THE BMA’s deputy chair of Welsh Council issues stark warning about the ‘truly grim’ predicament facing GPs in Wales after years of severe cuts to funding.

Speaking at the BMA’s annual representatives meeting in Belfast, Dr Phil White, who is also a GP in North Wales, accused the Welsh Government of burying their heads in the sand about the crisis facing GPs and the potential impact this will have on an already severely stretched NHS in Wales.

Addressing the BMA’s membership from across the UK he noted the BMA’s strength remarking on its record-high membership figures and the recent progress made by securing ‘three substantial pay offers’ to restore the significant pay loss for doctors working in secondary care in Wales.

Dr White said: “As a union we are stronger than ever, and we will do what it takes to fight for the service we all believe in.”

“Despite this strength and progress made, the predicament facing general practitioners in Wales is truly grim. The service hangs on a precipice, the funding has been slashed and Welsh Government continue to bury their heads in the sand.

“Continuing to ignore the vital role that General Practice plays in the national health service is a grave mistake. My message to Welsh Government is clear. Restore the proportion of the NHS budget which has been cut from General Practice or else it will collapse. If one part of the NHS crumbles, the rest will follow.

“Over the last ten years GPs have been expected to look after 33% more patients while the number of full-time GPs has decreased by 24%, with a fifth of all practices (nearly 100) closing their doors”

He spoke of the risks to patient safety and the personal toll it was taking on GPs with a survey showing that “80% of GPs fear their high workload is detrimental to patient care; morale is low, with many considering their exit.

“Practices are finding ways to stem rising costs – with many reducing existing staff hours or stopping recruitment entirely which all adversely impacts on workload. This is a crisis” he said.

“It is truly shameful, that GP surgeries are expected to run at a deficit, but health boards are simply bailed out by Welsh Government when they overspend” he added.

Referring to BMA Cymru Wales ‘Save our Surgeries’ campaign Dr White said “the public support for an appropriately resourced service is palpable. In a few short weeks, we gathered nearly 22,000 signatures on our Senedd petition, calling on Welsh Government for a rescue package.

Speaking of the bleak picture in Wales with record-high waiting lists rising he added:

“The NHS has been starved for years. Starved of investment, starved of doctors, starved of beds. The impact on patient care is plain to see. Ambulances queuing outside hospitals, patients deteriorating on waiting lists and patients stuck, waiting to be discharged but unable to move on due to a lack of investment in social care.

“The impact on staff is clear too. The rising workload has become unsustainable and understandably, morale is low.

“Three years ago, we publicly called for significant investment in our health service as well as a radical shake-up to create a seamless service. The NHS, social care and community services must work in partnership to effectively meet the needs of patients. Today, I’m restating those calls – the public is behind us – but are the politicians listening?

Dr White ended his speech noting that doctors would continue to campaign for a better service for patients:

“Rest assured, using our collective drive and strength, we will continue to fight for an NHS which has the resources to enable our profession to deliver the care that the people of Wales deserve.”

For years, hospitals and treatment centres focused primarily on medical care. However, the recognition of how the built environment influences patient outcomes has recently been growing. In fact, the environment you’re in plays a much bigger role than you might think. 

Inpatient facilities and treatment centers in London, which have patients for long periods, are moving away from sterile, clinical settings towards spaces that promote well-being and recovery. More and more research highlights the importance of the environment at hospitals and rehabilitation centres that influence your healing journey.

The Science Behind Space

Studies have shown that factors like lighting, noise levels, access to nature and the layout of rooms can impact a patient’s:

1. Pain perception: Dimmable, natural lighting helps regulate sleep patterns and reduce pain perception. 

2. Stress levels: Calming colours, soothing music and access to outdoor spaces contribute to a more relaxed state of mind and improve recovery. 

3. Sleep quality: Controlled noise levels and comfortable room temperature promote restful sleep, which is essential for healing.

4. Mental well-being: Including natural elements, like plants and water features, positively impact a patient’s mood and reduce anxiety.

5. Length of stay: A well-designed environment promotes faster healing and reduces the possibilities of longer hospital stays.

Creating a Calm and Controlled Atmosphere

Hospitals are usually noisy places. Machine beeps, alarms, and staff constant chit-chatting can disturb sleep. Studies have linked excessive noise to slower recovery times, higher stress levels, and increased medication use. Simple design solutions can make a big difference. Incorporating sound-absorbing materials in ceilings, walls, and furniture helps reduce noise pollution. Also, designated quiet zones within the facility give patients much-needed respite.

Design for Dignity and Privacy

Hospitals can feel impersonal and overwhelming. Inpatient facilities are increasingly incorporating design elements that promote a sense of dignity and privacy. Features like individual bathrooms with accessible showers and partitions that create personal space for examinations give a more respectful and comfortable experience. Simple things like adjustable beds and call buttons placed within easy reach encourage patients to take charge of their space and participate more actively in their recovery process.

Design Features for Specific Needs

Healing doesn’t only mean physical well-being. The emotional and psychological aspects also play an important role in the healing process. Design elements that stimulate the senses can be beneficial in this case. For example, calming colour palettes that promote serenity or artwork that expresses positive emotions can be beneficial. Even elements like indoor plants or access to beautiful, scenic outdoor spaces have been shown to reduce anxiety and promote faster healing.

How to Choose a Facility with a Healing Environment

When researching inpatient facilities, don’t just focus on the treatment programs. If available, take virtual tours, ask about the physical layout and amenities, and inquire about the facility’s philosophy on creating a supportive environment. 

Some questions you can consider include:

• Does the facility have natural light and access to outdoor spaces?
• Are rooms private and comfortable?
• Are there designated quiet areas and common areas for socialising?
• What noise-reduction strategies are available?
• How does the staff create a safe and secure environment?

