Transforming Primary Care in Mid Wales
We are all becoming too well aware that GP practices are experiencing an unprecedented increase in demand. The crisis which is facing GP recruitment is particularly prevalent in rural areas and just last week, there were reports in the media that not a single person had applied for a job vacancy to work as a GP in a Pembrokeshire surgery.
Here in Montgomeryshire, the story is a similar one with 90% of GPs saying that their workload has an adverse impact on the quality of patient care and 80% are concerned about the sustainability of their practice.
Indeed, results from my own health survey last year indicated that while patients in Montgomeryshire are generally pleased with their local GP practice, there is a specific concern about how long patients have to wait to receive an appointment.
I was therefore delighted to have the opportunity last week to champion an award winning approach to the delivery of healthcare which is unique to Llanidloes.
In association with Arwystli Medical Practice, Dudley Taylor Pharmacy in Llanidloes has pioneered the “Independent Prescribing Service”, which has recently won UK-wide recognition at the prestigious C&D Awards.
Supported by the Health Board and the GP prescribing lead at Arwystli, the new Independent Prescribing Service began at the Dudley Taylor pharmacy last December, enabling them to treat patients within the Pharmacy and reducing the need to visit the GP.
The service ensures that primary care, treatment and advice is quickly available to local people from the community pharmacy on the high street, helping to provide greater choice and a more convenient service to patients, particularly as the pharmacy is able to offer a prescriber service on Saturday when the GP practice is not open.
Patients are directed to the most appropriate provider more quickly, reducing pressure on GPs and increasing GP availability for more appropriate patients while boosting footfall and supporting the viability of the local pharmacy.
The new service in Llanidloes has also resulted in a sustained reduction in the number of patients using emergency appointments at the GP practice. On average, there has been a 23% reduction in GP appointments and evening surgeries in particular have been discernibly less busy and less pressurised for GPs.
This has allowed the practice to consider extending the number or increasing the duration of routine appointments and allocating more time to providing care outside of surgeries, such as home visits to palliative patients.
By offering patients an alternative to a traditional GP appointment, the evidence suggests that the pharmacy service facilitates a more appropriate use of GP time and allows for a greater focus on patients with complex care needs.
The service is now considered an integral part of the local primary care service in Llanidloes and is highly valued by the local community. In my view, it represents one of the most important primary care service developments of recent years, making a real difference to patients.
However, for all new initiatives to be a success, a commitment will be required from the Welsh Government to financially support community pharmacists to pursue additional training to become independent prescribers; and given that the benefit extends beyond the pharmacy, out into the wider community, I believe that this service should be centrally funded so that the benefits are not limited by the size of an individual pharmacy’s budget.
I firmly believe that this initiative has the potential to transform the way in which healthcare is delivered, particularly in rural Mid Wales. Delivering cost effective, high quality healthcare from the most appropriate provider will benefit the whole NHS and I would like to see this approach rolled out across Wales and beyond.