2. What plans does the Cabinet Secretary have to extend the range of allied professionals in primary health services? OAQ(5)0108(HWS)

Thank you for the question. We expect to see an even more extensive role for allied health professionals as part of the primary care team. Health boards are already extending the role of allied health professionals through their local plans to strengthen primary care, backed up by Welsh Government funding.

Thank you, Cabinet Secretary. I was very pleased to welcome you recently to Kidwelly to visit the Minafon surgery, where, a year ago, when the surgery faced a crisis when the doctors left, working closely with Hywel Dda health board, the range of local Labour councillors and the community, it designed a service where there is a pharmacist, a physiotherapist and other allied health professionals working together, and the service that the patients have has improved immeasurably. What can be done to extend that model to GP services right across Wales?

I thank the Member for the question. It was, indeed, a very interesting visit, and recognising there was a real threat about the future of primary care in Kidwelly not that long ago. And it was helpful to see a really challenging but supportive environment from local elected representatives. And, actually, the staff within the practice have kept it going, particularly the practice manager, who really had a significant role to play in keeping that together.

And it’s a good and practical example of some of the things we talk about in wider theory—why we need a different team of staff in terms of the mix, in terms of being able to deal with the healthcare needs, of professionals. And, often, that means people get seen more quickly, by the most appropriate professional. In particular, I was really impressed with the pharmacist, the advanced nurse practitioner, and the physiotherapist, taking demand away from GPs. They got to do more of what they need to do, in seeing more complex patients, and those people were actually being properly and safely seen and treated. And it’s been popular with patients too. We heard that directly from the community health council.

So, it’s more of this we need to see, not less, in the future, in every part of Wales—not just Kidwelly, not just Hywel Dda, but across the country. That is more and more the future of primary care—GPs at the centre of primary care, with more professionals around them, to properly meet and see and deal with the appropriate needs of their patients, wherever they may be in the country.

Minister, more policy development is recognising that we cannot work in silos and that many people will have co-morbidities, which will exercise the knowledge and skills of all allied healthcare professionals. What discussions have you had with professional bodies representing allied healthcare professionals, in order to determine that the training requirements for these bodies reflect not only the current but also the future needs of our population?

I have regular discussions with representative allied health professionals. They are an effective and very professional lobby, I find. And they come to you with a range of evidence to back up the statements they make about the future of the service. They are also a group of people who are very willing to change the model of care, and to say there’s evidence that doing things in a different way will provide better outcomes for patients, and that’s really, really encouraging. They have mentioned to me the potential of looking again at some of the particular requirements. But, most of the conversation I have with them is about the numbers that we have and how those staff are used.

You will see in the future of the primary care workforce, in the second half of this year, a particular focus on allied health professionals and pharmacy, and other groups, to understand the numbers of people that we need and what we want to do then to recruit more people, where we know we need more numbers—we are, of course, training more people in a variety of different allied health professions—and also how are the current staff, and how their skills are used. So, I think there’s lot of reasons to be positive about what’s happening, as well as recognising the challenge that does exist. So, I’m happy to continue having a regular conversation with them and other representatives of the primary care workforce.

Could I, following on from the question that introduced this, thank the Cabinet Secretary for his visit this morning to Tynycoed surgery in Sarn? And he saw the enthusiasm and the expertise of a wide range of professionals, but not only the GPs, not only the allied care professionals, but social care, healthcare professionals, people involved in social enterprises, people involved in the third sector. And the whole thrust of this was to move away, towards a system where it’s to do with well-being rather than the repair costs further down the river.

Does he share my hope, and those of other colleagues here, that these innovative collaborations—like the Abertawe Bro Morgannwg University Local Health Board cluster model—pump primed by Welsh Government funding, will ultimately prove those benefits of keeping people healthier for longer in their communities, reducing the load on our ever-stretched NHS services and wider health services, and potentially delivering cost savings too, by making sure that people are kept healthier longer, rather than washing up into acute, secondary, or even our GP care services?

Yes. And it was a particularly interesting visit this morning, for the launch of the cardiovascular risk assessment programme in the Abertawe Bro Morgannwg health board area, not just to meet GPs from around the cluster, but also to meet with healthcare support workers, who are going to be a key part of taking forward that particular programme. It’s a good example of building on what’s already taking place in Cwm Taf, and in Aneurin Bevan as well. There’s lots of learning there about going and understanding part of the population who don’t go to see their GP very often, but are at real risk of acquiring future conditions. So, it is about anticipatory care, and avoiding longer term and more chronic conditions in the future.

And I was particularly impressed, not just with the focus on well-being, but really taking forward learning. I want to see that rolled out on a consistent basis. That’s one of the things that, if we’re honest, we haven’t done as consistently or as effectively as we should have done in the past. And there’s a real imperative to do more of that in the future. The other really important message that I took from this morning was that clusters are something that GPs themselves are seeing more and more of the real benefit of—the way they get to work together, the way they do it with other professionals in health and care and the third sector—and the way that we release money directly for them has been a big part of gaining trust within that. Trust is a huge commodity, and I was really pleased to hear that the GPs who were there today recognised that there is a Government here that is willing to listen to them and to act with them.