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GP shortage ‘caused by Withybush downgrades’

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docsPEMBROKE residents have expressed concerns about reduced opening hours in the town’s doctors surgery as a result of a shortage of doctors. Since September 1, the surgery at St Oswald’s has closed at 1pm on weekdays. Until then, it had been open until 6.30pm on Monday, Wednesday and Friday. The surgery, a member of the Argyle Medical Group which also has practices in Pembroke Dock and Neyland, serves Pembroke, Monkton, and a number of outlying communities in the area. The surgery in Pembroke Dock will remain open from 8am – 6.30pm.

However, concerns have been raised about how the reduction of provision in Pembroke will affect elderly patients, or those with reduced mobility. Speaking to The Herald, Practice Manager for the Argyle Medical Group Juliet Goldsworthy confirmed that the reduction in surgery hours was a deirect result of staff shortages: “We’re two doctors down at the moment – its a common problem across Wales,” she said.

Safety was apparently a major consideration for the shorter opening hours. The practice was unwilling to let one doctor work at the surgery alone. “Its about managing the surgery safely andwe can’t do that at the moment,” Ms Goldsworthy added.

When we asked how long the staff shortage had been a problem for, she said that the staffing shortages were ‘relatively recent,’ though admitted that they had ‘struggled on’ over recent months. However, staff holiday time had meant that they were unable to keep the current provision. “The first doctor left about 18 months ago, and we lost another one 12 months ago,” she added.

“We have been advertising in national publications, but haven’t had any response. Accepting that the situation for patients was ‘far from ideal,’ she said that the problem was an all-Wales issue. Ms Goldsworthy confirmed that the practice had 10.75 FTE (full-time equivalent) doctors.

There are around 25,000 patients registered with the practice, which equates to 2325 patients per GP. Several years ago, the average number of patients per GP in Wales was 1640, and while Ms Goldsworthy said that this had risen to around 1900-2000, she still acknowledged that Argyle Street still did not meet these levels.

“Its not ideal – it puts a lot of pressure on both patients and doctors,” she added. Ms Goldsworthy pointed out that Argyle Street employed full-time nurse practitioners, who worked supporting GPs, as well as a full-time pharmacist who could ease the burden on doctors with work related to medication. “We were one of the first practices to take on a full-time pharmacist,”she added. “The health board seems to be looking more at approaches like this now. I understand that patients hanker for days gone by, but times have changed.”

With regards to the opening hours at St Oswalds, Ms Goldsworthy told us that if two new doctors could be recruited the situation would be reviewed after six months. At present, she said that the practice has been advertising ways for those unable to drive to attend the Argyle Street Surgery to travel there more cheaply.

“Services like country cars, and public transport can save people money on taxis,” she pointed out. Ms Goldsworthy emphasised that the surgery would still be open in mornings, and that hopefully people who would struggle to get to Pembroke Dock would be able to attend then. “We do visit a lot of people at home, if they are unable to get out. Our visiting rates are quite high,” she added. She pointed out that a shortage of GPs could lead to a continuing problem, because constant staff-shortages would lead to an increased workload, and the job becoming less attractive for medical trainees.

“There is talk of a ‘Golden Hello’ in Wales, but I’m not sure what is going to become of that,” she said. Concerningly, Ms Goldsworthy agreed with other commentators, including Simon Hart MP, who has previously said that a reduction in service provision at Withybush will lead to a knock-on effect on the county’s medical community.

“As Withybush downgrades and less doctors come to work there, their partners, who often used to work in surgeries won’t come here either, leading to the health community shrinking. We had a doctor who worked with us who was fantastic, but his wife worked in paediatric care, and when the department in Withybush downsized she had to move to Swansea to find work.

“There may also be issues with GP training at the hospital.” Speaking to The Herald, MP Simon Hart agreed that Issues faced by Withybush Hospital were a definite contributing factor in staffing problems across the medical community in the area: “From what I can discover there is a definite connection between recruitment and uncertainty over Withybush. For once the problem is not entirely about money,” he said.

“For the County to be able to attract Doctors and their families, they need to assure them that the services have a future and that there is certainty as far as their jobs are concerned. The Welsh Labour Government continues to fail in this regard and our county suffers accordingly.” We asked Hywel Dda University Health Board whether this was a fair reflection, and what if anything could be done to attract more GPs to the county.

At the time of going to press The Herald had received no reply. A spokesperson for Hywel Dda UHB said: “We would strongly urge caution when drawing ‘definite’ links between recruitment issues at a hospital and GP level as there is no absolute or clear evidence for this. GP recruitment is challenging across Wales, this is well documented, and we are experiencing this in areas across Carmarthenshire and Ceredigion as well as Pembrokeshire.

