Annual Report 2025-2026: Healthcare Inspectorate Wales calls for action to deliver lasting improvements for patients
Healthcare Inspectorate Wales (HIW) has today published its Annual Report 2025-2026, highlighting the need for faster progress in addressing long-standing challenges affecting healthcare services across Wales.
The report highlights the continued dedication of healthcare staff across Wales, while identifying persistent challenges including access to care, patient flow, workforce pressures, and the suitability of some healthcare environments that continue to affect the quality, safety and experience of care.
During the year, HIW carried out 216 on-site inspections, received 783 concerns from the public, and heard from more than 4,400 patients, families and carers, as well as more than 1,600 healthcare staff.
Compassionate, person-centred care remains a significant strength across Wales. Patients consistently described staff as kind, respectful and committed, and inspectors found many examples of healthcare professionals going above and beyond to support people receiving care despite challenging circumstances.
However, HIW’s findings show that healthcare services continue to operate under significant and sustained pressure. Demand remains high, delays in treatment continue to affect patients, and problems with patient flow continue to reduce capacity across urgent, emergency and planned care services. Workforce pressures and reliance on temporary staffing are also affecting the resilience and sustainability of healthcare delivery.
The report notes that many of these challenges are not new. They are recurring themes identified through inspections, concerns raised with HIW and wider system insight over a number of years. While progress is being made in some areas, improvement is not always happening at the pace required or being sustained over time, meaning patients are not always seeing the lasting benefits they should expect.
Mental health services remain one of the areas where the most significant concerns are identified through HIW’s work. Although inspectors found many examples of dedicated staff providing compassionate care, HIW continues to identify concerns about the condition and suitability of some NHS mental health facilities. The report highlights the impact that poor environments can have on patients’ safety, privacy, dignity and wellbeing, and the need for sustained action to address long-standing issues.
The report also identifies continued growth and change within the independent healthcare sector, including private healthcare, medical agencies, weight management, wellbeing and aesthetic services. While this brings greater choice for patients, HIW continues to identify concerns relating to unregistered providers and unsafe practice. It highlights concerns that current regulatory arrangements may not provide sufficient oversight in some rapidly expanding areas of healthcare, particularly laser and aesthetic treatments.
Concerns raised with HIW continue to reflect the wider pressures facing healthcare services, with people most commonly reporting issues relating to waiting times, emergency care pressures, access to GP and dental services, and mental health care.
The report reflects the breadth of HIW’s work across healthcare services in Wales, including NHS services, independent healthcare, mental health services, primary care, and dental services. It highlights both areas of good practice and areas where improvement is required, while identifying emerging challenges associated with changing models of healthcare delivery and growing patient expectations.
Alun Jones, Chief Executive of Healthcare Inspectorate Wales said:
“This report provides a clear and independent picture of the quality of healthcare across Wales. Across the NHS in Wales we continue to see dedicated healthcare staff delivering compassionate care in often challenging circumstances, and that commitment remains one of the greatest strengths within our healthcare system.
However, many of the challenges identified in this report are not new. Issues relating to access to care, patient flow, workforce pressures and healthcare environments continue to be identified through our inspections, concerns raised with us and wider system insight.
These challenges are well understood. What remains a concern is the pace at which improvement is being delivered and the extent to which improvements are being sustained over time. Patients need to see tangible improvements in their experience of healthcare services and lasting benefits from change.
As Wales enters a new period of government, there is a clear opportunity to address some of these long-standing challenges. This will require focused action, clear accountability and coordinated effort across the healthcare system. The evidence is clear, the challenges are well known, and patients need to see progress translate into meaningful and lasting improvement.
HIW will continue to provide independent assurance, highlight both good practice and areas of concern, and use its voice to support improvement for the people of Wales."
