The new Welsh Government's plans for health and social care reform place significant emphasis on the workforce. Their initial policy priorities include strengthening integration between health and social care, delivering more care closer to home, and a greater focus on prevention.
Delivering these reforms will depend not only on increasing workforce capacity, but also on reshaping the workforce to support different patterns of care. This points to the need for a workforce capable of supporting new models of care and a shift away from reactive, hospital-centred services towards a more sustainable system focused on long-term population needs.
Key workforce priorities
The Welsh Government's stated priorities include:
- Publishing a new long-term NHS Wales workforce strategy and plan (expected in autumn 2026).
- Improving workforce planning to ensure the right people are in the right teams and places, and to support priorities such as reducing waiting times and improving cancer services.
- Supporting recruitment, retention, and employment opportunities across the health workforce, including addressing challenges faced by nursing, midwifery, and paramedic graduates.
- Strengthening the social care workforce and supporting closer integration between health and social care services.
- Expanding community and primary care capacity, including multidisciplinary and allied health professional roles, to support prevention, early intervention, and care closer to home.
Taken together, these priorities reflect the Welsh Government's ambition for a more planned, sustainable, and integrated workforce spanning health, social care, and public health.
While this article focuses mainly on the NHS workforce, many of the challenges and policy developments discussed are closely linked to social care. A strong social care workforce is important not only for supporting people's wellbeing and independence, but also because it underpins the effective operation of the wider health and care system. This is particularly relevant as the Welsh Government seeks to strengthen integration between health and social care. Further analysis of social care workforce issues is available in our article, Vacancies and visas: the workforce pressures facing adult social care.
How do these priorities address longstanding workforce challenges?
Many of the priorities set out in recent ministerial statements reflect issues that have featured prominently in Senedd scrutiny and stakeholder evidence for several years, and in the approach of the previous Welsh Government. A Healthier Wales, the long-term plan for health and social care, first published in 2018, set out a vision for more seamless health and social care services, supported by a sustainable and skilled workforce. The Workforce Strategy for Health and Social Care (2020) and National Workforce Implementation Plan (2023) similarly highlighted the importance of longer-term workforce planning in supporting wider system transformation. While the challenges themselves may not be new, the commitment to a new NHS workforce strategy represents an opportunity to bring greater focus and coherence to efforts to address them.
Audit Wales has repeatedly highlighted workforce sustainability, recruitment, and retention as significant challenges for NHS Wales, and has called for a stronger, national approach to workforce planning. The Sixth Senedd Health and Social Care Committee also identified the recruitment and retention of the health and social care workforce, alongside the need for effective long-term planning, as recurring areas of concern that should remain a priority for its successor committee.
Recent concerns about employment opportunities for newly qualified nurses, midwives, and paramedics illustrate some of the complexities of workforce planning. While shortages remain a challenge across many areas of health and social care, reports of some graduates struggling to secure NHS employment have raised questions about how education and training pathways align with workforce needs and available NHS posts.
The Welsh Government's emphasis on strengthening the social care workforce reflects longstanding concerns about recruitment, retention, and capacity in the sector, as well as the wider effects of those workforce pressures on the health system, including delayed hospital discharges.
Similarly, commitments to expand community-based and multidisciplinary care build on long-established ambitions to deliver more care closer to home. As a result, workforce policy discussions have increasingly focused not only on workforce numbers, but also on the skills, roles, and ways of working needed to support new models of care. This includes enabling staff to work at the top of their competence, expanding advanced practice roles, and making greater use of multidisciplinary teams. For example, delivering more care closer to home may require expanding community nursing, pharmacy, physiotherapy, and other allied health professional roles, allowing people to receive support outside hospital settings where appropriate.
Workforce data challenges
Workforce data will play an important role in assessing progress against the Welsh Government's priorities. However, a number of challenges may make it difficult to determine whether reforms are delivering their intended outcomes.
Vacancy rates are widely used as an indicator of workforce shortages. However, vacancies do not necessarily indicate whether services have sufficient staff to meet current or future population needs. Audit Wales has emphasised that effective workforce planning must account for future service demand and population needs, rather than focusing solely on existing staffing gaps.
Workforce data can provide valuable information about workforce supply and trends, but it does not always capture how staff are deployed, how services are delivered, or the extent to which workforce changes are contributing to wider policy objectives. For example, while the Welsh Government has emphasised expanding community-based care and strengthening multidisciplinary working, available data does not always make it easy to assess whether changes in workforce capacity, roles, and deployment are supporting these ambitions.
Similarly, increases in staff numbers may not necessarily indicate improved workforce sustainability. Health Education and Improvement Wales’ workforce trends analysis suggests that workforce growth should be considered alongside factors such as retention, age profile, sickness absence, and service demand to provide a fuller picture of workforce pressures and sustainability.
What would success look like?
While workforce growth and increased service capacity may be important indicators of progress, they do not by themselves demonstrate whether workforce reforms are delivering the wider changes the Welsh Government wants to see in health and social care.
The publication of the new NHS Wales workforce strategy should provide greater clarity about how the Welsh Government intends to deliver its workforce ambitions and measure progress. An important focus for future scrutiny is likely to be whether the strategy and associated actions translate into a more sustainable workforce, support new models of care, and improve the quality of care and outcomes for people in Wales.
Further information
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Article by Philippa Watkins, Senedd Research, Welsh Parliament