Why 2026 Must Be a Turning Point

The health and care system in Wales continues to operate under intense pressure. Demand on urgent and emergency care remains high, ambulance services are managing a significant volume of immediately life-threatening calls, and hospitals are still seeing delays when people who are clinically ready to leave cannot be discharged because the right care, support or accommodation is not yet in place.

While there are signs of improvement in some areas, the reality for many health boards, local authorities, professionals, patients and families is that the system remains stretched. Seasonal pressures, workforce challenges, complex care needs, long waiting lists and constrained budgets all continue to affect the ability of NHS Wales and social care partners to plan ahead and deliver timely, person-centred support.

For Continuing Healthcare (CHC), these challenges are particularly significant. CHC sits at the point where health and social care must work together seamlessly. It involves some of the most complex and sensitive decisions in the system, often for people with long-term, unpredictable or intensive needs. When CHC processes are slow, inconsistent or reliant on manual administration, the impact is felt across the whole pathway: delayed assessments, delayed packages of care, delayed discharge, increased pressure on professionals, and frustration for individuals and families.

In 2026, the case for modernising CHC in Wales is stronger than ever.

The Welsh Government’s NHS Wales Planning Framework for 2026 to 2029 reinforces the need for a health and care system that is more sustainable, integrated and focused on outcomes. The NHS Wales Performance Framework for 2026–2027 also places clear emphasis on better quality, more accessible health and social care services, enabled by digital, supported by engagement, and focused on value, improvement and innovation.

This direction is highly relevant to CHC.

CHC cannot be viewed as a standalone administrative process. It is part of a wider whole-system challenge around hospital flow, community capacity, care planning, workforce sustainability and equitable access to services. The way CHC referrals, assessments, decisions, reviews and care packages are managed has a direct impact on people’s experience of care and on the ability of health and social care teams to use resources effectively.

There has also been an important policy development in 2026. The Welsh Government’s interim update to the Continuing NHS Healthcare Framework, operational from April 2026, reflects changes relating to Direct Payments and CHC. This update strengthens the focus on co-production, continuity of care, and ensuring that people do not lose their voice, choice and control when they become eligible for CHC.

That matters because modern CHC is not simply about determining eligibility. It is about supporting people through a complex journey in a way that is fair, transparent, timely and person-centred.

Across Wales, CHC teams are working in a highly complex environment. They must coordinate with hospitals, community teams, mental health services, social care, care providers, individuals, families and carers. At the same time, they are expected to meet timescales, manage demand, maintain accurate records, support robust decision-making, and ensure that people receive the right care in the right place.

Yet many CHC processes still rely on fragmented systems, manual forms, email-based communication, duplicated data entry and inconsistent information sharing. This creates unnecessary administrative burden and increases the risk of delays, errors and gaps in visibility.

The quality of data is also a major issue. If referral information is incomplete, inconsistent or difficult to access, decisions can be delayed. If documentation is stored across multiple systems, professionals may spend valuable time searching for information rather than progressing the case. If families and providers have limited visibility of where an application is up to, confidence in the process can be reduced.

These challenges are not just operational. They affect outcomes.

For patients, delays in CHC decision-making can mean longer stays in hospital, uncertainty about future care, or delays in receiving support at home or in the community. For families and carers, the process can feel confusing and difficult to navigate. For professionals, manual administration can take time away from higher-value work. For the wider system, inefficient CHC processes can contribute to delayed discharge, pressure on beds and avoidable escalation.

A continued challenge for CHC in Wales is variation. People’s experience of the process can differ depending on where they live, the systems used locally, the availability of services, and the level of integration between health and social care partners.

Some areas may have stronger digital infrastructure, more mature pathways and better access to community provision. Others may face greater difficulties because of rurality, workforce gaps, provider capacity, specialist service availability or local system pressures.

This variation can lead to unequal experiences for individuals and families. It can also make it harder for health boards and local authorities to understand performance, identify bottlenecks and share best practice.

A more consistent, digitally enabled approach to CHC would help Wales move closer to a fairer and more transparent model. By improving visibility, standardising workflows and supporting better information sharing, digital transformation can help reduce unwarranted variation while still allowing care to be personalised around individual need.

