The North Wales Population Health Directory (NWPHD) focuses on the public health priorities and provides information on population health need at different geographical levels (including at ) to NHS staff for planning purposes. The is on the Public Health Wales website.
Anglesey and Arfon clusters are undertaking a pilot study of the effectiveness of accessing FCP diagnostic tests. NICE guidance recommends FCP testing as an option to support clinicians with the differential diagnosis of Inflammatory Bowel Disease (IBD or Irritable Bowel Syndrome (IBS) in adults with recent onset of lower gastrointestinal symptoms for whom specialist assessment is being considered. This initiative is a cost effective use of NHS resources and also has great benefits to the patient who, without this test, may have had to undergo an invasive colonoscopy procedure. Anglesey and Arfon clusters have purchased 500 FCP tests from cluster funds, the first 100 tests completed are being audited, a full audit of the 500 tests will be undertaken in due course.
A pilot study was undertaken in a GP surgery in Anglesey to demonstrate the effectiveness of C-Reactive Protein (CRP) testing in GP surgeries to guide antibiotic prescribing. The pilot involved CRP point of care tests on 94 patients over a 3 month period and showed a 22% decrease in antibiotic prescribing compared to the previous year. Positive feedback was also obtained from patient and user surveys. Following the results of the pilot a bid was submitted to WG to purchase an additional 10 CRP machines to be rolled out to outlier GP surgeries in Gwynedd and Anglesey. The effectiveness of the additional CRP machines once implemented in other GP surgeries will be evaluated to inform the further introduction of point of care analysers into clinical practice. There is limited experience of CRP Point of Care analysers in GP practices and this study examined the impact on antibiotic items and the practical experience and learning for further rollout across practices.
Since October, several practices on Anglesey have been able to access primary care-based AECG monitoring for their patients rather than being referred at the outset to specialist cardiology services. A full evaluation will be undertaken to review effectiveness of access to this primary care investigation and any subsequent reductions on referrals to specialist services. Initial data review indicated a positive outcome where only 31% of patients required onward referral to cardiology. The tests can also provide reassurance to the patient by the GP as a result of access to the tests results within primary care.
MEC has been operating successfully across Anglesey since 2012 and provides a suitable, safe and effective alternative to admission to hospital. This forms part of the introduction of Enhanced Care at home across North Wales. The Service is provided by the Health Board in conjunction with Social Services. This intensive service can provide rapid access to diagnostic tests, a consultant opinion, specialist nursing, and other health and social care professionals to GPs, patients, and their families. It gives the option of looking after patients at home, in certain circumstances, when before the only option was to admit them to hospital. In early 2016, Dr Linda Dykes, Emergency Department Consultant and GP joined the MEC team for a 12 month secondment – Community Care of the Elderly. Linda joined the other members of the MEC team comprising of an ANPs, HCAs and a GP all of whom continue to offer an excellent service to patients on Anglesey. Other Clusters in the West are looking to implement a similar model of enhanced care in their localities.