A new relationship between the health service and the patient.

You would be hard pressed to find anyone who has not come into contact with NHS services at some point in their lives.

As a system designed to care for us from cradle to grave, we are all likely to find ourselves needing the support, care and treatment of the health service at several points in our lifetime.

Manifesto focus Ahead of the Assembly Elections in May, Click on Wales is profiling some ofWales’ leading organisation’s ‘big asks’ for politics and policy in the fifth assembly. Today we’re looking at the big issues for the NHS Confederation in Wales. We’ve also hosted pieces from ATL Cymru, Oxfam Cymru and NSPCC so far. We’ll be posting each of the pieces in our ‘manifesto series’ category, which you can keep up to date with here.

Created almost 70 years ago, in a post-war era, the introduction of a new health system based on need rather someone’s ability to pay was both revolutionary and extremely ambitious.

Since that period, the way we live our lives has changed in almost every aspect. The world has adapted to different needs and demands and developed completely new ways of working, many of which would have been unimaginable to the people who were to become the first patients of the NHS.

One of the major societal changes is that we are all living longer. This is, obviously, great news and is in part down to the success of the health service.  But the ways in which many of us live, as well becoming older, pose fresh challenges for our health service.

In the past, hospitals were geared towards single episodes of treatment such as fixing a broken leg or dealing with a heart problem. But many people now have a number of different problems which require more complex treatment.

This raises a number of issues for NHS Wales when it comes to meeting these changing needs in the future. These, as identified in our National Assembly election briefing, The 2016 Challenge: A Vision for NHS Wales, include:

• Need: An ageing population, combined with more people having increasingly complex needs, means that demand for health and social care services is predicted to grow rapidly in coming years.

• Workforce: Currently, more than 45% of workers within the NHS in Wales are aged 45 or over. This is coupled with the fact that the present workforce is designed to deliver services within historic models and patterns of care. It is vital the workforce develops new ways of working to address the expected shortfall and also be aligned with the overall direction for the delivery of services.

• Finance: While recent increases in funding have been welcomed, finances remain extremely tight. The NHS in Wales is committed to working more efficiently and prioritising spending in order to rise to the challenges that it faces. However, it has become increasingly clear that traditional methods of savings are unlikely to deliver what is needed in the future.

• Integration: We need to focus on partnership and collaborative working across all public bodies.  The NHS will not be able to rise to the challenges it faces without the help of our colleagues in other sectors.

• Public Health: Wales faces high levels of obesity, smoking and poor levels of physical activity. The impact of such behaviours on our health is resulting in significant demand being placed on the health service and, with the consequences of poor lifestyle decisions taking time to manifest, this will only increase in the future.

With predictions that the number of people over the age of 65 will increase from 16% to 26% by 2030, the NHS has to change the way it works. These changes include measuring care in outcomes and delivering more services in communities. Treatment should be provided in hospitals only when it is absolutely necessary to do so.

Alongside this, a new relationship between the health service and the patient needs to emerge. We all need to take more responsibility for our own health, be involved in shaping our care, and support the NHS to evolve and respond to our changing needs and expectations.

All of these issues were discussed in detail at our recent annual conference, where there was much debate around a vision for NHS Wales and what collectively needs to be done to achieve it.

What was clear from the conference and from recent discussions with other health and social care organisations is a continued focus and commitment to make sure the patient is placed at the heart of everything we do. The right care, at the right time and in the right place – doing all we can to help them achieve the best outcomes.

And while we need to adapt and find different ways of working, this key principle is what was at the heart of the NHS in its creation all those years ago and will remain so in the future.

We know that there will be differences of opinions when it comes to the NHS, which will be key issue in the debates in the run-up to the National Assembly election.

During this time – and beyond the election – our overarching call is for a vision from all political parties for NHS Wales that encapsulate the needs, assets and wishes of the people using the health and care system, and the values of the people working in it.