsh Government since devolution began in 1999, has pledged to maintain a publicly funded, publicly delivered NHS. Plaid Cymru has emphasised the need for a 'National Health and Care Service' to integrate health and social care. The Welsh Conservatives have called for more choice for patients, greater use of technology, and a reduction in management bureaucracy.
The Welsh NHS Confederation said it would engage with all parties over the coming months to ensure that the voice of health and care leaders is heard in shaping the policy agenda.

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