2000+

“Improving Health in Wales – A Plan for the NHS with its partners” (2001) proposed new structures and organisational change for the NHS in Wales. The structure was developed to meet the following principles:
  • Simpler for patients to understand
  • Accountable for the actions it takes and the service it delivers
  • Stronger democratic voice in the way it is governed

The 5 Health Authorities in Wales are dissolved in this new structure. The following identifies the key elements of the new structures:

  • The Health & Social Care Department: On 1st March 2004, as part of the commitment to partnership working at all levels, a new Health & Social Care Department was created as part of the Welsh Assembly Government. Ann Lloyd is Head of the new department and Chief Executive of NHS Wales.
  • Regional Offices: 3 Regional Offices, led by Regional Directors who act as the agents of the Director of NHS Wales on a day to day basis in holding to account the Chief Executives of the 36 statutory NHS bodies and managing their performance.
  • National Leadership and Innovation Agency for Healthcare (NLIAH) - was launched formally in March 2005. The purpose of the Agency is to provide a national strategic resource to support NHS Wales in delivering the ‘Designed for Life’ agenda by building leadership capacity and capability to secure continuous service improvement underpinned by technology, innovation, leading edge thinking and best practice. 
  • Health Commission Wales (Specialist Services): This “arms length” agency provides advice on specialised secondary and regional services commissioning. HCW also provides guidance and support for the commissioning of acute services. It is intended to be the first source of independent advice and guidance on commissioning issues that require determination.
  • The National Public Health Service (NPHS) and The Wales Centre for Health (WCH) (NB. These are now both part of Public Health Wales): The NPHS draws together the majority of public health functions previously provided by the Health Authorities. The NPHS provides public health advice and expertise predominantly to Local Health Boards and is structured around the 3 regional offices, each of which has a regional public health director. WCH is closely linked to the work on public health. It is an independent centre for public health advice, information, research and multi-professional development.
  • Local Health Boards (LHBs): There are 21 Local Health Boards and one unified healthcare board, each of which is co-terminous with local government unitary authorities. The main roles of LHBs are corporate and clinical governance; securing and providing primary and community care health services; securing secondary care services; improving the health of communities; partnership; public engagement; provision of services. In the short term LHBs are supported by a Business Services Centre (BSC) managed by Powys LHB providing financial services, human resources, management information and computer technology, estates support and procurement.
  • NHS Trusts: NHS Trusts, other than Powys, were not structurally affected by the structural changes of 2001.  They are however, expected to work closely with LHBs, local authorities and others. There are 13 NHS Trusts in Wales providing a range of services whose role involves the provision of health and community services, partnership building, organisational development, and public engagement.  The 13 integrated Trusts are complimented by one All Wales Ambulance Trust.
  • Community Health Council (CHCs) - There is a CHC in each of the 22 local government areas in Wales and they take up a wide range of health issues on behalf of the public.
  • Review of Health & Social Care in Wales

  • Designed for Life: a new strategy for health and social care in Wales