Primary Care Pathfinder: discovery report – findings
5. What we found out
5.1 The health and care system faces many challenges
Demand for and access to general practice services remains the central challenge in primary care. This was evident from our interviews with both citizens and practice staff. Many stakeholder groups cited this as the main area in which digital tools should play a mitigating role.
Demand for health and care services is increasing in volume and complexity and will continue to do so. This is due to an ageing population and increasing numbers of adults living with multiple long-term conditions.
Service capacity cannot be readily increased to meet rising demand. There are acute staff shortages in clinical and social care roles, including a shortage of GPs. Both recruitment and retention of staff are challenging. The cost of health and social care services is increasing faster than economic growth, leaving a funding gap.
Citizens’ health needs
Health and care are not always organised effectively around the needs of the citizen or in a joined-up way across organisational boundaries. This degrades the experience for citizens, negatively affects health outcomes and introduces inefficiencies, further reducing capacity and increasing cost.
A wide gap in health outcomes for different population groups persists, with social determinants having a bigger influence on population wellbeing than the direct provision of health and care services.
Finally, public expectations have changed due to the ubiquity, speed and convenience of interactions with modern digital services. Many people have the appetite to use digital methods to access and manage care. Increasing numbers expect to be able to do so. However, this means they also have low tolerance for digital services with a poor user experience and will abandon them if traditional access channels are faster, easier or more effective in helping them complete their task.
5.2 These challenges are forcing changes to models of health and care
The Primary Care Model for Wales describes how primary care will be reshaped to support the principles of A Healthier Wales: a Long Term Plan for Health and Social Care.
At a high level, this new model aims to:
- distribute demand more evenly across a wider range of providers and healthcare professionals in the local community
- have services planned, developed and improved at a cluster (local group of healthcare providers) level
- emphasise place-based care and support, closer to home
- give citizens a proactive role to play in their own health in terms of prevention, self-care and self-direction, as well as the design of local services
- use data, digital and technology to support this change
There is a gap between this vision and how it can be achieved in practice by those providing primary care services. The Strategic Programme for Primary Care is working to address this gap.
Next: Some alignment with the future model is evident across primary care