URGENT and fundamental change is needed to create seamless health and care services for the people of Wales, an independent review has concluded.

"Artificial barriers" between physical and mental health, primary and secondary care, and health and social care should be swept away, with care "organised around the individual and their family as close to home as possible", according to the review report.

But it concludes that change must happen quickly, and that the people who will use such a system should have a greater say in how it is developed.

The Parliamentary Review of Health and Social Care in Wales, chaired by former chief medical officer for Wales Dr Ruth Hussey, delivers a stark summation of the current state of health and social care services.

It highlights workforce shortages, outcomes for patients that are not improving as fast as desired, and inconsistencies in the delivery of services.

It also describes a "risk-averse culture" that "hampers change in the health and care system, and limits efficient and effective decision making."

"The current situation is of great concern for service users, health and care organisations, health and social care workers, and society more broadly," states the review report.

The review was not commissioned to consider issues of funding in health and social care, but it stresses that they "consume a growing proportion of the Welsh Government’s budget, at the expense of other public service areas, for example education, housing and the arts, which also have a great influence on the health and wellbeing of the people of Wales."

And it thus identifies that "a key aim therefore should be to maximise the value of care and by being more efficient, to enable resources to be directed to the areas that have a bigger impact on health and wellbeing."

The review concludes too however, that Wales "has the potential to overcome all of the challenges we have identified."

"The strong intent to improve health and wellbeing is apparent, as is the desire for a high quality NHS and social care system.

It highlights Wales' Wellbeing of Future Generations (Wales) Act, and the Social Services and Wellbeing (Wales) Act 2014, as positive developments that "many other health and care systems aspire to", though "the challenge is turning the ambition into reality."

At the heart of the review's recommendations is what it calls the 'quadruple aim' - four linked goals with which a revolution in health and social care provision should be developed:

To improve population health and wellbeing by focusing on prevention; to improve the experience and quality of care for individuals and families; to enrich the wellbeing, capability and engagement of the health and social care workforce; and to increase the value achieved from funding of health and care through improvement, innovation, use of best practice, and the elimination of waste.

“The scale of the challenge ahead should not be underestimated. It is clear that change is needed and even clearer that this should happen quickly," said Dr Hussey.

“We have detected an appetite for change and a desire to ‘get on with it’, a strong commitment to transform not just how much is done, but what and how it is delivered is needed."

A new long term plan for health and social care in Wales will be published in the spring, and health secretary Vaughan Gething said it will take account of the review's recommendations.