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Health

Difficulties accessing GP practices leaving older people suffering in pain

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A SIGNIFICANT number of older people throughout Wales are facing difficulties when trying to access GP practices, leaving many individuals suffering in pain, living with deteriorating conditions and feeling worried and anxious.

That’s the key finding of a new report published today by the Older People’s Commissioner for Wales, Access to GP Practices in Wales: Older People’s Experiences, which is based on evidence shared by over 900 older people living throughout Wales.

The Commissioner’s report reveals that changes to the way that GP services in Wales are accessed, which have accelerated a great deal in recent years, and the changing relationships between patients and their practices often make it difficult for older people to find suitable appointments with an appropriate clinician.

Of particular concern is the fact that these kinds of difficulties have resulted in some individuals withholding information about their health or symptoms with some clinicians, preferring to discuss certain matters only with their own doctor, something that presents a significant risk to people’s health.   

Many older people also told the Commissioner that services often do not feel ‘joined-up’ and that communication between services can be poor, which has resulted in cases of patient information going missing, crucial prescriptions being delayed, and people being sent ‘from pillar to post’ when trying to resolve issues.

In addition to these issues, the Commissioner found that around two-thirds of older people who responded to her survey find it difficult make suitable appointments, or face issues when trying to contact or communicate with their GP practice, whether by telephone or online. Other issues highlighted included accessing services and information in a language of choice – a particular barrier for Black, Asian and Minority Ethnic older people – and getting to surgeries via public transport. 

Discussing the findings of her report, Older People’s Commissioner for Wales, Heléna Herklots CBE, said: “As we get older, accessing GP and other health services often becomes a more prominent part of our lives and these play a crucial role in supporting many older people to stay healthy, independent and safe.

“Older people often share concerns about the difficulties they experience when accessing GP practices with me and my team at engagement events, as well as through my Advice and Assistance service, and I wanted to examine these issues in more detail to ensure older people are not prevented from accessing a crucial part of the health service.

“The large number of responses to my survey demonstrates that these kinds of issues are affecting the lives of many older people throughout Wales, and I would like to thank everyone who got in touch for making their voices heard and providing so much evidence to support my calls for action.

“My report shows that alongside long-standing issues that will be familiar to us all – such as difficulties making appointments or getting through to practices on the phone – the changing nature of GP services and relationships between patients and their GP practices also appears to be creating barriers for older people in terms of arranging the right kinds of appointments or accessing an appropriate clinician.

“These kinds of difficulties are leaving many individuals suffering in pain, living with deteriorating conditions and feeling worried and anxious, something that is deeply concerning.”   

The Commissioner’s report includes a series of recommendations for GP Practices, health boards, Welsh Government and other health bodies and organisations, which set out the action needed to improve older people’s experiences and tackle the barriers that make accessing GP practices more difficult.

This includes action focused on building relationships of trust between patients and their surgeries, removing practical barriers to access and improving communication, as well as ensuring there is sufficient investment to modernise systems and improve wider infrastructure.

The Commissioner added: “I am acutely aware of the significant pressures being faced by health services, including GP services, and this was also reflected in responses from many older people, who recognised that staff were doing the best they could under difficult circumstances.

“Much of the action I am calling for will deliver improvements at little or no cost, or is focused on ensuring that existing standards and frameworks – such as the Welsh Government’s Access Standards – are being met and that this is reflected in older people’s experiences.

“Delivering the action I am calling for will help to ensure that people can access the health services they need, when they need them, in a way that suits them, which will make a positive difference to the lives of many thousands of older people throughout Wales.

“As Commissioner, I will be monitoring the progress against this action, and will continue to encourage and support health services, GP practices, and other key organisations to reach out to and engage with older people throughout Wales in a meaningful way so that the voices of patients of all ages help to shape policy and practice. 

“I also want to empower older people by helping them to better understand what they can expect in terms of access to GP practices and where people can find help and support if they experience issues or barriers, and will be soon be publishing a new guide to provide the information they need, which is being developed with support from older people.”

