GPs split over “telephone first” system to free up face-to-face appointments

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Here’s a summary of the latest questions to the Health Minister.

Better leadership key to turning around poor A&E performance in the north-east

Helen Mary Jones AM (Plaid, Mid & West Wales) returned to a point her party leader has recently raised regarding poor A&E waiting times at Ysbyty Glan Clwyd and Wrexham Maelor Hospital – to the point that it’s dragged the all-Wales average down. Whatever the Minister was doing under special measures clearly wasn’t working.

Echoing recent comments from the First Minister, the Health Minister, Vaughan Gething (Lab, Cardiff S. & Penarth), was willing to concede that A&E performance in the north-east was unacceptable. The causes were complicated:

“It’s about relationships between health and social care. It’s about clinical leadership, and it’s actually about leadership across the board. And there’s a challenge about understanding that, in other parts of Wales, when there is significant pressure on our system at this time of year…. performance stands up better. So, it isn’t just about saying ‘This is unacceptable, sort it out’; it is actually about working with our staff because the worse thing I could do is to simply say, ‘It’s unacceptable and I want people to go down the road'”
– Health Minister, Vaughan Gething

Helen Mary Jones asked whether it was time for a root-and-branch review of the whole system?

The Minister rejected the idea and any suggestion that simply “doing something radical” would make a positive impact. He’ll listen to staff and look at the evidence.

Should a young adult carers grant be introduced?

Shadow Social Care Minister, Janet Finch-Saunders AM (Con, Aberconwy) said with there being around 370,000 carers in Wales, many younger carers will miss out on education and employment opportunities for fear of losing their carer’s allowance – would the Welsh Government consider a £60-a-week carer’s future grant?

The Deputy Minister for Health & Social Services, Julie Morgan (Lab, Cardiff North) would certainly consider it.

Janet followed up by asking about a carer’s ID card to help schools identify them.

“….it is a frightening fact that YoungMinds suggest that 68 per cent of young carers have been bullied at some point because of tackling their homes responsibilities. So, they’ve made clear signals that professionals, particularly in schools, are not yet able to spot and identify training needs, not just for the carers themselves, but for their peers.”
– Shadow Social Care Minister, Janet Finch-Saunders

The Deputy Minister said proposals for a Young Carer’s ID card are being worked on by government officials in collaboration with Carers Trust Wales.

Mr Smith from Pontypridd

Andrew RT Davies AM (Con, South Wales Central) did a rare thing and raised a constituent’s concerns by name.

“A constituent of mine, a Mr Owen Smith from Pontypridd, who I think you know, recently took to his Twitter account to highlight how he’d rung his GP surgery 300 times over the last five weeks. In his words, the appointments were sold out by 8.35 a.m. on each occasion….Many patients struggle to get an appointment. What confidence can you give us that your department is putting energy into making more accessible the appointment system at GP surgeries?”
– Andrew RT Davies AM

The Health Minister didn’t think this was a fair reflection of the system as a whole but accepted it varied from place to place. Access will be vitally important in any future model of primary care, but people need to think carefully about where to go when a GP isn’t available.

He said GPs were split over whether to adopt a “telephone first” system, where patients discuss a problem over the telephone to check whether they actually need an appointment or whether they can be redirected to a pharmacy or nurse:

“I recognise this will continue to be a point of discussion with GPs….and the wider health service, but actually between GPs themselves, because some GPs are evangelists for a new system of ‘telephone first’ and others are deeply sceptical and dismissive of it.”
– Health Minister, Vaughan Gething

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