Health
Dental services ‘facing collapse’ in Wales
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.
Health
More than 400,000 visit pharmacies for common health issues
THE WELSH public is being encouraged to visit local pharmacies for free advice and treatment for a wide range of illnesses. New figures reveal that over 400,000 people used the Common Ailments Service in the past year alone.
Pharmacies offer convenient access to healthcare professionals, often without the need for an appointment, freeing up GP slots for those with more complex or urgent medical needs.
Common ailments service
Available in 99% of pharmacies across Wales, the service provides free, confidential advice and treatments for 28 common illnesses, such as sore throats and urinary tract infections. Since its launch in 2013, it has supported nearly 1.25 million people.
Around 220 pharmacies now offer the Pharmacist Independent Prescribing Service, allowing pharmacists to treat conditions such as ear, skin, and respiratory infections, sinusitis, and migraines.
A survey found that 95% of patients who used the service would have otherwise sought help from a GP or other healthcare provider.
Prescribing services expanding
Each year, up to 100 community pharmacists in Wales undertake prescribing training. From 2026, all newly qualified pharmacists will be registered prescribers, enhancing the range of services available at local pharmacies.
Primary care reforms
The Cabinet Secretary for Health and Social Care, Jeremy Miles, highlighted ongoing reforms to deliver more care closer to home during a statement to the Senedd.
Key statistics include:
- GPs handle around 100,000 calls and 68,000 appointments daily.
- Optometrists conduct over 2,000 consultations each month.
- More than 420,000 new dental patients have been treated since April 2022.
- District nurses see approximately 31,000 patients each month, equating to 1% of Wales’ population.
Comments from key figures
Health Secretary Jeremy Miles said:
“We know there is very high demand for GP services in Wales, with around 1.6 million people contacting their practice each month.
“For most common health concerns, your local pharmacy is the best option, providing free and easy access to treatment.
“We are working with the NHS to provide more care in the community, closer to people’s homes, and to make it easier for people to choose the right service for their health needs.”
Gwawr Davies-Jones, a pharmacist at High Street Pharmacy in Barry, added:
“Since the new pharmacy contract was implemented in 2022, our role has changed considerably. Instead of being in the dispensary, we are now in the consultation room for most of the day, offering clinical services.
“On average, we carry out more than 20 consultations daily, from providing contraception to emergency medicine supplies.
“The demand for advice on common conditions is great, giving pharmacists an opportunity to share advice and treatment, including prescribing antibiotics and other prescription-only medicines without the need to see a GP. This helps free up much-needed appointments for more complex conditions.
“We feel we offer an invaluable service to our community. The services we provide alleviate pressures on the NHS, giving pharmacists great satisfaction knowing they are making a difference.”
Supporting NHS pressures
Pharmacies in Wales offer treatment for 28 common illnesses under the Common Ailments Service. Many also provide emergency contraception, annual flu vaccinations, and regular contraception services.
The Welsh Government has significantly supported this service expansion, increasing its investment by 24% since 2016-17, with an additional £9.9 million allocated this year.
Health
Lymphoedema patients to benefit from online mental health support
NHS Wales’ digital wellbeing service has teamed up with a pioneering clinic to help patients manage the mental health impacts of Lymphoedema and Lipalgia Syndrome.
The Lymphoedema Wales Clinical Network (LWCN) established a psychological support service – the only one of its kind in the UK – after patients spoke of the emotional challenges of living with these conditions.
Patients revealed how their physical symptoms were often accompanied by depression, anxiety and worries about appearance.
Support offered by the service’s two psychologists is now being complemented by direct referrals to SilverCloud® Wales, a suite of online, self-help courses based on Cognitive Behavioural Therapy (CBT).
Dr Jayne Williams, National Lymphoedema Consultant Psychologist for LWCN said: “This is an exciting time for us.
“We’re looking at different ways for people to access psychological therapies – SilverCloud being one of them. The aim is to provide timely, preventative support before people get to crisis point.
“As SilverCloud is online, it has the capacity to reach many more people than we could see face-to-face, and its flexibility means that it fits around busy work and family lives.
“Being able to offer something that patients can do in their own way, at their own pace is brilliant.”