• If you are currently in an inpatient facility and feel the environment could be improved, voice your concerns. Facilities value patient feedback, and your suggestions could positively impact you and future patients. 

Here are some ways to advocate for change:

• Talk to patient support or counsellors within the facility.
• Organise group discussions with fellow patients to raise concerns.
• Write a formal letter to the facility administrator.

The Final Thought

Although the experience of medical professionals plays the most important role, the physical environment of the facility patients stay in during their recovery shouldn’t be an afterthought. Hospitals and rehabs that have thoughtful environments improve patient outcomes. The space where patients spend the most time should promote healing, reduce stress, and encourage faster recovery. From the calming colours to the access to natural light, these features may seem subtle, but they are effective for your healing journey.

• A NEW set of Welsh NHS performance data was released today (Thursday, June 20), and it contains more bad news.

The Welsh Government described the data as “disappointing”.

WG “LACKS GRIP” ON FUNDAMENTALS

Sam Rowlands MS, the Conservatives’ Shadow Health Minister, said: “These atrocious statistics show that the NHS is going backwards under Labour.

“Two-year waiting lists have increased for the first time in two years.

“Keir Starmer has called Labour-run Wales his blueprint for what a UK Labour Government would look like: these figures are a stark warning for the whole UK.”

Mabon ap Gwynfor MS, Plaid Cymru’s health spokesperson, said: “Labour’s complete mismanagement of the NHS in Wales has left us with waiting lists at the highest on record, targets for diagnosis and treatment are being consistently missed, and people are getting stranded in A&E departments for hours on end.

“It’s no wonder that we have such astronomical waiting times when the government has failed to deal with problems in primary care and social care.

“Until the government gets to grip with these fundamental problems, then waiting lists will continue to climb.”

A Welsh Government spokesperson said: “We have made it a priority to reduce long waiting times, and today, the Cabinet Secretary for Health met with health board chairs to instruct them to redouble their efforts to tackle these.

“These figures show the NHS is continuing to manage incredible demand for urgent and emergency care – the number of immediately life-threatening 999 calls in May was 25% higher than the previous year, and demand is nearly two-and-a-half times higher than pre-pandemic levels.”

THE LOCAL PICTURE: HOSPITALS

Over 30% of patients waiting to start treatment in the Hywel Dda UHB area have been waiting for over 36 weeks.

The Health Board has the second-highest proportion of the population waiting to start therapy. In practical terms, that means that around 4,000 people are yet to get the therapy they need.

The number of patients told they did not have it fell. However, the number of patients starting treatment has remained stable for years.

With rising demand for cancer diagnosis and treatment and no improvement in the numbers starting treatment, performance against the target for treating cancer dropped.

At least 75% of patients should start treatment within 62 days of first being suspected of cancer.

Only 42% of cancer patients in the Hywel Dda UHB area started treatment within the target time. To meet a revised target of 80% by 2026, Hywel Dda UHB will have to increase its performance by almost 100%.

The Welsh Government’s performance target for patients waiting to start treatment for less than 26 weeks is 95%.

No Health Board is close to meeting that target, although Hywel Dda UHB is the second-best performer—just over 50% of patients start treatment within six months.

Despite a dramatic fall in the number of inpatient beds in Hywel Dda UHB’s hospitals over the last six years, the number of inpatient admissions rose sharply in April, placing even greater pressure on chronically overstretched staff and resources.

THE LOCAL PICTURE: AMBULANCES

The percentage of red emergency calls being met within eight minutes fell across Wales.

The ambulance performance target is for 65% of all red calls to be attended to within eight minutes.

Across Wales in May, there were 5,110 red (life-threatening) calls to the ambulance service, 13.9% of all calls.

45.8% of red calls received an emergency response within eight minutes, 2.2 percentage points lower than in April.

In the Hywel Dda UHB area, 47.6% of red calls received an emergency response within 8 minutes, compared to a sharply reduced number of calls in the red category.

Examining more detailed data for the Hywel Dda UHB area demonstrates the pressure on emergency hospital admissions and the knock-on effect on the ambulance service.

When an ambulance takes a patient to hospital, admission is supposed to take place within 15 minutes of arrival, with the ambulance returning to service 15 minutes after that.

In the Hywel Dda UHB area, ambulances were tied up beyond those markers for almost 4,000 hours beyond expected admission and return to on-call.

Fewer than 18% of patients conveyed to a Major Injury Department were admitted within 15 minutes. For Major Acute Units, that turnaround was even worse, at barely 15.5%.

Once cleared, however, well over 80% of ambulances were back out on call.

Diving deeper into the data, we see that just over 1,700 patients travelled by ambulance to major emergency, major acute, and maternity and mental health units.

By a very crude piece of arithmetic, we can calculate that if those 1700 patients accounted for the 4000 hours of “lost time”, the handover stats would be even more shocking, with an average turnover of over two hours.

Moreover, localised data shows that 35.6% of all people who are attended by an ambulance go to a hospital using other means of transport.

A CRISIS ACROSS THE BOARD

The issue could not be clearer: delays at hospitals are keeping ambulances off the road.

The upward pressure on A&E services caused by the collapse of out-of-hours primary care (GPs, etc) is driving up attendance at all hospital A&Es.

The lack of beds is driving up a backlog of treatment. The lack of clinical staff means more junior staff fulfil tasks -including initial diagnoses- formerly taken by clinicians and registered nurses. Consolidating rural services on an urban model is making things worse.

Whatever the cure for the disastrous condition of the Welsh NHS, money will not be enough to turn around decades of decline.