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Insight Bulletin – June 2024

Bwletin Arsylwi  / Insight Bulletin


Welcome to our latest Insight Bulletin

Each quarter, we share our latest news and highlight the key themes and learning emerging from our work. It is part of our commitment to better understand our stakeholders’ expectations, proactively engage, share our findings and report on our activity.

We believe there is significant value in sharing learning and experiences from our work. We want healthcare services to reflect on our findings and measure their own services against the findings, to drive service improvement. We hope the findings illustrated within this bulletin can be transferred between organisations, and across the wider health service to support improvements across the system.

In this bulletin we highlight the role and function of our Escalation and Enforcement team. We also share key themes from the recent Healthcare Summits and spotlight areas of good practice following a recent inspection of the University Hospital of Wales’s Emergency Department.

The last few months have been a busy time for HIW, particularly in May as we published three key pieces of work. The first of these being our Equality, Diversity, and Inclusion (EDI) Strategy 2024 – 2028, this is a joint strategy developed with Care Inspectorate Wales (CIW). The strategy reinforces our commitment of embedding equality, diversity and inclusion considerations throughout our work and organisation. 

We published our National Review on Do Not Attempt Cardiopulmonary Resuscitation (DNACPR) Decisions, the review explored whether patients are actively involved in decision making about DNACPR and whether those decisions are clearly recorded and communicated between healthcare professionals.

Our Operational Plan for 2024-2025 was also published in May, the plan outlines the priorities and actions we have set for ourselves to support the delivery of our work, as we head into the third and final year of our Strategic Plan

Your feedback is crucial to us in improving how we communicate and share key messages with you, so please take the opportunity to provide your feedback of this Insight Bulletin edition, using this survey. 

Thank you.

Alun Jones - Chief Executive - Healthcare Inspectorate Wales

Business update

Joint Equality, Diversity, and Inclusion Strategy  2024 - 2028


Equality, Diversity and Inclusion Strategy 2024 – 2028

Together with Care Inspectorate Wales, we have published our Joint Equality, Diversity and Inclusion Strategy for 2024 – 2028.

The joint strategy will complement Welsh Government’s equality plans, and aims to align and make connections between existing plans (such as the Anti-Racist Action Plan for Wales and LGBTQ+ Action Plan for Wales for example) amplifying the intersectionality of people’s lives and experiences.

The strategy will provide new opportunities to help reduce inequalities across healthcare, social care, and childcare servicesThis strategy aims to drive forward improvement and demonstrate our commitment to equality, diversity, and inclusion principles, to address our social responsibilities as regulators and inspectorates to ensure everyone in Wales has access to good quality care.

Find out more: Joint Equality, Diversity and Inclusion Strategy 2024 – 2028.

Operational Plan 2024-2025

Operational Plan 2024 – 2025

We have now published our latest Operational Plan for 2024 – 2025. 

This year’s plan builds on our development through proactive learning and listening carefully to feedback on how we carry out our work. People are at the heart of what we do, and it is important we strive to share lessons learnt, reflect on what has worked well and take forward this learning to continuously improve. Through this plan, we aim to have equality, diversity, and inclusion deliverables embedded, to help us assess the quality and accessibility of healthcare for everyone across Wales.

Read our plan in full.

Icons of book in hand, cogs turning and a group of people on light green background

Healthcare Summit

Healthcare Summit meetings take place bi-annually to enable discussion between audit, inspection, regulation, and improvement bodies. They provide an interactive forum for sharing intelligence on the quality and safety of healthcare services provided by NHS Wales. 

The key themes within the Welsh healthcare system that emerged from our most recent summit in May, included: staffing shortages and their impact on services (especially maternity services); challenges obtaining GP and dental appointments; long wait times and overcrowding in emergency departments; long wait times for outpatient appointments and treatments; increasing number of healthcare associated infections (infections obtained whilst receiving medical treatment); long waiting times for both child and adolescent mental health services; and neurodevelopmental assessments.

The key themes emerging from each Summit are shared with the NHS Wales Chief Executive. 

The Healthcare Summit provided a valuable platform for shared learning and a discussion of key concerns within the Welsh healthcare system. 

Join Us

We are recruiting Peer Reviewers!

Become a Peer Reviewer

We are currently recruiting for Peer Reviewers. Peer Reviewers are health professionals from a range of specialisms across Wales.

Peer Reviewers usually form part of a multi-disciplinary team and their knowledge and expertise ensure our work is based on current practice and experience. This work is carried out in person or at times on a remote basis. This helps us to highlight good practice and to reinforce and share Healthcare Standards within both the NHS and Independent Healthcare Sector for public assurance and improved service for patients.

We provide a comprehensive induction program delivered remotely and opportunities for continuous professional development. 