NHS Wales online CBT project manager Fionnuala Clayton said the new referral pathway was inspired in part by feedback from a ‘Living Well with Lymphoedema’ event hosted by LWCN, where patients were asked what they would like from its emerging psychology service.
“Patients wanted to feel as though they were not alone and that they still had a healthy and happy life despite their condition,” said Fionnuala. “They wanted easy access to support for building resilience alongside help to help themselves.
“Coming away from the event, we knew a referral pathway would support many patients across Wales.”
Lipalgia Syndrome – also known as Lipoedema – is an abnormal build-up of adipose fatty tissue, usually in the lower half of the body, which more commonly affects women.
Lymphoedema is another incurable, long-term condition which develops due to a damaged or poorly-functioning lymphatic system. Damage can occur as a result of many factors including obesity, surgery, cancer treatment, infection or injury.
People who are sedentary are particularly vulnerable as the lymphatic system relies on movement to remain healthy and move the lymph fluid around the body. Symptoms include swollen and painful heavy limbs and a higher risk of skin infections and wounds.
Said Dr Williams: “These are conditions that people have to learn to live alongside forever, which can be incredibly difficult.
“They have to cope with swelling and pain, they may have to wear compression bandages or garments, carry out daily skin care routines and do lots of movement.
“We see lots of people with very low mood. There’s also a lot of anxiety around body image and intimacy.
“Feeling people are judging you, and perhaps not being able to find clothes or shoes that fit you, means your whole identity and your social confidence can be affected. You can feel more isolated and withdrawn.”
Around 25,000 people across Wales use LWCN services.
Local health board lymphoedema services can refer people to the psychology service within the National Lymphoedema Team, which is hosted by Swansea Bay University Health Board.
Dr Williams said several patients had been referred to SilverCloud’s Space for Positive Body Image programme after attending a body image workshop.
Other courses on offer include support for anxiety, depression and stress.
Anyone in Wales aged 16 or over can self-refer to SilverCloud, without seeing a GP and from the comfort of their own home.
Fionnuala Clayton added: “We’re delighted to onboard the Lymphoedema Wales Clinical Network. This has been a collaborative effort between services, working together to identify how best support patients living with Lipalgia Syndrome and Lymphoedema.”
For further information and support on Lymphoedema and Lipalgia Syndrome, visit https://lwcn.nhs.wales/
To self-refer to SilverCloud Wales, visit https://nhswales.silvercloudhealth.com/signup/
Health
Tufnell talks tough on health care following ‘in-depth survey’
TOP Hywel Dda health board officials are turning a blind eye to its escalating health care failings despite pocketing six-figure salaries.
So says Mid and South Pembrokeshire MP Henry Tufnell who is calling for an urgent meeting with Hywel Dda’s chief executive, Phil Kloer.
“The Hywel Dda Health Board needs to recognise that there’s a problem with health care outcomes and care delivery, but what is it going to take for them to recognise that?” Henry Tufnell commented this week.
His comments followed an in-depth survey of 1,000 people living in Pembrokeshire which confirmed that a staggering 62% have to wait more than a week for a GP appointment. 43% have cited a lack of available appointments as their biggest challenge, while no fewer than 87% claim healthcare services have worsened in recent years.
“But it’s the real stories that show the scale of the crisis,” continued Henry Tufnell.
“I know of a cancer diagnosis that has been delayed by over a year, while ambulance waiting times can be more than 13 hours, even for urgent cases. Critical care needs are going unmet and this is forcing patients to seek private treatment.”
Tufnell has now submitted a Freedom of Information (FOI) request to Hywel Dda University Health Board demanding greater transparency on waiting times, service provision and a plan strategy to fix the crisis.
“Despite all the latest evidence, in addition to everything we gathered during the election campaign, there’s still no acceptance by the Board that there’s a problem,” he said.
“But it’s their responsibility to deliver health care within this county, and they’re failing. The management is failing us here in Pembrokeshire and there’s a complete lack of transparency and accountability. All these people sitting in management roles are being paid huge amounts of money, some bringing in six figure salaries. But they’re failing.”
Mr Tufnell has now requested an urgent meeting with Hywel Dda chief executive Phil Kloer which is expected to take place on February 14.
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