StructureThe NHS in Wales underwent major change in 2009 to equip it to deliver better heathcare to the population of Wales in the 21st century.

Why the need for change?

The Welsh Assembly Government's One Wales Strategy document determined that the delivery of the NHS in Wales needed redesign to improve health outcomes and ensure that the NHS delivers care effectively with its partners.
A growing older population, more people living with chronic conditions, challenges in providing timely, effective and cohesive services in rural locations, increasing obesity rates and low levels of physical activity, service targets and a challenging financial climate, are just some of the major challenges facing us.
We need to provide more care closer to people’s homes and more self-care programmes to help people live more independent lives, provide more joined up services between health and social care, and increasingly focus on public health, creating a wellness service, rather than a sickness service. It means a shift in the balance of care, looking at whole systems rather than just hospitals. There is a strong emphasis on public health and long-term planning. (Source:NHS in Wales: Why we are changing the structure. Welsh Assembly Government October 2009)
The reorganisation of NHS Wales, which came into effect on October 1st 2009 created single local health organisations that are responsible for delivering all healthcare services within a geographical area, rather than the Trust and Local Health Board system that existed previously.  

The NHS now delivers services through seven Health Boards and three NHS Trusts in Wales. 


Map of Health BoardsHealth Boards

The seven Local Health Boards (LHBs) in Wales now plan, secure and deliver healthcare services in their areas, replacing the 22 LHBs and the 7 NHS Trusts which together performed these functions in the past. 

NHS Trusts

There are currently 3 NHS Trusts in Wales with an all - Wales focus. These are the Welsh Ambulance Services Trust for emergency services, Velindre NHS Trust offering specialist services in cancer care and a range of national support services and the new Public Health Wales.
Public Health Wales is the unified Public Health organisation in Wales. 
The organisation became fully operational on 1 October 2009 and now exercises the functions of the National Public Health Service, Wales Centre for Health, Welsh Cancer Intelligence & Surveillance Unit, Congenital Anomaly Register & Information Service for Wales, and Screening Services Wales all with a nation wide remit.

National Delivery Group

The Chief Executive, NHS Wales, is responsible for providing the Minister with policy advice and for exercising strategic leadership and management of the NHS. To support this role, the Chief Executive will chair a National Delivery Group, forming part of the Department for Health and Social Services (DHSS).
This group is responsible for overseeing the development and delivery of NHS services across Wales.

Community Health Councils

Community Health Councils in Wales are statutory lay bodies that represent the interests of the public in the health service in their district. They give people an independent voice in their local NHS and the services it provides. The number of CHCs are being reduced to 7 contiguous with the new Local Heath Boards. The 7 new CHCs will be underpinned by 23 area associations with strong local links.


The NHS Wales Shared Services Partnership

The NHS Wales Shared Services Partnership (NWSSP) is an independent organisation, owned and directed by NHS Wales. NWSSP supports NHS Wales through the provision of a comprehensive range of high quality, customer focused support functions and services.

National Leadership and Innovation Agency for Healthcare (NLIAH) Functions Transfer to NHS Wales and Welsh Government

A review has been undertaken of the National Leadership and Innovation Agency for Healthcare.  

The purpose of the review was to simplify, align and streamline functions and accountabilities with the result that from 1 April 2013, the functions and staff of NLIAH have transfered to:

  • Welsh Government
  • Public Health Wales
  • Shared Services Partnership

You can find more detailed information on the transfer of functions on the NLIAH web page below. This is an archived resource and will no longer be updated.