More information, including how to apply

Activity Update

Assurance and Inspection Activity

We inspect NHS services and regulate independent healthcare providers against a range of standards, policies, guidance, and regulations to highlight areas requiring improvement. Following our inspection and assurance work we will publish a report outlining our findings and recommendations. 

Latest highlight publications include:

All published reports can be found: Find an inspection report.

Want to find out when HIW reports are due to be published? Take a look at our Publication Schedule.

Inspectors with clipboards, map of wales and checklist on clipboard on orange background


The Escalation and Enforcement Team 

The HIW Escalation and Enforcement team leads on escalation and enforcement activity in relation to NHS, independent healthcare and private dentistry in Wales. This includes instigating and conducting criminal investigations in relation to unregistered providers. 

We have seen a rise in the number of unregistered aesthetic service providers. This can lead to us initiating criminal proceedings for those services operating without registering. We encourage the reporting of unregistered providers, as registering with HIW is not just a legal requirement; it’s a step towards ensuring safe and legal operation in accordance with established standards.

Using or buying a laser?

Using Lasers and IPL for Treatment in Wales? Here’s What You Need to Know

If you’re planning to use Class 3B/4 lasers or Intense Pulsed Light (IPL) for treatments, it’s important to check with HIW whether registration is required.  

Already registered with HIW? Even if you’re already registered with HIW, you need to tell us if you’re going to use a new or different laser or /replacement class 3B/4 laser and/or IPL.

Need to Register? Not sure if you need to register your device? Just fill out a quick form, and the HIW Registration team will help you out. 

Map of Wales with magnifying glass on green background


National Review of Do Not Attempt Cardiopulmonary Resuscitation (DNACPR) Decisions

On 23 May, we published a report detailing our findings of a review of Do Not Attempt Cardiopulmonary Resuscitation (DNACPR) decisions for adults in Wales.

The review explored whether patients are actively involved in decision making about DNACPR and whether those decisions are clearly recorded and communicated between healthcare professionals.

Our findings highlight clear examples of noteworthy practice across Wales, however, there is room for improvement. In particular, we found there is a need to strengthen communication about DNACPR decisions across healthcare teams, and with patients and their loved ones, to ensure people fully understand the reasons for the decision and the plans about care.

Read a summary of our findings.

Emoji at desk with grey waves and thumbs up and thumbs down coming from head

National Review of Child and Adolescent Mental Health Services

We are leading a joint review with Care Inspectorate Wales and Estyn, to evaluate how well healthcare, education and children’s services are supporting the mental health needs of children and young people across Wales.

Our review focuses on 11 – 16-year-olds in mandatory education, and through research and stakeholder engagement, we aim to answer the question: 

  • How are healthcare, education, and children’s services in Wales supporting the mental health needs of children and young people, as they wait for assessment, or who do not meet the criteria for specialist CAMHS intervention?

Our surveys for this review have now closed. Thank you to everyone who shared our social media posts, and other resources, surrounding this review; we are really pleased with the level of responses that we received.

The review will conclude with the publication of a joint national report in the autumn of 2024.

For more information, please visit our website.

HIW stand at Royal College of Midwives Conference

Royal College of Midwives St David’s Day Conference

We attended the Royal College of Midwives St David’s Day Conference, at The Angel Hotel in Cardiff. The theme of this year’s conference was ‘Inclusive Maternity in Wales’. The conference featured a variety of engaging speakers, who covered topics such as improving our awareness of equality, diversity and inclusion in the workplace, cultural awareness, gaining a greater understanding of the LGBTQIA+ community, surrogacy, neurodiversity and working in health care in relation to the Welsh language.

This event allowed us to gain valuable insight into maternity services across Wales, as well as a deeper understanding of the challenges facing women and birthing people. 

Learning and Insight

Sharing Learning and Insight to Improve Healthcare

Spotlight Case Study of Good Practice – University Hospital of Wales Emergency Department

HIW Inspectors completed an unannounced inspection of the hospital’s Emergency Department, Clinical Decisions Unit and Paediatric Emergency Department across three consecutive days in March 2024.

It was positive to see that many improvements have been made since our previous inspection in June 2022, with many areas of good practice noted. 

Particular areas of good practice included the department’s ability to manage the high demand and pressure placed upon it (via the Rapid Assessment and Treatment Zone (RATz) service); the respectful and friendly staff delivering high quality care; and the promotion of Welsh language across the department. 

Our previous inspection highlighted the need for improvement regarding infection prevention and control. These had been addressed through the recent refurbishment of the unit, and the clinical areas being relocated. A suitable management structure was in place, new staff had been recruited into critical roles, and initiatives have been put in place to increase staff retention, including an induction pathway for new staff. 

Read our case study

Have Your Say

We want your views! Head over to our website where we have a range of patient surveys now open, and we welcome your views.

All open surveys can now be found on our surveys page

Got a minute? We’d love to know what you think about our Insight Bulletin – just a few questions and you're done!

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