The annual 2024-25 report by Healthcare Inspectorate Wales (HIW) identifies recurring risks and a concerning pattern of previously identified issues resurfacing, with staff working under immense strain in environments that are not fit for purpose.
Alun Jones, chief executive of HIW, said: ‘This report is not just a record of our work - it is a challenge to the system to do better.
‘We have seen environments that are unsafe and systems that are being stretched to their limits, but we have also seen staff delivering exceptional care in difficult conditions.'
HIW said it remained deeply concerned about the condition of the estate in many NHS mental health facilities, with 36% of mental health inspections triggering immediate assurance or non-compliance processes.
In addition, the inspectorate issued more urgent enforcement actions in the independent sector than ever before, with 60 new services registered.
Overall concerns rose by 21% on the past year to 743, with whistleblowing concerns up by 36% to 120.
Dr Hilary Williams, Royal College of Physicians RCP vice president for Wales and clinical vice president said investment in people and resources was needed to embed change.
The RCP called for a ‘clinically led long-term health and social care workforce plan that addresses rural recruitment, changing working patterns, infrastructure and technology, and puts a clear focus on supporting and empowering early career doctors by improving competition ratios, the quality and experience of medical training, and career progression'.
A Welsh Government spokesperson said: "We welcome this report from Healthcare Inspectorate Wales and we will consider the findings in due course.
‘The report clearly shows a service under pressure and we recognise further work is needed to improve access to and people's experience of NHS services.
‘We continue to work closely with health boards and NHS trusts to improve services. We would like to thank NHS staff across Wales for their continued professionalism, compassion, and commitment to providing safe, person-centred care in challenging circumstances.'