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Community

Plea to save at-risk Anchorage day care centre

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AN ONLINE plea to save a Pembrokeshire day centre from being closed has been lodged with the county council.

The Anchorage Day Care Centre in Pembroke Dock has been a “safe and happy place” for adults with learning difficulties and additional needs for decades.

In more recent years it has expanded to support elderly dementia sufferers.

But now the centre is expected to close, with services instead being offered elsewhere in the county, including Haverfordwest and Milford Haven.

A series of engagement events have taken place at The Anchorage recently, outlining the reasons and the options in continued service.

One parent, who wished to remain anonymous, said: “The parents and carers are all very upset at the way we have been treated, kept in the dark and then presented with what is a fait accompli to close the Anchorage, while at the same time going through the motions of a ‘consultation’ with us.

“The clients at The Anchorage have friendships with each other and staff going back decades in some cases.

“One young woman who attends ran out of the first meeting sobbing when she was told it was going to close. Another, at the second meeting, tried to address the meeting but was so chocked up at the thought of not seeing her friends anymore she could hardly speak.”

She added: “The Anchorage has been a respite in the day for parents and a safe, happy place for the clients.

“Everyone feels that the county council is not considering the feelings of the clients, most of whom are upset and frightened by change to their routine.”

Another person raising concerns said: “The centre is set to close as early as next month – meaning the sudden retraction of a service which, for many families in the area, is nothing short of a lifeline.

“I’m not sure PCC understand the gravity of the impact that closing the centre will have on the lives of many people, particularly the customers, some of whom may not understand or cope well with such a total upheaval of the familiarity of their daily routine.

“It’s so upsetting that the people who will be most affected by the closure of the centre are as much a part of the Pembrokeshire community as anybody else that the council claims to represent, and yet in this decision, I feel they’re not being seen as such.”

Since then, an online e-petition, on the council’s own website has been launched calling for it to stay open.

It says: “The centre provides day-care support to a number of vulnerable adults with varying levels of disability who are unable to process, and understand, the implications of such a decision.

“Some of those attending the centre have been doing so for over 20 years and continuity is a vital part of their lives. Removing this service will have nothing other than a huge detrimental impact on their health and mental wellbeing.”

The petition has attracted 284 signatures to date.

A Pembrokeshire County Council spokesman said: “Following the engagement sessions held with families and service users regarding the future of the centre on April 10 and 17 at the Anchorage, families said that they would like to maintain the Anchorage Day Centre and explained that they would write to the council in order to ask for the decision to be overturned.

“People who attend the service will be offered alternative care, all service users are currently having their individual care needs assessed by social work teams to fully understand which other services best meet those care needs.”

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Health

Dental services ‘facing collapse’ in Wales

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DENTAL services are at risk of catastrophic collapse, with people resorting to “DIY dentistry” and pulling their own teeth with pliers, the Senedd heard.

Peter Fox warned that NHS dental services are seeing rapid decline following the Welsh Government’s introduction of a new contract in 2022.

He told the Senedd: “These contracts don’t work for dentists, nor do they work for patients,” as he highlighted a 60% fall in the number of NHS dental posts compared with 2021.

Echoing concerns raised by the British Dental Association, the Conservative MS said dental services face potential catastrophic collapse due to the contract reforms.

Mr Fox, who represents Monmouth, cautioned that patients are being left with a choice between years’-long waiting lists or paying hundreds of pounds for private care.

He said: “This lack of accessibility has led people to drastic action – from harrowing stories of people pulling out their own teeth with pliers or people being forced to take 200-mile round trips to get dental appointments. Clearly, this is just simply unacceptable in the 21st century.”

Leading a debate about primary care on April 24, Mr Fox warned GPs are also struggling due to a lack of contract funding, which is not uplifted in line with rising costs and pay uplifts.

He told MSs some GPs are having to pay staff and utility bills out of their own pockets, with practices forced to withdraw more and more services.

