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Health

Good news for patients: Fresh approach rescues GP practice in Johnston

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NEW and late information available to the Health Board relating to accommodating GP services in the Neyland and Johnston Medical Practice means that a decision to move Johnston patients to practices in Haverfordwest and Milford Haven has been scrapped.

The Board’s Vacant Practice Panel had recommended the immediate closure of the Johnston Surgery, with patients there re-registered in practices in Milford and Haverfordwest at the end of October.

Local GPs, pharmacies, community councils, and patients vehemently objected to the plan.

However, until the new information arrived, the Board was certain to follow the Panel’s recommendation.

However, the Board heard that a fresh proposal involving alternative premises, the possible recruitment of more GPs, and fresh provision on a new model gave the Board the chance to avoid dispersing patients in Johnston elsewhere.

The Board will establish a new practice to cover all 6,000 patients registered and will review the Vacant Practice Panel procedure.

The Board acknowledged retaining a 6,000-patient practice was a risk but that keeping a practice of that size would be more attractive to new GPs.

The key submission to the Board came from Community Interest Care CIC, a group including a former deputy director of the Health Board, business stakeholders, and input from the Council’s Director of Social Services, Jonathan Griffiths.

Member of the CIC, Cllr Paul Miller, told The Herald the Board deserved praise for listening to the strong concerns of patients and other practices about retaining a consolidated service.

He said: “Since the Vacant Panel process, it has become apparent that there are opportunities to use alternative premises, and additional GPs have come forward to support the practice in the short term.
“Given that maintaining the full list of 6000 patients will support the medium-long term sustainability of the practice, we can now commit to maintaining the list at 6000 patients.

“I’m very pleased that Hywel Dda Health Board’s meeting today confirmed the recommendation to manage the Neyland GP Practise for 12 months directly.

“Their decision gives us the breathing space we need to develop a sustainable, long-term plan for maintaining GPs’ services.”

He continued: “I was also pleased to note that the Health Board rejected the recommendation to disperse the patient list from Johnston.

“That’s really good news in my view for the long-term viability of the practice, and I’d like to put on record my thanks to the Health Board for listening to the concerns I, many patients, the LMC and the neighbouring practices raised.

“We’ve now got 12 months to come up with a plan to sustain the service long term and I look forward to working constructively with the Health Board to make sure we do.”

Neyland Town Council welcomed Thursay’s decision by the Board of the Hywel Dda University Health Board to retain the full patient list currently held by the Neyland and Johnston Surgery, and to run the Practice as a whole as a Health Board ‘managed practice.’

In an official statemenet the council said: “We appreciate that a ‘managed practice’ is not the ideal solution for any Practice, but as an interim measure to allow time for an alternative GP services provider to put forward a viable business case, the Board’s bold and sensible decision in light of new information not to accept the initial Vacant Practice Panels recommendation to disperse the patient list, will certainly be welcomed by Neyland’s community, as well as the communities in Johnston and other areas surrounding Neyland.

“The decision to maintain the existing patient list of approximately 6000 patients is important to the long-term future of the Practice, and is something that Neyland Town Councillors have been calling for since meeting with Members of Hywel Dda’s management team on the 11th August 2022. Removing the immediate uncertainty around the future of the Practice will go some way to address the concerns and worries of our community, regarding obtaining Health Care Services locally, in line with a stated aim of the Board. Neyland Town Council would urge Hywel Dda UHB to fully engage with alternative providers, as the Vacant Practice Panel suggested in their report to the Board and indeed in today’s meeting and would ask them to explore all avenues available to secure the long-term future and success of the Neyland and Johnston GP Surgery.

“Moving forward, to address concerns raised in today’s meeting regarding the process followed by the Vacant Practice Panel, if faced with a similar situation again we would ask that the Board seriously consider automatically moving a vacant practice to a ‘managed practice’ for a set period of a minimum of 12 months. A proposal previously made by Neyland Town Council in the 11th August meeting. This would provide some security for surgery staff and importantly remove immediate concerns of the patient base, while allowing the Vacant Practice Panel sufficient time to explore every avenue, which would be in addition to their already extensive workload.”

