C257 - Health, Social Care and Sport Committee
Inquiry into primary care
1. Cluster Group Meetings:
· No locum cover for meetings themselves so GPs have to attend when on call.
· As a group we communicate together and share issues constructively, however poor engagement with some Secondary Care Services.
· Work carried out on within the Cluster - EOL/Polypharmacy/Cancer care which is all very time consuming and very much a tickbox exercise like rest of QOF.
2. Cluster Pharmacist:
· We have been allocated 4 hours per week, so there are limitations of what can be achieved.
· Very enthusiastic Pharmacist and at present is carrying out polypharmacy reviews which is very useful for the practice.
3. Mental Health:
· Cluster meetings have little impact on mental health generally.
· Workload issues for GPs such as dementia, ADHD, CAMHS are not being adequately addressed- little input from Secondary Care.
4. MDT’s
· These meetings function well, but only dealing with tip of iceberg. We have fostered good relationships and communication between service providers.
· Lack of resources in community- Physiotherapists, OTs, major equipment shortages, lack of responsiveness in crises.
· Knock on effect of reduction in social care budgets into primary care.
· Lip service being paid to funding for primary care which isn’t happening on the ground- health care generally secondary care-led
5. Core issues affecting practices:
· Lack of funding for many years
· Inadequate buildings
· Inadequate parking
· Whole system for funding projects needs an overhaul, too bureaucratic.
6. Attached staff:
· Major problem for us with district nurses for years since attached nurses were withdrawn without consultation with us.
· ART teams need increased funding to enhance skills and promote home care rather than hospital admission.
· Heavy workload with care homes- little support, enhanced service has been withdrawn.
7. Recruitment:
· With added issues of GP recruitment and numbers of GPs due to retire there appears to be a lack of urgency by Welsh Assembly and LHBs of scale of problem- this was predicted 10 years ago.
· Urgent need for direct funding to practices- funding via clusters inadequate and bureaucratic
o e.g. in house phlebotomy services to free up valuable nurse time.
o Funding to invest in nurse practitioners, physiotherapists for MSK problems.
o Increase funding for Pain Management to reduce waiting lists.
o Direct Access to Counsellors
o In house help for patients with housing/benefits issues
o Premises investment.
o A lot more work needs to be done to make GP attractive again – flexible working, income.
o LHB employing a pool of salaried or locums to fill gaps.