Future Hospital update from Wales
The president and senior college officers once again attended the Annual Joint Autumn meeting between the Royal College of Physicians (RCP) and the Society of Physicians in Wales. This conference, which also acts as the RCP regional update in general and acute internal medicine for Wales, was bigger than ever this year with more than 300 delegates attending over the two days and included a poster display of 30 examples of innovation and clinically led improvement initiatives. During her stay, the president visited the Frail Older Peoples’ Liaison Service (FOPAL) project at the University Hospital Wales in Cardiff. This service innovation project is designed to avoid inappropriate admissions of frail elderly people, and while the president was there she was able to learn more about the initiative and discuss practical issues with junior doctors, therapists and consultants.
A satellite meeting at the update addressed the prospects of physician associates (PAs) in Wales and was attended by Teresa Dowsing, president of the Faculty of Physician Associates at the RCP. The Welsh government established a task and finish group in April 2015 to develop a commissioning and governance framework to support the training and employment of PAs in the Welsh NHS and this has now completed its work. The RCP has been extensively involved in shaping the governance framework, suggesting that the NHS must only employ PAs who are registered on the voluntary register and that a common approach to support and funding is implemented. While detailed awareness of the value of PAs remains low and misconceptions exist, overall there is still great enthusiasm for active participation in this new initiative and the well-attended satellite meeting with its vigorous debate represents the start of the RCP's engagement to fully implement this new initiative.
The Safe Nurse Staffing Levels (Wales) Bill has moved one step closer to becoming legislation after Welsh assembly members passed the motion on its financial resolution. It will now move onto the next part of the legislative process, but two more stages will still need to be passed before the bill can become law. There is strong public support for the bill, with almost 90% of people taking part in a poll organised by the Royal College of Nursing in Wales, saying it was important for the bill to be passed.
As a devolved health service, Wales is not facing the same junior doctor disquiet as England. The first minister confirmed in the Assembly that there were no plans to change doctors contracts in Wales at present. The health minister, Mark Drakeford is encouraging junior doctors to ‘come and train, live and work in Wales’, quoting high overall satisfaction rates in the General Medical Council trainees’ survey for all trainees in Wales, which have increased for a fourth consecutive year to 83% in 2015 and show higher satisfaction rates than in other parts of the UK. While workforce pressures remain, we are keen to do more to support our junior doctors and enable them to stay in Wales and receive a first-class experience as they develop their careers.
Following the April report of the Health Education Investment Review,1 we know that there will be a central body established to oversee, planning, development and commissioning of the professional workforce. The RCP in Wales will continue to play a full role in shaping the next steps of this major change and to reaffirm the importance of the medical budget. While there is a general welcome for the prospect of meaningful workforce planning, there are also anxieties that if the funding of all medical training posts is transferred to a common pool, then funding for unfilled posts might be lost to medicine and there is a strong move to ensure this does not happen.
Turning to our public health challenges, the Welsh government wants to be ready to introduce minimum unit pricing for alcohol if the European decisions are positive following a legal challenge on Scottish proposals. The minister for health and social service has already announced that the Labour government supports the use of further legislation including a sugar tax.
We have concluded our work to visit all the health boards in Wales to see how they are progressing to implement level three of the All Wales Obesity Pathway. The RCP Wales Obesity Working group has concluded its visits to local health boards to discuss progress to implement level three services as defined within the All Wales Obesity Pathway. These findings will be shared with colleagues next year. The latest weight management service became operational in September 2015 at Llandough Hospital, Cardiff.
During the autumn, many stakeholders issued their manifestos to influence the different political parties’ manifestos. It is encouraging to see how many issues are common across our respective members concerns and priorities, including developing a national workforce, making patient care a reality and putting health into all major policies. One thing is for certain, health will remain at the centre of politicians campaigning as we move closer towards the outcome of the next elections in Wales.
- © Royal College of Physicians 2016. All rights reserved.
References
- ↵Evans M, Phillips CJ, Roberts RN, Salter D. Health professional education investment review. Cardiff: Welsh Government, 3 August 2015, Available online at http://gov.wales/docs/dhss/publications/150414report1en.pdf [Accessed 31 December 2015].
- (December 2015.) RCP Wales Obesity Working group issued in.
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