Access to Primary Care Services

In October 2003, guidance was issued to Local Health Boards on the implementation of the Welsh Assembly Government’s strategic plan for the development of primary care services which defines the access target for Wales.  The guidance sets out an undertaking that patients will be able to access an appropriate member of the primary care team within 24 hours of requesting an appointment and much sooner in an emergency.

On 14 October 2003, Jane Hutt AM, the previous Minister for Health and Social Services announced a commitment of £7.1m to deliver a package of enhanced services as part of the new GMS Contract.  £2.6m of this was devoted to preparing and delivering Access. Each practice was able to claim £5,000 to make changes to the way they work subject to the production of an access plan for the practice that is agreed by the Local Health Board.  Local Health Boards are responsible for approving and monitoring the access plans for practices in their area.

In addition to this payment that has been available in each of the 3 years 2003/4 to 2005/6 a bonus payment of 50 quality points is made to each practice that achieves the target.  This is worth around an additional  £6,000 per annum to an average practice. The total package available to each practice is approximately £11,000.

The National Leadership and Innovation Agency for Healthcare supports practices that are signed up to delivering the access target through the Coaching Advanced Access scheme.  This emphasises the need to develop a reliable system that allows patients to be seen on the day they wish to be seen.  This includes the facility to pre-book appointments if circumstances such as continuity of care or convenience dictate. All practices across Wales entering the scheme must sign up to deliver the target by April 2006.  Currently 93% of GP Practices are achieving the Welsh access target and are claiming payment for it.

Additionally, the Welsh Assembly Government is currently developing a policy to address the issues of how patients access all areas of unscheduled or unplanned care.  This policy will provide the framework for the development of an integrated approach to a wide range of services including access to urgent primary care and emergency services.  The key theme of the policy to ensure patients can access the most clinically appropriate service, regardless of how they contact the service.