Even before the birth of the NHS, GPs played a central role in the delivery of healthcare in Wales. I originally trained as a GP, and some things haven’t changed since then; GPs are highly respected in their communities, providing personal care and advocacy for local populations.
We know that patients continue to report very high levels of satisfaction for the services that they receive; in a recent survey, 92% of people were satisfied with the care they received from their GP at their last visit. However, health needs are changing and the role of the GP needs to develop accordingly.
The Welsh government’s five-year vision for the NHS, Together for Health, retains primary and community care services at the heart of care delivery. There is an increased emphasis on prevention and support for individuals to make choices about their care, supported by high quality information. GP practices have already developed a team approach to care but the increasing service demands will require new ways of working.
Local Integrated Care Plan
We are currently developing the Local Integrated Care Plan, which will support working across organisational and professional boundaries to ensure seamless, high quality services and to make the most effective and efficient use of available resources. This will build upon the networks already developed through the QOF quality and productivity work.
We need to transform our services so they become people-centred. We know that GPs are supporting increasing numbers of patients with multiple co-morbidities. Practice teams are ideally placed to coordinate care and support patients and their carers through the complexities of health and social care systems.
The RCGP recognises the need for GPs to spend time with patients, creating clear, patient-centred management plans. These plans will be supported by a range of resources from the public and voluntary sector, coordinated through locality networks. To create capacity for this work, health boards will ensure that local systems are efficient, developing skill mix, IT and partnership working to meet local needs.
The NHS in Wales continues to develop My Health Online, which enables people to correspond with the GP surgery to book appointments and order repeat prescriptions. Health checks for the over 50s are also being established as an online service.
Keir Hardie Health Park in Merthyr Tydfil demonstrates how health, wellbeing and social services can be brought together. The new £35m development brings together three GP practices, outpatient clinics, therapies, local authority, community dentistry, community health, mental health and learning disability services, as well as voluntary sector services such as MIND and Citizen’s Advice.
Improving GP access is a key Welsh government commitment to ensure services are available for working people at times which are convenient to them. The latest statistics indicate GPs are working hard to meet these needs, with 94% of Welsh practices offering evening appointments at least two nights a week.
Health in Wales is improving overall, but serious challenges remain. It is unacceptable that the average gap in healthy life expectancy between the most and least deprived areas is 19 years for men and 18 years for women. This is of course a complex matter and lifestyle choices contribute to some differences. However social determinants continue to determine life experience and the availability of services does not reflect local need.
Two health boards are currently developing proposals to address this inverse care law, and these will be integrated with the Welsh government’s Communities First programme, which focuses on tackling poverty and deprivation.
In West Wales Hywel Dda Health Board has worked with local universities to establish a chair in community health and wellbeing to lead research and policy development to improve the health and wellbeing of rural communities.
GPs and their teams play a vital role in supporting the health and wellbeing of people in Wales, wherever they live and whatever their circumstances. Primary care services are recognised for their ability to adapt and develop quickly and effectively. Through local integrated care, GPs will play a key role in developing local services, with partners, to meet the needs of patients and to increase the focus on prevention and health promotion.This is a great opportunity for GPs to lead new models of care and truly integrated services.
- Dr Ruth Hussey is CMO for Wales.