“Whilst we are taking clear actions to address recruitment at our hospitals, we have numerous responses to recruitment challenges at a GP level. For example, we are in the process of developing a Primary Care Support Team to offer support to Practices with workforce issues to which we have successfully appointed a GP clinical lead and three Advanced Practitioners, due to start shortly.

“We are also supporting the development of other roles that can provide patient care in General Practice working alongside GPs. For example, Argyle Surgery have employed a practice based pharmacist to support the GPs on a day to basis. This is alongside developing portfolio GP roles to increase the appeal of working in the Hywel Dda area to those wanting diversity within their role.”

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Business

MP makes Budget case for support for self-employed and small businesses in Ceredigion

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BEN LAKE MP has called on Chancellor Rishi Sunak to extend the government’s financial support package for businesses and self-employed workers in next week’s Budget as many struggle to stay afloat during continued lockdown restrictions. 

The Chancellor, Rishi Sunak is to set out the UK Government’s budget on Wednesday 3 March, almost a year since the last Budget on 11 March 2020. 

To help businesses and our local high streets over coming months, the Ceredigion MP has called on the Chancellor to extend the lowered rate of VAT at 5% for hospitality and tourism for a year to March 2022 and to extend the business rates relief package. 

Mr Lake also called on the Chancellor to retain the furlough scheme for the duration of pandemic restrictions, as recent figures show more than 178,000* in Wales are still receiving government help from the CJRS. He also urged the Chancellor to expand the existing eligibility criteria for the Self-Employed Income Support Scheme in order to offer some help to the many individuals who have not received a penny in Government support thus far. 

Ben Lake MP said: “For many businesses and self-employed workers, the financial support government has offered over the last 12 months has been a lifeline. Now, as we are finally starting to see light at the end of the lockdown tunnel, we cannot remove this lifeline prematurely. Extending this help for a little longer, and expanding the criteria to help those that have been excluded thus far, would offer small businesses the support they require to ‘bounce back’ from the pandemic.” 

Many businesses who are still not open due to lockdown measures are also now expected to start repaying their Bounce Back Loans. This is despite their situation largely remaining unchanged since they took out the loan, or in some unfortunate instances, worsened as they have not yet been able to trade.  

UKHospitality has estimated that the hospitality sector lost around £72 billion in sales in 2020 and faces, frankly, a debt mountain, including £4.2 billion in state-backed loans.  

Mr Lake said:  “It is important that businesses that took out bounce back loans and CBILS are required to pay only when they are in a position to do so – once they have ‘bounced back’ from the pandemic. Affording such a level of flexibility, and thus preventing avoidable business failures, would protect jobs, the taxpayer’s investment in the recovery, and the integrity of our financial system.

“We remain in the early stages of a vaccine-led recovery, and it is likely that we will have some form of restrictions for many months to come. Having done so much to protect the economy and the workforce, we must not withdraw support prematurely, as to do so would risk throwing away the investment taxpayers have made in the last year, and potentially our economic recovery.” 

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Covid-19 vaccination venues and timeline announced for everyone locally over 50

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EVERY person in JCVI priority groups 5 to 9 will be offered a COVID-19 vaccination by 18 April, Hywel Dda University Health Board has confirmed.

While the health board’s vaccination programme has the capacity to offer a vaccine to everyone in groups 5 to 9 by the original target date of 4 April, the delivery plan has had to be adjusted based on confirmed vaccine deliveries.

Carmarthenshire, Ceredigion, and Pembrokeshire residents in priority groups 5 to 9 can expect to receive their vaccine as follows:

  • Group 5, people aged 65 – 69 years – delivered by GP practices between 15 February and 12 March
  • Group 6, people aged 16 years to 64 years with underlying health conditions and unpaid carers – delivered by GP practices between 22 February and 4 April
  • Group 7, people aged 60 – 64 years – delivered by mass vaccination centres starting 8 March
  • Group 8, people aged 55 – 59 years – delivered by mass vaccination centres starting 22 March
  • Group 9, people aged 50 – 54 years – delivered by mass vaccination centres starting 5 April

The health board currently has mass vaccination centres located in Aberystwyth, Cardigan, Haverfordwest, Tenby, Carmarthen and Llanelli.

Group 6 is significantly the largest cohort to be vaccinated to date and we understand that many in this group will be anxious to receive a vaccine. Please do not contact your GP or the health board to ask about your appointment, you will be contacted directly when it is your turn and we thank you for your patience.

People in groups 7, 8 and 9 will receive a letter with an appointment date and time. Please arrive as close to your appointment time as possible. The letter will include a phone number to contact the health board should you need to rearrange or cancel your appointment but please make every effort to keep your allocated appointment time.

