This week saw the Health Minister, Vaughan Gething, update AMs on the Welsh Government’s Transformation Fund, a £100m pot to implement the recommendations of the Parliamentary Review of health and social care in Wales. Our health expert Madelaine Phillips takes a closer look.
One Year On
A year after he first announced the fund, Mr Gething said seven projects across Wales have been allocated a total of £41.2m. During his statement to the Assembly, he discussed his ambitions for the fund, which is designed to drive wholesale changes across health and social care and promote more integrated ways of working across the whole system.
A Healthier Wales
The Transformation Fund was borne from the Welsh Government’s long-term plan for health and social care, ‘A Healthier Wales’, which set out plans for a ‘transformation programme’. This programme forms part of a wider push within the government to reform the system by placing a greater emphasis on integrated working, prevention, and a person-centred approach.
The transformation programme is led by Dr Andrew Goodall, the Welsh Government’s director general of health and social services. It is governed by regional partnership boards (RPBs), bodies established in 2016 to drive the delivery of social services on a regional basis in close collaboration with health. The programme was recommended in the Parliamentary Review and aims to ensure a national approach to the transformation of health and social care services.
The Transformation Fund constitutes part of the overall transformation programme and at £100m, represents a relatively small investment compared to the total health budget. ‘A Healthier Wales’ makes it clear that the fund must be targeted at priority projects that will be able to generate new models of health and care.
The Transformation Fund’s total budget of £100m is for the delivery of projects over two years. In July 2018, the Assembly’s Health Committee challenged Vaughan Gething on whether the scale of change envisioned by ‘A Healthier Wales’ is possible within that two-year timeframe. He said this must happen, referring to the Parliamentary Review which warned that current systems are not fit for purpose.
The role of Wales’ seven RPBs is central to the Transformation Fund as all project proposals under the fund must be submitted with the endorsement of at least one RPB. ‘A Healthier Wales’ sets out 10 design principles that are being used as the primary criteria for deciding which projects receive money from the fund:
- Prevention and Early Intervention – acting to enable good health and well-being
- Safety – healthcare that does no harm and enables people to live safely in communities
- Independence – supporting people to manage their own health and wellbeing
- Voice – empowering people with the information and support they need
- Personalised – health and care services which are tailored to individual needs
- Seamless – services and information which are less complex and better co-ordinated
- Higher Value – better outcomes and a better experience for people at reduced cost
- Evidence Driven – using research, knowledge and information to understand what works
- Scalable – ensuring that good practice scales up from local to regional and national level
- Transformative – ensuring that new ways of working are affordable and sustainable
Emphasis is placed on Scalable and Transformative projects, with guidance stating that Transformation Fund proposals must meet these criteria and at least one other. While there is no proportional allocation of funding, the aim is to support a variety of projects that are spread evenly across Wales. Projects are also required to set out how they would adopt a phased approach, which would allow them to be rolled out widely and at pace.
In his statement on Tuesday, Vaughan Gething said he is reviewing proposals which, if accepted, would see the total allocation of the fund rise to £65m. Plaid Cymru’s health spokesperson Helen Mary Jones said there is a risk projects could fall victim to “projectitis”, appealing to the government to ensure they can be scaled up nationally. Mr Gething sought to assure AMs that the Transformation Fund is backed up by a set of indicators that are being developed to evaluate emerging models of health delivery and ensure the fund’s aims are realised.
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