Healthier People in Thriving Communities’: A Vision for an Integrated, Future-Ready Health, Care and Wellbeing System in Wales

Background: Health and Care Services in Wales continue to face increasing demand, workforce fragility, and system fragmentation. Despite policy commitment and supportive system structures, integrated care remains challenging to deliver in practice. Seeking to look beyond immediate challenges and towards the future, the Bevan Commission convened The Sir Mansel Aylward Spring Summit ‘The Turning Point: Uniting for the Future of Health & Care in Wales’ in March 2025 to co-design a shared, long-term framework for a fair, future-ready health and care system.

 

Approach: Over 120 senior leaders and partners from health, social care, local government, the voluntary sector and national bodies participated as equal contributors. Through facilitated, evidence-informed dialogue including projections for the next two decades, participants coalesced around a shared vision, surfaced ten key and strategic themes, and highlighted a set of actions to progress that vision. The Bevan Commission synthesised and validated these outputs to form a nationally owned, action-oriented framework for transformation in Wales.

 

Results: The Summit generated a shared national vision for Wales’s future health and care system: “Healthier people in thriving communities”, achieved only through Prevention, Equity, Partnerships, Prudency, Technology, Data and Integration across health, care and wellbeing.

Building on this vision, attendants identified Ten Key Themes, of which six relate directly to integrated care principles:

3. Equip and enable people and communities to manage and shape their own health and wellbeing.
4. Invest in prevention and tackling wider determinants of health and wellbeing.
5. Redesign services and structures around people and communities to ensure seamless integration across sectors, systems and pathways.
6. Redesign care structures and settings based on biopsychosocial principles throughout all stages of the life course.
7. Ensure prudent, sustainable care by eliminating waste, minimising complexity and maximising efficiency, productivity and value.
8. Reframe performance, governance and resource allocation to reflect need and greatest value.

 

Across these themes, action signals for integration emerged, which included:

• Align financial, operational and clinical system architecture to facilitate joined-up commissioning and shared infrastructure.
• Pool budgets at locality level and empower Regional Partnership Boards and Public Services Boards with combined accountability.
• Reframe performance around outcomes that matter to people, using broader definitions of value such as Social Return on Investment.
• Build interoperable, person-centred digital infrastructure.
• Strengthen place-based, multidisciplinary teams and flexible roles with coordinated “one-and-done” assessment.
• Hardwire prevention and equity into funding, accountability and metrics.

 

Collectively, these actions position integration not as a structural reform but as a cultural and system-wide shift, aligning leadership, governance, workforce, digital and community assets around the vision of healthier people in thriving communities.

 

Implications: H The Sir Mansel Aylward Spring Summit provided Wales with a nationally owned blueprint to accelerate integrated care. By aligning incentives, data, roles and accountability with people’s real journeys, Wales can act as a living laboratory for integration at scale. Building on this momentum, the Bevan Commission will continue to advance the strongest possible case for integrated care in Wales, as both a necessity for sustainability and an opportunity for international learning.