Royal colleges unite in call for ‘better patient care’ and an end to fragmented services that leave people facing delays, confusion and avoidable risk

The Royal College of Physicians and the Royal College of General Practitioners have today published a joint briefing setting out practical steps to improve integration between primary and secondary care and deliver better outcomes for patients across Wales.

The new briefing – For better patient care: improving integration between primary and secondary care in Wales – sets out the findings and recommendations from a joint national workshop held by RCP Cymru Wales and RCGP Cymru Wales in July 2025. Senior doctors from around Wales were joined by representatives from the Welsh government, NHS Wales, Health Education Improvement Wales (HEIW) and political parties to discuss next steps on integrated care.

Warning that doctors regularly see examples of patients experiencing delays that lead to worsening health when they move between systems, with fragmentation between services leaving patients facing confusion and avoidable risk, consultant physicians and GPs have identified five key priorities for the Welsh government and NHS Wales:

1. Improve communication and understanding between healthcare professionals.
2. Strengthen clinical leadership in national decision making.
3. Increase shared training opportunities that embed integrated ways of working.
4. Invest in digital infrastructure so IT systems can talk to each other.
5. Scale up successful pilot projects, rather than relying on short-term schemes.

The briefing highlights examples of good practice already underway, including integrated GP fellowships in Hywel Dda University Health Board, a GP–consultant exchange scheme in north Wales that improves mutual understanding, and an award-winning community liver service in Gwent that has reduced hospital admissions and improved patients’ final months of life.

It also draws on an RCP snapshot survey and an RCGP Cymru Wales call for evidence.

RCP clinical vice president and vice president for Wales, Dr Hilary Williams said:

"Patients get the best care when the NHS works as one team. This report shows that clinicians in Wales are already leading innovative, integrated services – but we need national support to spread what works, invest in digital tools that join the system up and give doctors protected time to train and lead together across traditional boundaries."

RCGP Cymru Wales chair, Dr Rowena Christmas MBE said:

"General practice and hospital medicine are two sides of the same coin. GPs hold risk and complexity in the community every day, but too often our separate systems, contracts and IT keep us apart from hospital colleagues. By prioritising shared pathways, realistic models of care for people with multiple conditions and genuine patient involvement, we can reduce pressure on services and improve care close to home."

Together, the royal colleges represent around 3,000 doctors in Wales. They are calling for:

• expanded foundation placements in general practice and more primary care exposure during specialty training in secondary care
• sustained funding for integrated roles and fellowships that cross boundaries, including a Wales-wide GP/consultant exchange scheme
• urgent action from Digital Health and Care Wales, the Welsh government and NHS Wales to deliver interoperable IT systems and ensure new AI tools work safely across primary and secondary care
• a shift away from short-term pilots towards long-term, stable funding for proven integrated services.

RCP Cymru Wales and RCGP Cymru Wales say royal colleges have a key role in convening clinicians, providing modern, inclusive joint learning spaces and championing community-based, compassionate models of care.

Notes to editors

1. Representing around 1,200 physicians in Wales, RCP Cymru Wales aims to educate, improve and influence for better healthcare. They are independent, patient centred and clinically led and aim to drive improvement through advocacy, education and research, in the UK and across the globe.
2. RCGP Cymru Wales represents a network of over 2,000 GPs, committed to improving patient care. They work to encourage and maintain the highest standards of general medical practice and act as the voice of GPs on resources, education, training, research and clinical standards.
3. This report was developed following a joint workshop in Wales that brought together representatives from the Welsh government, NHS Wales, Health Education Improvement Wales (HEIW), political parties and other experts. The discussion was chaired by the RCP vice president for Wales and chair of RCGP Cymru Wales.

Further information

Nicolas Webb
Policy and Public Affairs Manager
Tel: 073 4173 7034
nicolas.webb@rcgp.org.uk