Healthcare services where you live
Enhancing care in our communities
Around 90 per cent of the contact patients have with the NHS every day is with primary care, not hospitals. In North Wales, we have:
- 121 GP (family doctor) practices
- 102 dental practices
- 153 pharmacies
- 90 optometrists’ practices (eye care)
These provide services for people of all ages. They all play an important role in supporting patients and carers stay well and making sure hospital care can be reached when needed.
They work closely with each other as well as with social services and the voluntary sector to improve and bring together services in local communities. In each local area we have appointed a leader for this work (usually a local GP) who is helping to redesign and improve services.Over recent years there has been more importance placed on providing safe, high quality services as locally as possible, closer to people’s homes. We have identifed our initial priorities in discussion with representatives of local communities.
Our priorities for action
Enhanced care at home
Moving care from hospitals to the community
We know that there are a number of factors that have an effect on health, and we want to promote good health as well as treating ill health.
“Targeted prevention” means taking action to support people where we can have the greatest impact, by promoting good health and preventing illness.
- GPs and community pharmacists will advise and offer support to people, concentrating on priority areas such as smoking, diet, exercise, alcohol consumption and immunisation
- We will extend health visitors’ work with young children and their families
- We will support work to reduce the number of falls older people have
- We will promote patient education programmes which help people with long-term illnesses learn about their condition and live in a way that helps manage this
- We will use more technology to help people identify problems early on and reduce the distance people have to travel
- We will work closely with social services to identify and support carers
In 2010 we developed a new service in north Denbighshire to provide more care for people in their own homes who might otherwise need to go into hospital. This is now being extended into other areas.
The patient’s GP practice decides with the patient and their family whether they can be safely cared for at home with extra help from nurses, therapists, social workers and voluntary organisations. This care is available 24 hours a day, seven days a week.
This includes improving care for patients at the end of their life, bringing together primary care (GPs), community services, hospices and specialist end-of-life teams to support people to die at home. This work has already started.
The Community Health Council undertook a survey of people using this service and also their carers. Just over a third of patients and half of carers returned the survey and the feedback was very positive, with a few suggestions for improvement which are being addressed.
Our clinical staff are already moving services into local areas to bring better results for patients. Work has started on the services below as the first phase and it is expected that patients in all areas will benefit from these by 2013.
More end of life care support so that people can choose to die in their own home
Co-ordinated care to help patients manage pain better
More blood tests in the community – such as for patients on Warfarin so that they don’t have to go to the acute hospital
Pre-operative assessment – checking a patient’s health before they have a planned operation
Improving access to mental health services for children
More care in the community for people with dementia
More support for people with respiratory diseases
More services for people with hearing problems
Community based Heart Failure Service
More outpatient services using different methods, e.g. telephone advice, appointments using video technology, and appointments with senior nurses
We will carry on looking at other services that can move from hospitals into local communities. We will need to release money from hospitals and other buildings to do this. We will monitor and discuss our progress with the Community Health Council.