C257 - Health, Social Care and Sport Committee

Inquiry into primary care

1. Cluster Group Meetings:

· No locum cover for meetings themselves so GPs have to attend when on call.

· As a group we communicate together and share issues constructively, however poor engagement with some Secondary Care Services.

· Work carried out on within the Cluster - EOL/Polypharmacy/Cancer care which is all very time consuming and very much a tickbox exercise like rest of QOF.

2. Cluster Pharmacist:

· We have been allocated 4 hours per week, so there are limitations of what can be achieved.

· Very enthusiastic Pharmacist and at present is carrying out polypharmacy reviews which is very useful for the practice.

3. Mental Health:

· Cluster meetings have little impact on mental health generally.

· Workload issues for GPs such as dementia, ADHD, CAMHS are not being adequately addressed- little input from Secondary Care.

4. MDT’s

· These meetings function well, but only dealing with tip of iceberg.  We have fostered good relationships and communication between service providers.

· Lack of resources in community- Physiotherapists, OTs, major equipment shortages, lack of responsiveness in crises.

· Knock on effect of reduction in social care budgets into primary care.

· Lip service being paid to funding for primary care which isn’t happening on the ground- health care generally secondary care-led

5. Core issues affecting practices:

· Lack of funding for many years

· Inadequate buildings

· Inadequate parking

· Whole system for funding projects needs an overhaul, too bureaucratic.

6. Attached staff:

· Major problem for us with district nurses for years since attached nurses were withdrawn without consultation with us.

· ART teams need increased funding to enhance skills and promote home care rather than hospital admission.

· Heavy workload with care homes- little support, enhanced service has been withdrawn.

7. Recruitment:

· With added issues of GP recruitment and numbers of GPs due to retire there appears to be a lack of urgency by Welsh Assembly and LHBs of scale of problem- this was predicted 10 years ago.

· Urgent need for direct funding to practices- funding via clusters inadequate and bureaucratic

o e.g. in house phlebotomy services to free up valuable nurse time. 

o Funding to invest in nurse practitioners, physiotherapists for MSK problems.

o Increase funding for Pain Management to reduce waiting lists.

o Direct Access to Counsellors

o In house help for patients with housing/benefits issues

o Premises investment.

o A lot more work needs to be done to make GP attractive again – flexible working, income.

o LHB employing a pool of salaried or locums to fill gaps.