The Conservative said some constituents face 50-mile round trips and 50-week waits for services in hospitals that were previously carried out routinely and timely in GP practices.

Mr Fox, who led Monmouthshire council for more than a decade before being elected to the Senedd in 2021, urged the Welsh Government to urgently review GP and dental contracts.

Eluned Morgan told the chamber the majority of contacts with the NHS are in primary care – with up to one-and-a-half million contacts a month in a population of three million people.

Wales’ health secretary recognised the extreme pressure on practices, saying the contract last year provided a 5% uplift not just to GPs but also staff who work in their surgeries.

She said: “We want to reform the dental contract on a preventative basis, responding to risk and need, and we have introduced up to 300,000 appointments to new dental patients.”

Baroness Morgan, who is married to a GP, stressed the importance of other professionals in the community, such as pharmacists and opticians, to the preventative agenda.

She said most pharmacies in Wales provide a free service for 27 common ailments, helping to reduce pressure on GPs and other parts of the healthcare system.

During first minister’s questions on April 23, Sian Gwenllian said many of her constituents are unable to access public dental services – “an entirely unacceptable situation”.

The Plaid Cymru MS for Arfon raised concerns a new dental academy in Bangor closed its books to NHS patients despite promises it would help tackle a lack of public services.

Sam Rowlands, the Conservatives’ new shadow health secretary, said far too many people across north Wales do not have access to an NHS dentist.

He raised comments from Russell Gidney, chair of the Welsh general dental practice committee, warning of a rise in “DIY dentistry” due to a lack of proper access.

Vaughan Gething said the Welsh Government is committed to reforming the dental contract to unlock capacity and access to NHS services is one of the health secretary’s top priorities.

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Health

Pembrokeshire residents suffer severe health decline ‘due to landfill gases’

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A PEMBROKESHIRE couple, Mr Richard and Revd Patricia Rogers of Crud yr Awel, are experiencing severe health issues attributed to emissions from the Withyhedge Landfill, resulting in drastic lifestyle changes and severe symptoms.

Revd Rogers, who has managed asthma since childhood, reported a significant deterioration in her condition following exposure to landfill gases. Despite having controlled her asthma with minimal medication for years, she now requires intensive treatment including increased doses of Symbicort and Salbutamol Sulfate inhalers, alongside courses of steroids and antibiotics. Her symptoms have escalated to include extreme breathlessness, a hacking cough, frequent nosebleeds, continual headaches, and vertigo, culminating in a severe impact on her ability to perform daily tasks and care for her disabled daughter.

The couple’s health is closely monitored through their doctor’s surgery, and they attend the asthma clinic regularly. However, feeling powerless to directly change the situation, they have taken a stand by cancelling their council tax payments, a decision they plan to maintain until the landfill issue is resolved.

Revd Rogers has also prepared a letter to the Coroner, outlining the severity of her health issues as potentially life-threatening due to the landfill’s impact. This dramatic step underlines the gravity of their situation and their desperation for a resolution.

The Rogers’ story is not just a personal tragedy but a stark example of the broader environmental and health challenges faced by the community surrounding the Withyhedge Landfill.

They are calling for punitive measures against those responsible, including compensation for the financial impacts of their ordeal.

Their story has surfaced on the same day we reported that Natural Resources Wales is taking further enforcement action against the firm running the site.

NRW has issued site operators Resources Management UK Ltd (RML) with a further Regulation 36 Enforcement Notice which requires the operator to deliver a series of actions by specified deadlines to address ongoing smells from the landfill.

You can read more about the Enforcement Notice on the NRW website.

Outgoing Council Leader, Cllr David Simpson, said in a statement this week: “The smell from Withyhedge is having a major impact on residents and visitors. This situation has gone on too long and it is unacceptable.

“We now need to see RML act on the demands of the Notice and within the deadlines.

“The Council fully backs NRW’s stance that nothing is off the table in terms of further enforcement, including suspending the site’s environmental permit if appropriate, and we remain committed to working with NRW to ensure a long term solution to these issues.”

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