Steve Moore, Chief Executive of Hywel Dda UHB, said: “While  our programme has had to slow  due to supplies, we want to reassure everyone in groups 5 to 9 that our amazing teams of vaccinators and GP practices have the capability and flexibility to deliver our vaccine supplies as they arrive into the region.

“Vaccine supplies will start to increase again from mid-March, and we are confident that everyone living in our three counties in the top 9 priority groups will be offered a vaccine by mid-April.

“In Hywel Dda we have an older population compared to some other health boards and so over 50% of our adult population will have been offered a vaccine by milestone 2.

“To be able to say that as we approach the anniversary of the first national lockdown is nothing short of extraordinary.

“And again, I must say thank you to everyone living in our three counties who continue to come forward in substantial numbers for the vaccine. Uptake remains remarkably high and we hope to see this continue through groups 5 to 9 and into group 10.”

People are asked, wherever possible, to use their own private transport to attend an appointment. Lifts can be accepted from someone in their household or support bubble, but not from anyone else due to the risk of transmission of the virus.

The health board has put in place transport support for anyone who may have difficulty attending their vaccination appointment. If you have no other means of travel, please contact the health board on 0300 303 8322 and we will be happy to assist.

Everyone in priority groups 1 to 4 should have received an offer of a vaccination. If you have not been contacted, or have changed your mind, please contact your GP at the earliest opportunity. No one will be left behind.

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Wales looking for third win in a row against England

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WALES have won their first two games in the Six Nations Championship and on Saturday, February 27, they put that record on the line against great rivals England.

Having already beaten Ireland and Scotland, the Triple Crown will be on the line for Wales, a feat they last achieved in 2019 when they won the Grand Slam.

That will be incentive enough for Wayne Pivac’s men but to do it against England will make it that little bit sweeter.

With France’s game against Scotland on Sunday in doubt, it will also give the home side a great chance to extend their lead at the top of the table.

Wales do not have any fresh injury concerns going into the England game and it will likely provide a selection headache for Pivac.

George North could be set to make his 100th appearance for Wales if he plays against England, and is currently second in the list of all-time try scorers for his home country.

England lost their opening game of the tournament against Scotland but got back to winning ways with a resounding 41-18 win over Italy.

The 2020 Six Nations and Autumn Cup Champions will be eager to rediscover their winning form which brought them that success but they will not find it easy against Wales.

What happened the last time England visited the Principality Stadium?
Wales last welcomed England to the Principality on February 23, 2019, and it was a game which saw Wales earn a 21-13 victory.

Cory Hill and Josh Adams scored Wales’ tries in that match while Dan Biggar and Gareth Anscombe added the rest of the points from the boot.

Tom Curry scored England’s only try in that match while Farrell had a 100% success rate with his kicks.

What happened when the sides met in 2020?

It was an absolute classic last year with England triumphing by 33 points to 30 at Twickenham.

Anthony Watson, Elliot Daly and Manu Tuilagi got the tries for England on that day while Owen Farrell had again had a 100% record with the boot.

Justin Tipuric bagged two tries for Wales while Dan Biggar scored their other as the men in red came up short on this occasion.

Of course, the last two meetings between the two sides were played in front of capacity crowds but that will not be a factor this time around, owing to the current coronavirus pandemic.

Could that be a factor in the game or will both sides treat us to an excellent display of rugby?

After the England game, Wales travel to Italy on Saturday, March 13, while England will host France on the same day.

A win for either side this weekend will be crucial; a win for Wales and it sets them up for the Grand Slam while a win for England will reignite their hopes of retaining the Six Nations Championship.

Saturday’s game kicks off at 16:45 and can be seen on S4C as well as the BBC.

ENGLAND
Elliot Daly, Anthony Watson, Henry Slade, Owen Farrell, Jonny May, George Ford, Ben Youngs, Mako Vunipola, Jamie George, Kyle Sinckler, Maro Itoje, Jonny Hill, Mark Wilson, Tom Curry, Billy Vunipola.

Replacements: Luke Cowan-Dickie, Ellis Genge, Will Stuart, Charlie Ewels, George Martin, Ben Earl, Dan Robson, Max Malins.

Replacements: Elliot Dee, Rhodri Jones, Leon Brown, Cory Hill, James Botham, Gareth Davies, Callum Sheedy, Uilisi Halaholo.

WALES
Liam Williams; Louis Rees-Zammit, George North, Jonathan Davies, Josh Adams; Dan Biggar, Kieran Hardy; Wyn Jones, Ken Owens, Tomas Francis, Adam Beard, Alun Wyn Jones, Josh Navidi, Justin Tipuric, Taulupe Faletau.

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