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Priority 5: Delivering excellent public health services to protect the public and health outcomes


Protecting the public from the effects of infections and exposure to environmental problems (such as air pollution) and delivering our national screening programmes are our main responsibilities. We do this through our health-protection and infection-control services and national screening programmes. We deliver, monitor and evaluate seven screening programmes, and co-ordinate the all-Wales managed clinical network for antenatal screening. The aims of these programmes are either to reduce the rate of disease (for example, through cervical screening) or improve early diagnosis to reduce the effect of disease (for example, breast screening).

Overview - why this is a priority

Protecting people from infections and environmental threats is the key to achieving a healthier Wales. The Covid-19 pandemic, and its ongoing implications, highlighted the serious threat to health from communicable diseases and reinforced why health protection and health security will remain a public health priority in an interconnected world.

The pandemic has shown how connected we are with others around the world, and how we must be prepared to act on global threats to health, including identifying future threats. We will take on board what we have learned from the pandemic and make sure we are as prepared as we can be for future threats. One of these threats is antimicrobial resistance (where infections become harder to treat with drugs), and we must focus our services on reducing this. Connecting with our partners around the world so that we are aware of threats to health as they emerge and can put systems in place to deal with them will be important as we work to protect future generations.

We will deliver excellent screening programmes that are safe, effective, people-centred, prompt, efficient and fair, and which have been evaluated and proven to improve people’s health.

How we deliver our services to protect the health of the people of Wales is crucial. The Health and Social Care (Quality and Engagement) (Wales) Act 2020 highlights the ‘duty of quality’ we have to provide care within a learning environment. We believe providing our services in this way will deliver the best outcomes for the people of Wales. 

What this priority covers

We have defined excellence through the Institute of Medicine’s ‘dimensions of quality’, which are also used in the Health and Social Care (Quality and Engagement) (Wales) Act 2020. These are:

  • safety – services should be able to show, through reliable evidence, that they are safe and that interventions have more benefits than risks
  • effectiveness – services should be evaluated and proven to be effective; 
  • patient-centredness – services should be able to show that they regularly and actively engage with those who use them and stakeholders to assess their experiences as part of continuing to improve
  • timeliness – services should be able to respond promptly
  • efficiency – services should be able to show that improvements to health are being achieved in the most efficient way and 
  • equity – services should keep to a principle that decides what is fair when distributing healthcare.

Because we recognise the importance of continually innovating and improving our services, we also have the following additional measures of excellence.

  • Innovation and continuous improvement – excellent public health services always look to innovate and improve in order to achieve excellence
  • Education and training – to provide excellent public health services we must invest in our staff, making sure they have the right skills to achieve excellence
  • Internal and external collaboration – excellent public health services are those that work together across the organisation and the public health system to achieve our outcomes. 

This priority focuses on all public and patient services we provide, particularly screening, health protection and microbiology. However, as we put this strategy in place, we will also aim to use this approach for the other main public health services that we deliver.

National population screening programmes

We will provide screening programmes to help improve people’s health in Wales. The aim of these programmes is either to reduce the rate of new cases of disease or improve early diagnosis to reduce the effect of disease. We offer screening to everyone who is eligible for it, but the number of people taking part varies. One of our main priorities is to improve this (by sharing the pros and cons of screening). Our ability to provide our screening programmes was greatly affected by the Covid-19 pandemic. We will recover our two remaining delayed screening programmes through an ambitious programme that will use new technology, and use innovation aimed at improving practices.

Health-protection and infection services

Responding to the challenges of communicable diseases in Wales involves providing programmes and services, the importance of which were highlighted during the Covid-19 pandemic. We will learn from the experiences of our health-protection and infection services during the pandemic to make sure we are prepared for the challenges of future threats.
We will provide these programmes and services with our wider services, making them more reliable and sustainable. We have a leadership role, working with and advising our partners on strategies to make sure infection is diagnosed and treated early and effectively to control the spread. Our key services, including the Communicable Disease Surveillance Centre, support this response, which will help us understand the effect of communicable diseases and interventions on the people of Wales.

Covid-19 and other respiratory infections continue to show that immunisation is the most important way of preventing disease and reducing the severity of infection, alongside managing outbreaks effectively and controlling infection. The Vaccine and Preventable Disease Programme is the national programme for immunisations and vaccinations.  We will also play a necessary role in protecting people from environmental threats, such as air pollution. Our environmental public health services make sure that we reduce the number of people who become ill or die as a result of environmental threats and increase the number of people whose health benefits from a good environment. We will do this through support, policy guidance, expert advice and monitoring.

Our microbiology services will continue to provide world-class diagnostic and clinical advisory services and Specialist and Reference Microbiology Services to support how outbreaks are identified and managed.

Innovation and future threats

Our public health services will always aim to achieve excellence through innovation and improvement. Public health genomics focus on populations, health services and public health programmes, rather than individual clinical care, through using advances in human and pathogen genomics to improve public health and prevent disease. Our Public Health Genomics Programme will help us take the lead in improving outcomes for people in Wales. We will continue to lead the development of guidance on the use and effectiveness of antibiotics across the NHS, with the aim of reducing cases of infection and so the demand for antibiotics. 


By 2035, we will have:

  • delivered excellent, people-centred screening programmes that are improving people’s health by giving them fair opportunities
  • developed and adapted our screening programmes in line with current evidence and innovation to improve care plans
  • provided a comprehensive bowel screening programme and a sustainable diabetic eye screening programme
  • put in place new UK National Screening Committee recommendations for people in Wales
  • experienced fewer infections associated with health and social care and only use antibiotics appropriately
  • given clinicians the evidence they need to make faster diagnoses so patients can be treated quickly and accurately (through our microbiology services, using world-class, modern techniques developed through continuous innovation and improvement)
  • better identified communities at increased risk of harm from communicable diseases, leading to interventions to reduce the number of people who become ill or die from these diseases or environmental threats
  • helped lead and support excellent immunisation and vaccination programmes, resulting in much less ill health and
  • provided information promptly to help stop disease being passed on and reduce the effect of communicable diseases on individuals and healthcare services