RCP Cymru Wales has welcomed the Welsh government’s ambition to provide more care closer to home but warned that service redesign must be backed by continued investment in the medical workforce, digital infrastructure and hospital and specialist services.
At the 2026 Plaid Cymru annual conference, RCP Cymru Wales brought together clinicians and politicians to discuss how NHS Wales can provide more care closer to home while continuing to meet demand for specialist and acute hospital care.
With Plaid Cymru now in government in Wales, the session was chaired by RCP joint vice president for Wales, Dr Ben Thomas with a panel that included acute medicine and respiratory consultant Dr Sarah Dyer, cabinet minister for health and care Mabon ap Gwynfor MS, deputy minister for public and preventative health Nerys Evans MS, and RCP joint vice president for Wales Professor Sam Rice.
- Read our blog, Community by Design needs a workforce by design
Community by Design is the Welsh government's vision for providing more care closer to home, with services organised around patients' needs rather than organisational boundaries, while ensuring hospital care remains available for people with more complex or acute needs. RCP Cymru Wales supports the ambition but has argued that Community by Design also needs a ‘workforce by design’, with workforce planning and service redesign developed together. Providing more care closer to home will only work if NHS Wales has the staff, facilities and support needed to deliver it.
The conference discussion considered the pressures facing hospitals as well as the potential benefits of community-based care. Sarah was invited to describe the effect of corridor care on patients and staff and to consider what must be put in place to protect hospital care as services change, and Sam emphasised that hospitals and community services should not be treated as competing priorities.
‘Many people will continue to need specialist and acute care, including patients with complex or escalating clinical needs,’ he explained. ‘Physicians will also have an important role in identifying deterioration, interpreting risk and supporting community teams.’
The panel discussed the practical workforce implications of providing specialist care outside hospital. It considered the value that community-based services can offer patients, alongside the time, travel and clinical capacity required to deliver them. Ben said that physicians must be involved in designing new pathways from the outset. Their work across specialties and care settings gives them important insight into where pathways work well, where they break down and what is required to make change safe and sustainable.
The discussion also considered the role of digital systems and infrastructure in supporting more integrated care. Sam said that effective information sharing will be essential if clinicians are to work across organisational and geographical boundaries.
Reflecting on the Plaid Cymru conference panel discussion, RCP joint vice presidents for Wales, Dr Ben Thomas and Professor Sam Rice said:
‘Community by Design offers an important opportunity to provide more joined-up care closer to home. But moving care into community settings does not remove the need for specialist expertise, staff or resources. That is why it needs a workforce by design. With the right investment in people, services and technology, it can deliver better care for patients across Wales.’