Written Statement: Access to Primary Care Services

Accessing health and wellbeing services continues to be a matter of significant importance to this Government.  Throughout the pandemic, being able to access Primary Care services, remains a key priority even where the way in which these services look and how people access them has changed.

Over the last year, all Primary Care services have had to find ways to respond to the unique requirements of the pandemic including social distancing, increased infection control measures and reducing physical contact where appropriate. This has been balanced with the need to maintain essential services and reintroduce routine services. The use of digital technology is a key part of the response, with more than 130,000 appointments since the start of the pandemic and currently over 5000 video consultation appointments every week, which is helping us to increase the services that can be offered. Remote consultations, whether over the phone or via video call, have become a core part of how services are now delivered safely but have not replaced face to face appointments where these are necessary. 

Activity has changed, as the service has adapted to the need to keep patients and professionals safe and to reduce the risk of transmitting the virus, but primary care has continued to be open and available for those who need them. The focus for the GP services has changed with an emphasis on greater use of clinical judgement in assessing patient need and the delivery of care. This has allowed GP practices to deal with additional work generated by pandemic, answering queries, providing advice and supporting the most vulnerable people in our communities who have been asked to shield. 

In March 2019, I announced GMS In Hours Access Standards which I expected all GP practices to meet by the end of March 2021. Whilst the associated investment in digital infrastructure have been invaluable in enabling practices to deliver services and met patient needs, the Standards themselves were not designed for service delivery during a pandemic. This last year has not provided a true platform to show the impact of the current standards. I have therefore agreed to carry these standards forward until March 2022. Extending them for another year will allow the measures to embed and a true measurement to be taken of how effective the standards have been in improving access for all.  

Dentistry is an essential part of healthcare delivery and we continue to support dental practices during the pandemic. We are making good progress in restoring NHS dental services, with increasing numbers of patients being treated, and that will continue over the coming months. Dentistry is one of the most complex areas of primary care and requires enhanced PPE and time between treatments to reduce the risk of coronavirus. Dental practices have been asked to treat people according to need and those who have experienced problems during lockdown first. While  practices are not yet seeing the same number of people as they were pre-pandemic, even with stricter measures in place to protect people, 22,000 people are now being seen in-person every week across Wales and a further 6,000 people are receiving advice and consultation or follow-up from their dental practice virtually. 

Throughout the pandemic, patients have been able to access optometry primary care services and this has been supported through the use of digital technology for remote consultations by phone and video call.  This will now become a core part of service delivery, when appropriate. Optometry is making good progress in restoring services.  We are already seeing increased numbers of patients and this is set to reach pre-pandemic levels in the coming months.

NHS Wales primary care optometry continues to respond swiftly and innovatively to patient demand during the pandemic, supporting wider primary healthcare provision.  The optometry workforce supported the pharmacy national Volunteer Prescription Delivery Scheme established in response to the pandemic to ensure prescription medicines continued to be delivered to patients with no other means of support to access medicines.  In addition, optometrists are engaged in vaccine delivery across Wales supporting the aim to deliver the vaccine as close to home as possible.  Optometry will continue to work with health boards to drive forward active engagement to support vaccination programmes in the future.  

During the recovery period, optometry is working with the Welsh Government and other key stakeholders to implement contract reform, moving to a clinical service model.  This is a substantial change but one that will improve service delivery for the profession and improve outcomes for patients during the next decade.

The National Volunteer Prescription Delivery Scheme and the Royal Mail Service were established in response to COVID-19 to ensure prescription medicines continued to be made available to those shielding, and those self-isolating with no other means of support, during national lockdown.  Both were introduced to supplement the capacity and resilience of pre-existing medicines delivery arrangements operated by community pharmacies and dispensing doctors in Wales, following an increased demand resulting from measures taken to reduce the spread of Coronavirus. Established within just five weeks of shielding being introduced in Wales, a total of 7,984 medicines deliveries were made in just 5 months.

In terms of care recovery, we are beginning to implement the three year agreement reached with Community Pharmacy Wales moving to a clinical service model including significant modernisation of the sector through increasing the availability of independent prescribing, workforce development and implementing modernised ways of working such as remote consultation and automation.

We have also seen Primary Care, and GMS in particular, take a pivotal role in vaccinating people against Covid-19.GMS has currently undertaken 454,000 vaccinations, accounting for 38% of the vaccinations completed in Wales so far.  I am thankful for the way in which services have responded quickly and with agility to support the efforts to vaccinate as many people, as quickly and safely as possible. This does not come without an effect on capacity in the system to deliver other services or to begin to reintroduce more routine care. Both I and officials continue to monitor very carefully to ensure we have the right balance moving forward and to ensure any impact on access is minimised. 

I am hugely grateful for the whole of the Primary Care workforce for maintaining vital support and advice during the pandemic and subsequently. As a result of keeping their doors open, the public have been able to access high quality clinical services when needed.