One doctor for over 6,300 patients at GP surgery

Richard Evans Local Democracy Reporter

A GP surgery in north Wales was operating with just one doctor for over 6,300 patients.

The detail emerged in a council cabinet meeting about how population growth could affect health care services.

The Conwy Council report was one of several background papers to inform the Replacement Local Development Plan (RLDP), which details what can be built and where and how it impacts on local infrastructure.

Over the RLDP period the population is expected to grow by 4,950 residents between 2018 and 2033.

Councillors were told key pressures on health services included the population increasing, an ageing population, and the number of older residents living with long-term conditions, such as type-two diabetes.

Concerns

The cabinet discussed how financial contributions could be sought from developers by the NHS to help fund new health care facilities or those that needed to increase in size.

Councillors rubberstamped the report that proposed health care facility policies take a ‘positive approach to new and existing sites’.

But during the discussions, several councillors raised concerns about their wards and the pressures GP surgeries were experiencing.

The meeting was attended by Betsi Cadwaladr University Health Board’s assistant director Alison Kemp.

Cllr Chris Cater said the GP surgery in Penrhyn Bay had been operating with one doctor looking after over 6,300 patients.

Referring to the report and its figures, Cllr Cater said: “I’ll ask Alison about the worst figure there, which is in my ward, the medical centre in Penrhyn Bay where one doctor is coping with 6,338 patients, and we are talking about 152 new houses going up in Penryhn Bay under the existing LDP, so I just wanted to know whether the health board is giving that, that practice, the full support that it needs. Because on paper, those figures look dreadful. That ratio looks awful.”

Ms Kemp admitted: “They do.” But she then explained another two GPs had since been recruited at the surgery.

She added: “These things do change, but for that one, I’m very pleased to say there are three GPs working out of Penrhyn Bay, or there will be in the coming weeks.”

Cllr David Carr said: “What really depressed me was when I read the Welsh Government had no more money for the health service in north Wales,” he said.

“So how can we expand, how can we provide these services without the money being available?”

Ms Kemp replied: “If a practice has an increased list size, it gets an increased income.

“The issue is the premises. Every independent contract holder, it is part of their contract that they provide the building. They are reimbursed through the contract for the cost of those premises, but it is their responsibility to secure those premises.”

Strain

Ms Kemp then admitted that new homes planned in Old Colwyn and Colwyn Bay could put a strain on Cadwgan surgery as it was the only surgery serving the large area.

But she then explained the NHS could look to seek funding streams from community pots and section 106 agreements as part of the planning process.

Section 106 agreements are legally binding contracts, usually between a local planning authority and a developer or landowner, in which the developer agrees to provide funds for local infrastructure, like playgrounds.

Ms Kemp said Cardiff and Vale Health Board had successfully secured funds for health facilities and part of a section 106 agreement but added that was for a very large development of 5,000 homes.

“One of the things we’ve talked to Conwy colleagues about is whether, as part of the approval for such a significant development, is that health facilities could be provided as part of that in the way that, historically, playgrounds or other things have been built, and that the health facility is the priority for any section 106 money,” she said.

“The situation we have is that the section 106 monies may or may not be sufficient to actually deliver a building, and so one of the things we’ve talked about is whether there are other community assets that could be extended to provide some health facilities than a stand-alone branch surgery for example, to be run by another practice.

“So those are the things we’ve talked about. The health board doesn’t have… we don’t have significant capital money to build that sort of thing. We have to bid from the Welsh Government for it, and there are timescales for it. We can’t mandate practices necessarily to expand their premises either, for example. That is their own decision as to how they wish to fulfil their contract.”

Colwyn Bay councillor Chris Hughes said: “In terms of health outcomes in Conwy, my ward has the worst health outcomes within the county borough and the fourth worst health outcomes within North Wales.

“It will also be, as it was previously, the most affected ward by any redrawing of the boundaries of Cadwgan (surgery). I wrote to you on July 25, Miss Kemp, regarding my concerns and the concerns of residents within my ward, who do feel that they’ve been trying for three days to get an appointment at the West End Medical Centre, which was where they were transferred to, and they said it is a non-existent service.”

He added: “The ward that would be most impacted by any amendment (to GP surgery catchment boundaries regarding planned new developments) is the ward with the worst health outcomes in the county, and that can’t be allowed to happen as far as I’m concerned. We would be negligent as a council if we allow that to happen again.”

Cabinet member for housing Cllr Emily Owen then said it was important that new houses were built due to need, reminding councillors that not all patients would be new patients, as the homes would be built for people already living in the area.

According to the report, there are 20 GP surgeries in the county, which has a population of over 117,200 and 52,750 households (2018 figures).

The report also highlighted that the RLDP strategy planned for 360 new homes in the Llanfairfechan, Penmaenmawr, and Dwygyfylchi area; 1,080 in Llandudno, Penrhyn Bay, Deganwy, Llandudno Junction, and Conwy areas; 1,260 in the Rhos on Sea, Colwyn Bay, Old Colwyn, Mochdre, and Llysfaen areas; and 540 in Abergele, Towyn, Kinmel Bay, and Llanddulas areas.

These figures include some homes that are already now built.