Planning and implementing service change: a cautionary tale from the South Wales programme

The South Wales programme aimed to deliver significant service change, using planning and inter-organisational collaboration as the key drivers. It was set up in January 2012 to determine the future of four services delivered across four health boards. Implementation was due to commence from April 2014, with the previous 2 years dedicated to public consultation and discussions to determine an agreed way forward. Over the next 6 years, only one recommendation was fully implemented – a change to maternity services. Other recommendations were only partly implemented, or not implemented at all. The South Wales programme can thus be used as a case study to explore the problems that are often encountered during strategic change in the NHS, such as inadequate implementation planning, ‘planning blight’ and difficulties gaining traction on the delivery of controversial changes. This case raises a major question as to whether the processes used by NHS Wales to deliver service change are truly effective. This article will discuss the South Wales programme in this context, looking at the lessons for future initiatives, both in Wales and the wider UK healthcare system.