Survey reveals 50% of doctors in Wales say patient safety has deteriorated over the last 12 months.
A new snapshot survey by the Royal College of Physicians (RCP) has revealed more than half of doctors think patient safety has declined in welsh hospitals.
Four out of five physicians think staff shortages are also a problem.
The RCP says the impact of a historically underfunded social care system is now being seen across all hospitals in Wales.
As consultant physicians, trainees, nurses, GPs and pharmacists gather at the North Wales Future Hospital Joint Symposium on Thursday 20th April to discuss the future of hospital services, the RCP is calling for more specialty care to be delivered in the community.
Among the results of its recent survey, the RCP found that:
- Almost three quarters of respondents said that there had been a big rise in NHS demand in the past 12 months
- More than half of respondents thought patient safety in their hospital had deteriorated in the past 12 months
- Four out of five respondents told us that they had experienced staff shortages across the team in the past 12 months
- More than three quarters of respondents had experienced delays in discharge due to a lack of capacity in social care
The RCP said in all welsh hospitals, the impacts of a historically underfunded social care system are now being seen.
It says we must transform a fragmented NHS by improving joined-up planning across health and social care.
It says above all, Wales needs to give front-line clinicians - and their partners in social care - the time and space to innovate, and the freedom and support to step beyond organisational walls.
Key thing the Welsh NHS needs according to the RCP:
- More specialist care delivered in the community: Physicians and specialist medical teams should spend more time working in the community. The role of the community physician should be developed.
- New ways of communicating: More patients should be able to communicate with healthcare professionals using telemedicine to reduce pressure on hospital beds. Communication between primary, secondary, community and social care should be improved.
- Break down barriers: Wales should actively promote itself as a place to develop highly specialist skills in rural and community-based medicine, with doctors working in collaboration with their partners in social care and community teams.
Dr Gareth Llewelyn, RCP vice president for Wales said, "Across Wales, consultant and trainee physicians are working at the hospital front door and on the wards.
"These physicians are leading the multidisciplinary care of thousands of people every day, working with colleagues in primary and social care to put patients at the very centre of our NHS. But despite their hard work, these doctors are struggling to cope.
"The recruitment crisis is getting worse - last year, we were unable to fill 40% of consultant physician vacancies in Wales and there are major trainee rota gaps in every hospital in Wales. This simply cannot continue.
"As part of the solution, the RCP wants a fresh look at how specialist doctors will work with their primary care colleagues in the future. For example, hospital doctors should be able to hold more of their clinics in the community as part of the wider primary care team. This is important because we desperately need to break down the barriers between hospitals and the community.
"It's really important that future investment into the health service does not go towards propping up the old, broken system.
"The recommendations we've published today, along with our recent report on the medical workforce, 'Physicians on the front line' show that we want to work with the NHS to develop a really ambitious long-term vision, improve patient care and solve the workforce crisis."