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Health

State of the NHS in Wales: Balancing challenges and progress

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THE NHS in Wales continues to navigate a complex landscape of challenges and achievements as it strives to deliver quality healthcare to its population.

Recent reports highlight both the pressures faced by the system and the initiatives underway to address them.

Healthcare professionals across Wales have expressed concerns over increasing workloads and resource constraints. Hospitals are grappling with high patient numbers, leading to extended waiting times for elective surgeries and specialist consultations. According to figures released by NHS Wales in September 2023, the number of patients waiting for treatment exceeded 750,000—a record high.

Emergency departments have reported surges in attendance, putting additional strain on staff and facilities. In August 2023, A&E departments across Wales recorded their busiest summer on record. Dr. Rachel Davies, an A&E consultant at the University Hospital of Wales in Cardiff, commented, “We’ve seen unprecedented numbers of patients this year. Our staff are working tirelessly, but the demand is overwhelming.”

In rural areas like Pembrokeshire, the situation is compounded by geographical hurdles. This newspaper has recently highlighted concerns over ambulance response times in the county, noting that residents in remote locations often face longer waits for emergency services. Local resident Sarah Jenkins shared her experience: “When my mother fell ill, it took over an hour for the ambulance to arrive. In critical situations, every minute counts.”

A shortage of medical personnel remains a significant issue. Recruitment and retention of doctors, nurses, and allied health professionals are ongoing concerns. The Royal College of Nursing Wales reported in October 2023 that there are over 1,800 nursing vacancies across the country. Many professionals cite burnout and limited resources as factors influencing their decision to leave or avoid joining the NHS workforce in Wales.

Eluned Morgan, the Welsh Minister for Health and Social Services, acknowledged these challenges during a recent Senedd debate. “We are acutely aware of the staffing shortages and the immense pressure our healthcare workers are under,” she said. “Addressing these issues is a top priority for the government. We’re investing in training and recruitment to bolster our workforce.”

Opposition parties have called for more decisive action. Plaid Cymru’s health spokesperson, Rhun ap Iorwerth, stated, “The staffing crisis in our NHS is not just a numbers problem; it’s about the wellbeing of those who dedicate their lives to caring for others. We need urgent measures to support and retain our healthcare professionals.”

In response to the mounting pressures, the Welsh Government has increased funding for the NHS, aiming to improve infrastructure and service delivery. The 2023 budget included an additional £425 million allocated to health and social services. Investments are being made in modernising hospitals, expanding digital healthcare services, and streamlining patient care pathways.

The then First Minister Mark Drakeford addressed the situation during a press briefing in September 2023: “Our commitment to the NHS is unwavering. We are working closely with health boards to tackle waiting times and ensure that everyone in Wales has access to the care they need.”

The government has also launched targeted recruitment campaigns and enhanced training opportunities to bolster staffing levels. “We are investing in our future workforce,” Eluned Morgan added. “By supporting education and providing incentives, we aim to attract new talent to the NHS and retain our valued staff.”

Despite the hurdles, there are success stories emerging within the NHS in Wales. Community-based health programmes are making strides in preventive care, focusing on wellness and early intervention to reduce the burden on hospitals. For instance, the “Healthy Pembrokeshire” initiative aims to promote healthy lifestyles through local events and education.

Telemedicine initiatives have been accelerated, particularly in response to the COVID-19 pandemic, enhancing access to care for those in remote areas. Dr. Gareth Thomas, a GP in Ceredigion, noted, “Virtual consultations have been a game-changer for patients who live miles away from the nearest clinic. It has significantly improved access to care and reduced travel times.”

Healthcare professionals are also embracing collaborative approaches, with multidisciplinary teams working together to provide comprehensive care. These efforts aim to improve patient outcomes and increase efficiency within the system.

Patients have offered mixed feedback on the state of the NHS in Wales. While many praise the dedication of healthcare workers and the quality of care received, others express frustration over delays and difficulties in accessing services.

John Evans, a patient awaiting hip surgery, shared his experience with Wales Online: “I’ve been on the waiting list for over 18 months. The pain limits my mobility, and it’s affecting my quality of life. I understand the pressures the NHS is under, but the delays are disheartening.”

Advocacy groups are calling for increased transparency and patient involvement in decision-making processes. The Patients Association Wales has urged the government to “prioritise patient voices in policy development and healthcare planning.”

The Welsh Conservative health spokesperson, Russell George, commented, “Patients are bearing the brunt of systemic failures. The Welsh Government must take responsibility and implement effective strategies to reduce waiting times and improve service delivery.”

The NHS in Wales stands at a critical juncture. Balancing immediate demands with long-term strategic planning is essential to address the systemic issues at hand. Continued investment, innovative solutions, and collaborative efforts between the government, healthcare providers, and communities are key to strengthening the NHS for future generations.

As the nation navigates these challenges, the resilience and commitment of its healthcare professionals remain a beacon of hope. The path forward will require concerted efforts to ensure that the NHS can continue to uphold its founding principles of providing comprehensive, accessible healthcare to all.

Health

More than 400,000 visit pharmacies for common health issues

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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.

Cabinet Secretary Jeremy Miles visited High Street Pharmacy in Barry today to meet pharmacist Gwawr Davies-Jones. 

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Health

Lymphoedema patients to benefit from online mental health support

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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/

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Health

Tufnell talks tough on health care following ‘in-depth survey’

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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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