Health Minister announces radical shake-up of outpatient services, 11 February 2016

Outpatient care will be delivered in a radically different way in the future, Health and Social Services Minister Mark Drakeford announced today, as he launched the prudent healthcare action plan.

The plan Securing Health and Wellbeing for Future Generations outlines work all health boards and NHS trusts will undertake over the next 12 months to transform outpatient services and reduce over-testing and over-medication in the Welsh NHS.

Speaking at the launch of the plan at a citizen engagement event in Newport, Professor Drakeford said:

“I’m announcing the start of a national project to redefine the outdated outpatient model and to make it easier for people in Wales to get specialist advice in primary care.

“This will free up hospital-based specialists so they can care for people with the most complex problems.

“Prudent healthcare describes the distinctive way of shaping the Welsh NHS to ensure it makes the most effective use of all its resources and staff skills, to secure health and wellbeing for our future generations.”

As part of the approach to transform the way outpatient services are provided, more services will be provided closer to people’s homes, starting with orthopaedics, ear nose and throat (ENT), urology and eye care services.

A new pilot project will see wet age-related macular degeneration clinics based in the community instead of in hospitals in some parts of Wales with care provided by optometrists and nurses, overseen by ophthalmologists.

This will ensure that people are seen faster and enable hospital-based specialists to concentrate on those people with the most complex problems.

New community-based audiology services, which were announced earlier this week, will receive direct referrals from primary care for hearing loss, tinnitus and dizziness, freeing up hospital-based services to treat the most complex cases.

Other national actions outlined in the plan include:

A clinical and patient-led programme which will be developed to reduce inappropriate antibiotic prescribing and tackle antibiotic resistance;

The Academy of Medical Royal Colleges in Wales, Public Health Wales and the Board of Community Health Councils will develop a campaign to help clinicians and the public to make choices together about tests, treatments and procedures, based on the best evidence – this will be based on the successful Choosing Wisely campaigns in the US and Canada;

The Prudent Prescribing Implementation Group will lead a review of the repeat prescription process to reduce unnecessary and inappropriate prescriptions.

Professor Drakeford said:

“Prudent healthcare is a way of reshaping the NHS around the things that matter most – continuing to provide care for all, based on clinical need.

“Involving people in the care they receive can provide huge practical benefits to the health service and the people it serves and this plan sets out how professionals and patients will work together to re-design services.”

Judith Paget, chief executive of Aneurin Bevan University Health Board, who will be taking a leading role in the national work around outpatients, said:

“More than 3.1 million outpatient appointments were provided by NHS Wales last year.

“In many ways our outpatient services across NHS Wales have remained unchanged over the years and we know that technology, new facilities and new ways of working offer us the opportunity to assess, diagnose and treat patients safely and quickly in different settings.

“There are already examples across Wales where services have changed with positive feedback from patients. We want to ensure that patients have access to specialist advice and support as quickly as possible and reforming our outpatient services is one way NHS Wales can work together to achieve this.”

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