Health

UK fertility rates falling: Welsh counties among worst-hit, new data shows

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Two-thirds predict family sizes will shrink even further by 2040

NEW figures released by Fertility Family reveal that parts of Wales have seen some of the steepest declines in fertility rates across the UK, with the Isle of Anglesey recording a drop of more than 44% over the past 15 years.

The Beyond the Birth Rate report combines official birth statistics with survey data to explore why fewer people are choosing to have children – and why they’re waiting longer when they do.

Wales’ top ten fertility declines

The study identified the ten Welsh areas most affected by declining birth rates. The Isle of Anglesey tops the list with a fall of 44.21%, followed by Wrexham, Caerphilly and Merthyr Tydfil – all of which have seen declines of more than 27%.

RankAreaFertility rate decline
1Isle of Anglesey-44.21%
2Wrexham-31.01%
3Caerphilly-27.74%
4Merthyr Tydfil-27.53%
5Powys-26.17%
6Conwy-25.45%
7Pembrokeshire-24.46%
8Denbighshire-24.35%
9Cardiff-23.54%
10Blaenau Gwent-23.18%

Newport recorded the smallest decline in Wales, with a drop of just 8.6%.

How does the rest of the UK compare?

London has mirrored Wales’ dramatic decline, with boroughs such as Southwark also showing a 44.21% drop in fertility rates. However, some parts of England have been less affected.

Colchester has seen the smallest national drop, at just -3.95%, while other areas such as Runnymede (-5.19%), Lancaster (-6.04%), and Gravesham (-7.07%) have remained relatively stable.

Financial pressure tops list of reasons

The report suggests that the primary driver behind shrinking family sizes is economic hardship.

  • 40% of people said financial stability was the key reason for delaying children.
  • 23% described starting a family as simply unaffordable.
  • 60% of respondents believe this financial strain is a major factor behind the rising age of first-time mothers.

Why are people waiting longer?

In addition to economic challenges, lifestyle and societal shifts are also playing a major role:

  • 47% cited career ambitions and workplace pressures.
  • 44% blamed difficulties in finding the right partner.
  • 34% pointed to the housing crisis and lack of affordable homes.

These factors are leading to more people having children later in life – a decision which often reduces fertility and the total number of children they may have.

Smaller families likely the future

Over the past 15 years, the UK’s overall fertility rate has declined by 26.9%. That means for every two women of childbearing age, one fewer child is being born.

Looking ahead, 67% of people surveyed expect family sizes to shrink even further in the next 10 to 20 years.

The study also revealed:

  • 40.7% believe more single parents will have children independently.
  • 20.5% expect an increase in adoption and surrogacy.
  • 14.9% foresee co-parenting arrangements becoming more common.
  • A striking 47% said they believe more people will choose not to have children at all.

With both economic and social factors contributing to the trend, the report paints a clear picture: the traditional family model in the UK is evolving – and quickly.

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Health

NHS performance in Wales ‘a mixed bag’ as latest figures released

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THE NUMBER of Welsh NHS patients waiting more than two years for treatment has fallen by 26%, according to data released by the Welsh Government on Thursday, April 17.

However, waiting times for ambulances have increased, while A&E performance continues to be under severe pressure.

The latest NHS statistics for Wales revealed that the NHS treatment waiting list remains at 793,946 pathways. 

 Two-year waits are 15,005 in Wales, compared with only 161 in England. The Labour Health Minister, now First Minister, Eluned Morgan, promised to eliminate these waits by March 2023 and again by March 2024 but failed to meet these targets. The target remains a long way off from being met.

The Welsh Government’s Cabinet Secretary for Health and Social Care, Jeremy Miles, said: “I am very happy to see a significant fall in the longest waits and the overall size of the waiting list falling for the third month in a row.

“This shows what can be achieved when health boards focus on delivering services, including faster treatment and increased NHS capacity, by embracing new ways of working.

“Those efforts have been supported by our £50m additional investment.

“We still have more work to do to reach our ambitious targets, but it is encouraging to see waiting times consistently falling.

“Two-year waits have fallen to their lowest levels since June 2021 and were more than 26% lower compared to the previous month.”

