Senedd backs new primary care model as trainee GP recruitment scheme expands

(Title Image: ITV Wales)

The Motion

The Senedd:

  • Notes the action being taken to transform services in line with the Primary Care Model for Wales.

Providing more services closer to home

Health Minister, Vaughan Gething (Lab, Cardiff S. & Penarth), told AMs the broad aim of the new primary care model was to provide more allied healthcare services closer to where people live and alongside GPs. There was also good news on GP recruitment, with 96% of training places filled in the first round (80% England) with additional funding provided to fill more places than originally planned.

“….our model in Wales is drawn on innovative practice, designed locally and agreed nationally by all stakeholders….bringing together people from pharmacy, from social care and, of course, from general practice. And it’s that range of stakeholders that have agreed on a new way forward. So, we’re using our programme of reform of primary care contracts to support community pharmacists to be members of clusters, and for more general medical services to be planned and delivered at a cluster level.”
– Health Minister, Vaughan Gething

Ideas in Wales were now being picked up elsewhere, with the English NHS’s ten-year plan adopting something very similar to Wales’ primary care clusters. However, he accepted access to GP services remained a big problem, though some GP practices are adopting new techniques which have brought appointment waiting times down to one or two days.

Not all “hunky-dory”

The Conservatives tabled a number of amendments to the motion – none of which were successful. Darren Millar AM (Con, Clwyd West) said the Minister’s speech gave the impression everything was “hunky-dory” in primary care when nothing could be further from the truth.

“….according to the BMA, 24 GP practices have closed across Wales, 29 are managed by the health board and 85 are at risk….On top of that, the Royal College of GPs, in their most recent survey, found that 23% of GPs have said that they’re unlikely to be working in general practice in five years’ time. That’s almost a quarter of the GP workforce.”
– Darren Millar AM

Recent changes to the GP indemnity scheme have made Wales a less attractive place for GPs to work and has taken £11million from cash available to individual practices.

Dr Dai Lloyd AM (Plaid, South Wales West) – who’s a GP – said there was a wider team within primary care including practice nurses, district nurses, dentists, pharmacists and administration staff. Some fantastic work was going on. However, the service remains under pressure; his practice in Gowerton receives 700 phone calls a day, requiring a triage system.

Innovation is key

Dawn Bowden AM (Lab, Merthyr Tydfil & Rhymney) said clusters employing GP support officers has reduced the workload, particularly with regard to non-medical issues. Alun Davies AM (Lab, Blaenau Gwent) shared constituents’ concerns about moves to multi-disciplinary primary care centres, but it was vital to provide 21st century-level services and he hoped it would lead to improved equality of access across class and geographical divides.

Hefin David AM (Lab, Caerphilly) said that no AMs wants to receive a call from constituents saying their GP surgery is going to close, but it happened in Bargoed. When one practice closed, it put pressure on the remaining practice (Bryntirion surgery).

“I completely understand the point made that we need to invest 11% of the budget in GPs….but you’ve got to say, ‘Where is that going?’ And where it went in Bryntirion….was to recruit a lead GP, Dr Mark Wells, who would then take responsibility for the design of the practice, design the practice himself, and then take responsibility for the running of it. And they did.”
– Hefin David AM

Three of the improvements said to have been made at Bryntirion (Twitter video) include a mini call centre where patients are directed to the most appropriate service, open access to allied health professionals (pharmacy, mental health, physiotherapy) in addition to GPs and stronger records to better plan and monitor ongoing treatment.

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