What is the Health and Social Care (Quality and Engagement) (Wales) Act 2020?

The Health and Social Care (Quality and Engagement) (Wales) Act 2020 is a piece of legislation passed by the Welsh Parliament (Senedd Cymru) to improve the quality of health and social care services in Wales. It focuses on increasing accountability, promoting public engagement, and ensuring a person-centred approach in delivering health and social care services across the country. The Act introduces several changes that aim to create a system built on trust, transparency, and continuous improvement.

This legislation is part of Wales’s broader commitment to achieving better and fairer health and social care outcomes for its people. It seeks to make services more accessible, responsive, and integrated while empowering service users and care providers alike. Below, we explore the key features of the Act and how it impacts the health and social care system in Wales.

Purpose of the Act

The primary aim of the Health and Social Care (Quality and Engagement) (Wales) Act 2020 is to improve the quality of services and enhance public engagement within the health and social care sectors. The legislation introduces a statutory duty of quality for providers and establishes mechanisms to ensure that the voices of patients, carers, and the general public play a central role in service design and delivery.

The Act is also designed to ensure that health and social care providers work together effectively to deliver joined-up services. By improving accountability, the Act seeks to give service users greater confidence that their needs and preferences will be respected.

What Does the Act Contain?

The Act contains several important provisions that aim to improve health and social care systems in Wales. These include:

Duty of Quality

The Act places a legal duty of quality on health boards and NHS trusts. This requires organisations to focus on continuously improving the outcomes of their services. It means that these bodies must monitor, assess, and enhance the quality of care they provide.

The duty of quality applies to all aspects of service delivery, including clinical services, patient outcomes, and organisational performance. These bodies must also produce annual reports on the quality of their activities, making them more accountable to the public they serve.

Citizen Voice Body

One of the most significant changes introduced by the Act is the creation of the Citizen Voice Body for Wales. This independent organisation replaces older structures, such as the Community Health Councils (CHCs), and takes on a wider remit.

The Citizen Voice Body is designed to represent the views of patients and the public in both health and social care settings. It will gather feedback, provide advocacy, and advise individuals about their care options. The Body aims to ensure that the public’s voice directly influences the planning and delivery of services.

This change signifies a stronger focus on making health and social care systems more responsive to the needs and experiences of those using them.

Duty of Candour

The Act introduces a statutory duty of candour. This requires every health and social care provider to act openly and honestly when things go wrong, particularly when mistakes result in harm.

Under this duty, organisations must:

• Inform the person or their family about incidents that have resulted in harm
• Apologise and provide clear explanations about what happened
• Share information about the steps taken to prevent recurrence

The duty of candour strengthens trust between service users and providers, ensuring that people receive honest and transparent communication when things do not go as planned.

Integrated Working

The Act recognises the interconnected nature of health and social care services. To improve the quality of care, the Act encourages more collaborative working between sectors, including the NHS, local authorities, and third-sector organisations.

Collaboration ensures that resources and expertise are pooled to provide care that is holistic and meets the varied needs of the person. This approach reduces duplication of effort and helps individuals move smoothly through different parts of the health and social care system.

Monitoring and Reporting

The Act requires regular reporting and oversight to ensure accountability across the system. For example:

• Health boards and trusts must provide quality reports annually.
• The Welsh Ministers are required to respond to these reports, providing additional scrutiny.
• The Citizen Voice Body also submits its findings and reports, creating transparency around public opinion and user experiences.

Who Does the Act Apply To?

The Act applies to a wide range of organisations and individuals involved in delivering health and social care services in Wales. This includes:

• NHS Wales, including its health boards and trusts
• Social care providers commissioned by local authorities
• Organisations involved in delivering public health initiatives
• Other health and social care professionals, such as community nurses, care workers, and allied health professionals

The Act also impacts patients, carers, and the general public by giving them a stronger voice in the way services are organised and delivered.

Benefits of the Act

The Health and Social Care (Quality and Engagement) (Wales) Act 2020 provides several benefits, including:

• Improved quality: The duty of quality ensures that organisations continuously assess and improve their services, leading to better care and outcomes for individuals.
• Transparency: The duty of candour promotes openness between service users and providers, helping to build trust.
• Public involvement: The Citizen Voice Body empowers individuals and communities to shape the services they rely on.
• Better collaboration: Integrated working across sectors leads to seamless care and allows for the efficient use of resources.
• Accountability: Annual quality reports and oversight mechanisms hold providers accountable for the services they deliver.

Issues in Implementation

While the goals of the Act are clear, implementing it poses certain challenges:

• Organisations may need to invest time and resources to align their processes with the new standards.
• Training may be required to ensure that staff understand and fulfil their duties under the Act, particularly the duty of candour.
• Collaborative working requires strong relationships between different sectors, which may take time to establish.
• The Citizen Voice Body must gain public trust and demonstrate its effectiveness in representing user feedback.

Supporting Legislation and Policies

The Act works alongside other laws and policies already in place in Wales to improve health and social care. These include:

• The Social Services and Well-being (Wales) Act 2014, which focuses on person-centred social care services.
• The Well-being of Future Generations (Wales) Act 2015, which promotes sustainable development and long-term thinking.
• The NHS (Wales) Act 2006, which defines the structure and organisation of NHS Wales.

Together, these laws aim to create a health and social care system that is inclusive, fair, and grounded in quality.

Feedback and Public Engagement

Public feedback has been a cornerstone of shaping the Health and Social Care (Quality and Engagement) (Wales) Act 2020. Consultation events and surveys conducted before the Act’s passage revealed issues such as dissatisfaction with the previous structures for public engagement. These concerns influenced the creation of the Citizen Voice Body and the emphasis on user-centred care.

Ongoing public involvement will be critical in determining how well the Act achieves its goals. The Citizen Voice Body provides a reliable mechanism for collecting and acting on user experiences over time.

Final Thoughts

The Health and Social Care (Quality and Engagement) (Wales) Act 2020 signifies a progressive step forward in improving health and social care systems in Wales. The focus on quality, openness, and public input will likely lead to services that are more effective, person-centred, and aligned with the needs of the Welsh population.

The real impact of the Act will largely depend on how well it is implemented and supported. Continuous feedback, collaboration, and oversight will be key to achieving its desired outcomes. The Act represents Wales’s commitment to making health and social care fit for today’s challenges and future needs.