Health Secretary Vaughan Gething, has announced £1.7m funding for a Cwmtawe project to develop new models of health and social care.

The Welsh Government says the funding comes from the £100m Transformation Fund to support key actions from its long term plan for health and social care, A Healthier Wales.

The Cwmtawe Cluster project, developed by the West Wales Regional Partnership Board, will receive £1.731m to develop new ways of working, better integrating health and social care. The best ideas can then be scaled up and rolled out across Wales. As the NHS moves into its next seventy years, the way services are provided is changing, with more of an emphasis of working with the communities it serves, and keeping people well, not just treating them when they are unwell. Abertawe Bro Morgannwg UHB (ABMU) says the funding will help turn this healthcare vision into practice for people living in these Swansea communities over the next eighteen months.

Cwmtawe Cluster Network is a group of three GP practices and healthcare professionals, including pharmacists; who work together with voluntary sector and social services partners to improve patient services. Together the cluster provides care for around forty four thousand people. The network’s vision for how primary care could be delivered in future is considered so innovative that it will now be put into play and serve as a test run for the rest of Wales.

The project has three overall aims:

• Improve wellbeing across the age spectrum, with a particular focus on ensuring children have the best start in life to be the healthiest that they can be.
• Co-ordinate services to maximise wellbeing, independence and care closer to home. With a particular focus on older people to develop new models of care closer to home and reducing unscheduled admissions.
• Test and evaluate the models of care that could be rolled out across Wales.

Some of the new ways of working, which have already started include:

• Clydach Community Hub, to enable people to access all Swansea Council services from October 2018 through a digital gateway. With access other partner organisations’ services too, either digitally, or via volunteers.
  An integrated health and social care team serving the Cwmtawe cluster is based in Gorseinon Hospital and Clydach Primary Care Centre.
• New workers to link up health and social care.
• Same day GP appointments and a new IT system to allow access to patient records away from the GP practice.

Vaughan Gething said “Our long term plan for health and social care, sets out how we will transform the way we deliver care to ensure it is sustainable in the future. This will require better integration of health and social services to reduce reliance on hospitals and deliver care closer to home. The Transformation Fund will be used to fund a small number of projects which have the most impact in developing and delivering new models of care, and which have potential to scale up so they can be used across Wales. The Cwmtawe Cluster already has a strong background in collaborative working and innovative thinking. I look forward to seeing the results from these new ways of working.”

Dr Iestyn Davies, Cwmtawe Cluster lead, said “We at Cwmtawe are thrilled with this very exciting announcement. The investment will really help us restructure and modernise the way we offer care to patients. We are delighted that Welsh Government recognises our vision for patient-focused primary care, which has a strong emphasis on supporting our communities and working with them to help keep people well – not only treating them when they are sick. This investment will allow us to expand our multi-disciplinary teams, giving patients better access to a wide range of healthcare professionals in their community, and bring some services traditionally accessed in hospitals closer to home.”

He said the cluster was now keen to involve the community in designing and implementing the plans.

Dr Richard Tristham, GP partner with the Cwmtawe Medical Group and Area Clinical Director for Primary and Community Services, said “It is fantastic news for Cwmtawe and recognition of all the hard work the team has put in. We hope this can be replicated across ABMU in the future to benefit all patients.”

Sharon Miller, ABMU Head of Primary Care, said “All 11 cluster networks across the ABMU area have developed some excellent, innovative services and we are really pleased that Cwmtawe has been recognised.”

At the heart of the vision is a whole-systems approach, which focuses on building strong communities as much as promoting health and wellbeing. Traditionally, the role of GPs has often been considered as examining patients, writing prescriptions and acting as gatekeepers to hospital care. Increasingly, however, GPs are only one part of much wider teams of healthcare and other professionals working together to offer much more rounded and holistic care. The funding will develop and accelerate even further this new way of working. In practice this means that of the services coming on line are not strictly medical. They include some aimed at tackling loneliness and isolation, along with a focus on prevention, and earlier and easier intervention.

Some of the new developments patients in the Cwmtawe Cluster Network can expect to see emerging over the coming months include:

• More healthcare professionals joining practices including: physiotherapists, advanced nurse practitioners, pharmacists and paramedics.
• A new community phlebotomy service.
• A community audiology service.
• A range of outpatient clinics moving from hospital sites to the community.
• A new dental hygiene service for care homes.
• Specialist eye care for patients who have had strokes.
• An acute clinical outreach team helping to keep patients out of hospital or helping them come home as soon as possible if they are admitted.
• Improved diabetes care and education.
• Local area coordinators to tackle loneliness and isolation.
• A repeat prescriptions hub.
• Support for young carers.
• Better cross agency working.
• The use of digital solutions to engage with patients and help them better care for themselves.
• The launch of an arms length social enterprise company to bid for Lottery and other grants that can support a wider range of services to support wellbeing.

In addition, the cluster is talking to Swansea Council about developing a Clydach Community Hub for local people to access all council services. It will also double as a digital gateway to assist those who aren’t comfortable with a computer to learn new skills.

Other work which the cluster will focus on in the months ahead include exploring with partners ways to strengthen social care, end of life services and services for patients with dementia. The cluster will also look at forging greater links between health and housing, the use of assistive technology and closer working with housing associations in the area.