William Eichler 22 October 2019

Reform of primary care in Wales ‘not happening quickly enough’

Plans to strengthen primary care in Wales have not happened as quickly or as widely as intended, according to auditors.

The proportion of people finding it difficult to get a GP appointment decreased slightly from 42% in 2017-18 to 40% in 2018-19 in Wales.

However, despite this slight improvement, a new report by the Auditor General for Wales warns that reforms of primary care are not happening quickly enough.

These reforms include the establishment of primary care clusters – groups of GP practices, other primary care services and partner organisations who work together – and the introduction of a National Primary Care Fund.

The care fund allocated £120m to health boards between 2015-16 and 2017-18 to support the development of primary care through various initiatives.

There is also a new Primary Care Model in Wales which promotes the development of multi-professional primary care teams to reduce the current pressures on GPs and to improve access and services for patients.

Auditor General, Adrian Crompton, welcomed these reforms but warned that progress on implementing the model is ‘patchy’.

There is a need for better engagement with the public to ensure they understand the new ways of working, Mr Crompton’s report said.

There is also a need to increase awareness, understanding and support for the model amongst NHS staff.

‘Primary care services play a vital role in the system of health and care in Wales,’ Mr Crompton said.

‘Whilst there has been a range of plans to develop primary care, progress in implementing these plans has been limited and primary care has not always had a high enough profile within the NHS in Wales.

‘This has to change, and the new model that is envisaged for primary care needs to be rolled out at a quicker pace and on a larger scale, and with appropriate engagement of staff and service users.

‘Failure to do so will create some real challenges to the sustainability of these vital services.’

Responding to the auditor’s report, Nick Ramsay, chair of the Public Accounts Committee said: ‘Primary care is the cornerstone of our National Health Service, providing services that are highly valued by patients.

‘However, it is a service under pressure with many patients struggling to get timely appointments. Today’s report by the Auditor General points to important action that is being taken to strengthen primary care but also highlights that these changes need to be implemented at greater pace and scale.’

‘It is clear that some of the challenges identified in our inquiry into out of hours services apply to primary care services more widely,’ he continued.

‘The NHS and Welsh Government must therefore ensure that primary care has sufficient prominence in NHS plans and performance measures, and that the investment that has gone into primary care in recent years translates into sustainable service improvement.’

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