However, the NHS in England has already eliminated two-year waits. At the same time, a significant number of specialisms in Wales, including orthopaedic care, are excluded from the waiting time data.

Jeremy Miles continued: “The number of pathways waiting more than a year for their first outpatient appointment has fallen for a third consecutive month and is nearly 28% lower than the peak in August 2022.

“The number of patient pathways waiting 36 weeks and the average time waiting for treatment were both lower than the previous month.

“Performance improved against the 62-day cancer target in February, increasing to more than 60%, whilst 1,800 people started cancer treatment and 13,000 people were told the good news they did not have cancer.

“A significant improvement was achieved in March in reducing the total number of delayed hospital discharges, with a drop of 114 delays over the previous month. This was the lowest delay figure over the past year and the overall second lowest since reporting began two years ago.”

However, despite the Welsh Government blowing its own trumpet, performance still lags far behind the already poor performance of the Welsh NHS against targets preceding the Covid pandemic.

James Evans MS, Welsh Conservative Shadow Cabinet Secretary for Health and Social Care, said: “Labour Ministers will try to claim success today, but these statistics are worse than a mixed bag.

“The reduction in two-year waits is welcome, but the fact that they still exist at all, when they haven’t for so many months in England, coupled with worsening ambulance response times, is a testament to Labour’s failure to meet their targets.

“The Welsh Conservatives want to see improvements across the board and we can only achieve that by removing restrictions to cross-border, cross-community and cross-sector capacity sharing and by, flnally, enacting a long-term workforce plan.”

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Education

Calls for all Pembrokeshire schools to have EpiPens on site

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A CALL to develop a group to look at a Pembrokeshire-wide policy on schools stocking potentially life-saving EpiPens has been deferred, awaiting the outcome of a Welsh Government scoping exercise.

The current Welsh Government position on emergency adrenaline auto-injectors, commonly known as EpiPens, is different from England, where it was mandatory for schools to hold a stock.

EpiPens are commonly used in the emergency treatment of Anaphylaxis, a severe allergic reaction that can be life-threatening.

Welsh Government guidance allows schools to obtain adrenaline auto-injectors (AAIs) without prescription for emergency use, with Pembrokeshire favouring a school-led decision rather than an authority-led one, replicating Welsh Government guidance.

A call to review the county policy was heard at the April meeting of Pembrokeshire County Council’s Schools and Learning Overview committee following a request from Independent Group leader Cllr Huw Murphy.

Cllr Murphy had said: “Ysgol Bro Ingli H&S Committee met on April 1 to review existing policies, one of which was the First Aid policy. The document provided is the Ysgol Bro Ingli First Aid Policy, which appears to be an adaptation of a generic PCC First Aid document sent to all PCC schools to adapt/implement as appropriate.

“It was highlighted at this meeting that the subject of ‘EpiPens’ was absent, and it appears that PCC may not have developed a county-wide policy on this subject to date, which I think needs scrutiny. At present the stocking of EpiPens is a matter for the Head of a School & Governing Body.

“As was the case when we as an O&S Committee moved to support the introduction of a mobile phone ban in schools, I think we as councillors should provide political leadership to also move to develop a county-wide policy on schools stocking EpiPens (possibly inhalers for asthmatics) and that PCC should fund this cost. It cannot be assumed every child with an allergy will always bring their EpiPen to school and furthermore this does not cover other potential severe allergic reactions eg bee stings.

“I was going to submit an NoM to council but with hindsight feel that the Schools O&S would be the appropriate forum for the matter to be given a thorough airing from where we can hopefully move a recommendation to council.”

Cllr Murphy’s call was backed by Cllr Micheal John, saying: “If there’s a chance of one person dying due to a lack of policy it’s something we have to consider,” moving for a working group to be established to obtain more data ahead of any formal decision.

Another supporter was Cllr Anji Tinley, herself an EpiPen user, compared the provision in schools with defibrillators, saying: “You don’t know you’re going to have a heart attack,” later adding: “£70 to save a life, I don’t think that’s a lot of money.”

Members heard a scoping exercise was currently taking place in Wales, with members agreeing to write to Welsh Government to for an update on its position ahead of any formal group being created.

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