Mental health, complex needs and the importance of joined-up working

Mental health services play a vital role in CHC, particularly where individuals have complex, fluctuating or long-term needs. However, access to mental health support remains under pressure, and delays in assessment or intervention can have a knock-on effect across the wider CHC pathway.

This makes integration even more important. CHC decisions often require input from multidisciplinary teams, including professionals across physical health, mental health, social care, community services and specialist provision. When those teams are not working from a shared view of the person’s needs, history and current circumstances, the process becomes slower and more difficult.

Digitally enabled CHC can support better multidisciplinary working by creating a single, structured process for referrals, assessments, evidence gathering, decision-making, reviews and communication. It can help ensure that everyone involved has access to the right information at the right time, reducing duplication and improving the quality of decisions.

A digital end-to-end CHC solution, such as IEG4’s Digital CHC Platform, can support health boards and their partners to manage the CHC pathway more efficiently, transparently and consistently.

By replacing paper-heavy and fragmented processes with structured digital workflows, CHC teams can reduce administrative burden, improve data quality and accelerate decision-making. Referrals can be submitted digitally. Assessments and supporting evidence can be captured in a consistent format. Tasks can be tracked. Information can flow between stages of the process without unnecessary rekeying. Teams can gain a clearer view of demand, progress, outcomes and bottlenecks.

Digital portals can also improve the experience for individuals, families, carers and providers. Instead of relying on phone calls, emails or unclear updates, people can be given more transparent access to relevant information and progress updates. Providers can interact with the process more efficiently. CHC teams can spend less time chasing information and more time supporting timely, person-centred decisions.

This is especially important in the context of Wales’ 2026 policy direction. If the system is to support co-production, continuity of care, voice and control, then the underlying processes must be capable of supporting those principles in practice. Digital transformation is not just about efficiency; it is about enabling a more responsive and person-centred model of care.

CHC modernisation also has a role to play in improving hospital flow. When people are clinically ready to leave hospital but are waiting for ongoing care, support or accommodation, the whole system feels the impact. Beds remain occupied, emergency departments come under greater pressure, ambulance handovers can be affected, and people may spend longer in hospital than is clinically necessary.

CHC is not the only factor in delayed discharge, but it is a key part of the wider pathway for people with complex needs. Faster, clearer and better-coordinated CHC processes can help reduce avoidable delays by ensuring that assessments, decisions and care planning move forward without unnecessary administrative friction.

By giving teams better visibility of cases and enabling earlier coordination between partners, digital CHC can support more proactive planning. This helps professionals identify delays sooner, understand where action is needed, and work collaboratively to move people safely into the most appropriate setting.

The future of CHC in Wales must be built around consistency, transparency, collaboration and person-centred care. That means creating processes that work for professionals, patients, families, carers and providers.

To achieve this, health boards and local authorities need systems that support:

• consistent digital referrals and assessments
• better quality data from the start of the process
• clearer visibility of case progress and decision-making
• stronger collaboration between health and social care teams
• reduced duplication and manual administration
• improved communication with individuals, families and providers
• better reporting on demand, outcomes and performance
• greater transparency across the whole CHC pathway

The policy direction in Wales is clear: services need to be more integrated, more digitally enabled, more outcomes-focused and more sustainable. CHC is a crucial part of that transformation.

Continuing Healthcare in Wales is entering an important period of change. The pressures facing NHS Wales and social care are not short-term issues, and the complexity of need across the population is only increasing. At the same time, the 2026 policy landscape is placing greater emphasis on co-production, continuity, digital enablement, value and improved outcomes.

That creates a clear opportunity.

By modernising CHC processes, Wales can reduce unnecessary administration, improve the quality and consistency of decision-making, support better discharge and community flow, and give individuals and families a more transparent and person-centred experience.

Digital transformation will not solve every challenge facing CHC, but it can provide the foundations for a fairer, faster and more sustainable model. With the right tools, better data and stronger collaboration between health and social care, CHC teams across Wales can be better equipped to meet today’s pressures while building a system that is ready for the future.