THE HERALD has previously reported on the crisis in communities regarding a shortage of GPs and on changes to GP practices.
Readers may remember the farcical situation at the Andrew Street and Dafen surgeries, where patients were locked out of their GP practice when the Board failed to reach an agreement with a retiring GP for the continuation of the service.
Most recently there have been a number of issues at the Kidwelly surgery.
Just on the border of Llanelli and Swansea, things are no different. The Talybont surgery in Pontarddulais has written to patients informing them of the problems they are having with GPs retiring or moving on and a shortage of GPs to fill the vacant positions. All this comes at a time when house building is racing ahead at an unprecedented level in the locality.
IF YOU BUILD IT, GPS WON’T COME
One hundred new homes are being built just down the road in Hendy and a further 750 homes are proposed to be built in Pontarddulais itself.
Across West Wales, GP practices face similar problems. The Argyle Medical Group in Pembrokeshire, the single largest GP practice in the county, has been forced to halt afternoon appointments in its Neyland and Pembroke surgeries due to a shortage of staff. In nearby Tenby, the GP practice has had to be provided with extra assistance from the local Health Board due to departures and retirements.
In Cardigan, there is a risk of a GP practice closing due to the retirement of the GP heading the practice, while across rural Ceredigion and Carmarthenshire, GP services are put under increasing strain by the shortage of trained GPs and the unwillingness of junior doctors to enter practice as GPs due to the unattractiveness of the role.
And all the time, councils give planning permission for more and more homes.
NO CARE YET FOR CARMARTHEN WEST
There are 1,200 new homes planned for the new development at Carmarthen West and yet, The Herald can report, not a single additional clinical resource or health service has been prepared or yet allocated for what could be a population increase of over 3,000 people in the area around Carmarthen town.
A spokesperson for the Health Board told The Herald: “The Health Board is reviewing the impact of the Carmarthen West development on local healthcare facilities, and work is on-going to consider future healthcare strategy around this.”
In Pontarddulais, people have taken to social media to highlight what they believe are some of the issues the community will face as a result of large scale housing developments at the same time as a crisis in health care and provision.
A dedicated Facebook page, Save the Bont, has drawn attention to the crisis and states: “With 750 new homes planned and according to the LDP, this figure does not take into account all the other proposed developments in the community. In all there are plans for approximately 1,000 new homes for the Bont.
“The doctors surgery has been struggling for some time to cope with the increased population and now that so many of the existing staff are leaving, it will be impossible to get the level of medical care we should have access to.
“As a community, we are already swamped with new dwellings leading to increased traffic and residents wanting to access all local amenities, including the doctors surgery and the three schools. None of the infrastructure has been modified to accommodate the hundreds of new homes that have been built over the last ten years.”
PONTARDDULAIS: EXPANSION AT ANY COST?
The town of Pontarddulais has been expanding rapidly over recent years as the council rubber stamp large scale housing sites. There are prospects of more homes being built in Kidwelly and Llanelli but it is unclear as to whether appropriate considerations are being given to modifying the infrastructure to cope with greater numbers of people in our communities.
Local authorities can charge a Community Infrastructure Levy (CIL) on new development in their area to support infrastructure needed by growth, such as improvements to roads, park/open space improvements or a new health provision.
The levy can be used to fund a wide range of infrastructure, including transport, flood defences, schools, hospitals, and other health and social care facilities – but not social housing. This definition allows the levy to be used to fund a very broad range of facilities such as play areas, parks and green spaces, cultural and sports facilities, academies and free schools, district heating schemes and police stations and other community safety facilities.
Local authorities must spend the levy on infrastructure needed to support the development of their area, and they will decide what infrastructure is needed. The levy is intended to focus on the provision of new infrastructure and should not be used to remedy pre-existing deficiencies in infrastructure provision unless those deficiencies will be made more severe by new development.
KIDWELLY COUNCILLORS ACT
In Kidwelly, the town’s team of Labour Councillors – Cllr Ryan Thomas (the County Councillor for Kidwelly), Cllr Mike Thomas and Cllr Philip Thompson (both Kidwelly Town Councillors) – have taken action to try and address problems with their local GP practice.
Following the large number of concerns directly raised to them, the Councillors have set up a series of meetings with the surgery and Hywel Dda Health Board.
The first of these meetings attended by Ryan, Mike and Phil and Rachel Pompa, Head of General Medicine and Anne Jenkins, the Practice Manager of Meddygfa Minafon, took place on Friday, August 12.
Following the meeting, Councillors Ryan Thomas, Mike Thomas and Philip Thompson released the following statement: “As the local Labour Councillors for Kidwelly, we felt that we needed to bring the very real concerns of the local community about the provision of GP services, which are causing upset and distress to residents to the attention of the practice and Health Board.”
The Councillors raised a number of issues about triage services, the ending of the telephone repeat prescription services, and disabled access to Meddygfa Minafon. But the first concern raised was staffing: “Both we and the surgery agree that there is a staffing issue in that there should an establishment of five GPs.
“We are pleased that we had the opportunity to open dialogue with the surgery and Health Board and are committed in the coming meetings to continue raising the community’s issues with them and look forward to working together to improve the service and ensure the community gets the GP service it needs and deserves.”
NOT ONLY A WEST WALIAN PROBLEM
At a time of national GP recruitment and retention challenges, the Health Board recognises the need to ensure care is provided by the most appropriate clinician available.
While recruitment campaign continues for GPs to work at the Kidwelly practice, a spokesperson for the Board told us: “Rising demand means that it is becoming increasingly important for a system of clinical triage and alternative means of consultation to be introduced. The Health Board is introducing new clinical roles into the General Practice, such as Advanced Nurse or Paramedic Practitioners, Prescribing Pharmacists, Physiotherapists and Occupational Therapists. These clinicians can see appropriate patients based on their presenting needs. The Health Board is committed to ensuring that patients receive the clinical care they need.
“New patient services are planned to start at Minafon Surgery, Kidwelly, in September, which will include a Frailty Clinic, Physiotherapist sessions and a telephone triage service. This triage service will be provided by fully qualified GPs, and will aim to ensure patients have full access to a GP via a telephone consultation, and an opportunity to see a GP and other healthcare professionals face to face at the practice as appropriate.”
Rachel Pompa, Head of General Medical Services at Hywel Dda University Health Board, said: “Anne Jenkins, Practice Manager at Minafon Surgery, and I were pleased to have the opportunity to meet with Kidwelly Town Councillors on Friday August 12 to discuss the ongoing service provision at Meddygfa Minafon.
“While the practice is actively trying to recruit GPs, they have developed a more diverse way of treating patients, using highly skilled healthcare professionals, including an Advanced Nurse Practitioner, Advanced Paramedic Practitioner and Pharmacist, who works at the practice to deal with all medication queries.
“As soon as the plans for the new services are finalised, within the next 14 days, patients will be invited to join the University Health Board to discuss the service in more detail and to fully explain the roles of all staff working at the practice.
“We will be writing to all patients with details of venues, dates and times in the next few weeks and we would welcome discussion.”
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