£3.5m investment in local health services is bringing care closer to people’s homes

A multi-million pound investment by the Welsh Government in local health services across Wales is helping the NHS deliver more care closer to people’s homes and reduce pressure on hospital services, Health and Social Services Minister Mark Drakeford said today.

In November last year,  the Welsh Government created its first £3.5m primary care fund, which included £2m to improve and develop the skills of NHS staff working in the community and GP surgeries.

The fund also provided more eye care services in local communities, with £600,000 allocated to each of Wales’ seven health boards to provide additional eye care appointments closer to people’s homes instead of in hospitals.

This year, the Welsh Government has been able to increase the size of the primary care fund to £40m, investing in community-based services and the primary care workforce to deliver more high-quality care closer to people’s homes and prevent the need for people to travel to hospital for their care.

To date, the fund has helped to improve the skills of the wider primary care workforce:

• In Abertawe Bro Morgannwg University Health Board, a partnership has been established with the merger of three smaller practices in the Swansea and Amman valley area to create the first stage of a multi-disciplinary primary care workforce system, with a telephone triage service, resulting in an increase in patient consultations with a nurse practitioner, pharmacist, or advanced paramedic, freeing GP time and reducing missed appointments;
• In Betsi Cadwaladr University Health Board, advanced musculoskeletal physiotherapy practitioners are working in GP practices, with 671 additional appointments available during the pilot phase as a result. About a third of GP consultations are related to musculoskeletal problems; the ability of physiotherapists to see patients has helped to  free up GP time to concentrate on other patients and more complex cases;
• In Cwm Taf University Health Board, five salaried GPs have been appointed, and placements secured, to support and a further two will be appointed shortly;
• In Hywel Dda University Health Board, primary care-focused independent prescriber training has been commissioned for eight successful applicants and a swallowing difficulties training package has been developed for care home staff to help reduce hospital admissions related to pneumonia.
• In Powys Teaching Health Board, a GP will undergo training in dermatology as part of a plan to set up a new service for south Powys and another will complete specialist palliative care training. Two children’s phlebotomy services have been set up in Brecon and Newtown, led by a qualified nurse and run by healthcare support workers and supported by a play therapist.

The investment has also seen more eye appointments provided closer to patients’ homes instead of in a hospital setting.

• To date, in Cwm Taf alone, more than 1,000 people have been seen in their local community instead of the hospital eye service, reducing the waiting time for wet age-related macular degeneration (AMD) treatment and freeing up emergency staff to deal with the most urgent patients;
• In Hywel Dda, demand for hospital eye services has been reduced by re-directing patients to be seen by community optometrists. A fifth of referrals (19%) were managed in a primary care setting, reducing waiting times and making sure people could be treated within their community;
• Cardiff and the Vale University Health Board has employed community optometrists to work in its eye casualty. This has improved the skills of primary care practitioners and strengthened joint working between primary and secondary care.

Aneurin Bevan and Cwm Taf university health boards have also used part of the primary care fund to tackle inequalities in health.

• Aneurin Bevan University Health Board used its allocation of £300,000 to help fund the roll-out of the Living Well, Living Longer programme in Blaenau Gwent in recognition of the heavy burden of cardiovascular disease in that area. The programme identified 221 people at risk of cardiovascular disease who have now been referred to their GP for further investigation and risk management. The scheme also promotes the uptake of national screening programmes – the incidence of cancer is higher in areas of socio-economic deprivation;
• In Cwm Taf University Health Board, work has been undertaken in eight GP practices. Three healthcare assistants have been recruited to provide face-to-face checks and practices have been provided with a training package developed by Public Health Wales. More than 600 people had a first assessment between January and March. Lifestyle advice has been given and new cases of hypertension, type 2 diabetes and hyperlipidaemia were diagnosed.

Professor Drakeford said:

“Improving local, targeted healthcare remains a key priority for the Welsh Government. These schemes have improved the quality of service provided by GPs, nurses, physiotherapists, optometrists and other health professionals to patients.

“The £3.5m primary care fund has put the Welsh NHS on the right track to create an even stronger, highly-trained primary care workforce, which can deliver a wide-range of services in local communities, reducing our dependence on hospital-based care.

“It has also provided a good platform on which we will now with this year’s £40m primary care fund to deliver the primary care plan and continue transforming the way we provide care in Wales.”