Pharmacists and pharmacy technicians are forming part of a multidisciplinary primary healthcare service in Prestatyn, North Wales, set up and run directly by the local health board in response to a GP recruitment crisis.
The service, Healthy Prestatyn Iach, is managed by Betsi Cadwaladr University Health Board (BCUHB), covers a population of around 23,000, and includes physiotherapists, occupational therapists, midwives, dieticians, advanced nurse practitioners and GPs. It replaced two GP practices on 1 April 2016.
“This is a pioneering model of primary care for BCUHB and the whole of Wales in terms of the scale on which it will be done,” says Chris Stockport, medical director for the health board’s central region.
Courtesy of Betsi Cadwaladr University Health Board (BCUHB)
Five pharmacists and three pharmacy technicians will be employed as part of the service, with a similar service operating in the neighbouring town of Rhuddlan.
Rory Wilkinson, locality team leader (central region) for Betsi Cadwaladr pharmacy and medicines management team, says each pharmacist will be responsible for managing the pharmaceutical care of around 5,000 patients.
“They will be required to conduct all necessary medication reviews for their patients, determine what monitoring they require and make sure it is done, and take patients, as necessary, for discussion at the multidisciplinary team review meetings — and they have that responsibility from day one,” Wilkinson explains. “This is not just about taking some of the workload off GPs; it is about making sure that anything that can be done by a pharmacist is done by a pharmacist.”
Healthy Prestatyn Iach will be supported by an academy that will undertake practice-based research and service improvement for patients. Services will be delivered from four sites — all of which will deliver planned care (i.e. the management of chronic conditions). “This will include pharmacists providing clinics for treating conditions such as hypertension, cardiovascular disease and gastric conditions,” Wilkinson adds. The main surgery site will offer a “same-day service” for patients who require an urgent appointment.
Berwyn Owen, the health board’s clinical director of pharmacy and medicines management, says: “This is a substantial investment in clinical pharmacy and an exciting opportunity to provide novel pharmaceutical care for Prestatyn. It provides a real opportunity for pharmacy skills to transform the future health provision in this area.”
Community pharmacies within Prestatyn will be integrated in the new model to provide a common ailments service, emergency medicines supply and discharge medicines reviews.
“The service will be evaluated to identify what works or what does not, with clarity around outcomes for patients, and the results will be published once completed,” says Owen.
Healthy Prestatyn Iach evolved after two practices in Prestatyn served notice to the health board that they would terminate their contracts on 31 March 2016. The practice in Rhuddlan has also served notice. Stockport explains that this was because of problems with GP recruitment. “The decision to implement the new service was taken by the health board after all three of the existing practices experienced difficulties in recruiting new GPs,” he says. “Pendyffryn, the larger practice in Prestatyn, had lost three or four GPs over the past couple of years and those who remained were struggling with the workload. GPs at the other practices were finding it difficult to get time off as nobody could be found to cover for them.”
Source: National Assembly for Wales
Mark Drakeford, Welsh health and social services minister, says: “Healthy Prestatyn Iach represents a more prudent way of providing local healthcare, using the skills of our dedicated primary care workforce and supporting them to innovate and develop the services they provide.”
Drakeford has also announced that a £43m fund will be available in 2016–2017 to help expand access to primary care services in Wales and move more treatments out of hospital. Of this, £26m will be made available to health boards while £10m will be given directly to GP clusters.