NHS Wales () is the publicly-funded healthcare system in Wales, and one of the four systems which make up the National Health Service in the United Kingdom.
NHS Wales was formed as part of the public health system for England and Wales created by the National Health Service Act 1946, with powers over the NHS in Wales coming under the Secretary of State for Wales in 1969. That year, the latter took over much of the responsibility for health services in Wales, being supported in this by the Welsh Office, which had been established in 1964.
Following the pre-legislative Welsh devolution referendum of 18 September 1997, Royal Assent was given on 31 July to the Government of Wales Act 1998. This created the National Assembly for Wales, to which overall responsibility for NHS Wales was devolved in 1999. Responsibility, therefore, for NHS Wales was passed to the Welsh Government under devolution in 1999 and has since then been the responsibility of the Welsh Minister for Health and Social Services.
NHS Wales provides emergency services and a range of primary, secondary, and specialist tertiary care services. District General Hospitals provide outpatient, inpatient, and accident and emergency services, and there is a network of community hospitals run by GPs. Specialist hospitals provide services such as burns units and plastic and cardiac surgery. NHS Wales also funds GP services, dental services, pharmacies, and sexual health services. Community services are also provided, including district nurses, health visitors, midwives, community-based speech therapists, physiotherapists and occupational therapists.
Structure
NHS Wales provides services through seven health boards and three NHS trusts.
Health boards
The seven local health boards (LHBs) in Wales are shown below. Each LHB is responsible for delivering all NHS healthcare services within a geographical area, divided into a number of Network Clusters.
NHS trusts
The three NHS trusts, called "all-Wales trusts", are: the Welsh Ambulance Service Velindre University NHS Trust, which operates the Velindre Cancer Centre and the Welsh Blood Service Public Health Wales
The current health boards were created on 1 October 2009 following a reorganisation of NHS Wales that saw the abolition of the 22 local health boards (LHBs) and seven NHS trusts that had existed since 2003. Since the reorganisation health boards have been responsible for delivering all NHS services, replacing the two-tiered trust and LHB system. In April 2019 responsibility for health services in Bridgend County Borough was transferred from the former Abertawe Bro Morgannwg University Health Board to the former Cwm Taf University Health Board, leading to changes in names and boundaries for both health boards.
The University Hospital of Wales in Cardiff is the largest teaching hospital in Wales, the largest hospital outside London and the third-largest in the United Kingdom.
Five of the health boards paid for spot contracts with private healthcare providers costing a total of more than £6 million between 2013 and 2015 to carry out NHS work on elective surgery.
General practice
In 2019 the Welsh government decided to introduce an NHS indemnity scheme for GPs, to reduce the financial burden of their insurance premiums. The cost, £11.3 million, was to be deducted from the global sum, thus reducing GP practice income. This was not welcomed by the British Medical Association, which complained that indemnity costs for all other staff were borne centrally. A similar scheme in England was centrally funded.
Other NHS Wales bodies
Another important organisation is the Health Commission Wales, an executive agency of the Welsh Government whose primary role is to organise and fund tertiary care and other highly specialist services. It also provides advice and guidance about specialist services to other parts of NHS Wales.
Health Education and Improvement Wales is a Special Health Authority that provides education and training services for health care professionals.
The NHS Wales Shared Services Partnership (NWSSP) supports NHS Wales through the provision of a range of support functions and services at an NHS Wales wide scale. It is hosted within Velindre University NHS Trust, as well as being governed by the Shared Services Partnership Committee.
Digital Health and Care Wales (DHCW), established in April 2021 is a Special Health Authority responsible for building and designing digital services for health and care in Wales. DHCW replaces the NHS Wales Informatics Service (NWIS) that was established in April 2010.