GP Practices in Bridgend West
Bridgend West Network is one of 8 Primary Care Clusters within Cwm Taf Morgannwg University Health Board footprint.
There are 3 GP practices in the West Cluster, namely:
Porthcawl Group Practice who are a training practice
North Cornelly Surgery who have a branch surgery in Kenfig Hill
Heathbridge House Kenfig Hill who are also a training practice
The West is the smallest of the three clusters within Bridgend with a total practice population of 34,519. The geographical area covers Porthcawl, Pyle, Kenfig Hill and Cornelly, which is coastal, rural and urban with pockets of severe deprivation. Porthcawl is a holiday resort and home to a large static caravan park which results in a high transient and seasonal patient population.
The West Cluster area also has:
The Cluster all work together with partners from the voluntary sector and the Health Board’s Integrated Team.
Porthcawl Group Practice moved to their new purpose built premises at Clos Y Mametz, Porthcawl in February 2019. In addition to general medical services provided by Porthcawl Group Practice there are a number of Health Board community services being delivered from these premises including district nursing, midwifery, health visiting, wound care, physiotherapy and AA screening.
Bridgend West Annual Delivery Plan 2023_2024
Cluster Pharmacy Team - Experienced and well established team consisting of 2 Pharmacists (1.6 WTE) and a Pharmacy Technician (0.8 WTE).
The Cluster has increased Cluster Pharmacist capacity in order to facilitate and improve prescribing, patient experience and concordance. This releases GP time and improves patient safety though effective use of Cluster pharmacists.
Pharmacy Technician support enables expansion of work streams in line with prudent healthcare principles.
Chronic Conditions Management Nurse - The role provides a person-centered, holistic approach to the management and education of patients with chronic morbidities.
The Cluster Band 6 Nurse undertakes housebound patient reviews and develops support plans to enable patients living with a chronic disease to manage their condition effectively. This improves the quality and structure of chronic disease monitoring for the housebound.
Working within an Integrated Health and Social Care team has allowed the Nurse to have direct access to therapists within the multi-disciplinary team, including members of the third sector.
First Contact Physiotherapy - Delivery of a first contact physiotherapy service across the Cluster. Working in conjunction with the Physiotherapy Department at CTM UHB the service provides physiotherapy sessions within GP practices, which aims to improve access and outcomes for patients, avoiding the need for patients to travel to hospital sites for initial assessments.
Through earlier contact and intervention it will provide better outcomes for patients, reduce the need for repeat visits and also reduced referrals to secondary care, unnecessary treatments and prescribing.
The Cluster has also invested in Vision 360 software to support the First Contact Physiotherapy service roll out. This software package enables GP Practices to book appointments directly to this service.
AWDPP - All Wales Diabetes Prevention Project - Public Health Wales are leading the development and implementation of an All Wales Diabetes Prevention Programme with plans to roll it out across Wales over the next 3 years. Merthyr and the West Cluster have been chosen as pilot areas for CTM UHB.
The AWDPP involves a brief intervention, delivered by trained Health Care Support Workers, supervised by local dietitians, to people identified as being at risk of developing type 2 diabetes (HbA1c 42-47 mmol/mol).
Between October 2022 and September 2024:
Additional Information:
Tackling pressures in primary care: increasing spirometry testing in Bridgend West - The project used Population Segmentation and Risk Stratification data to case-find patients with COPD and mitigate increased healthcare demands over the winter period.
The primary objective of the project:
The secondary objective of the project:
In CTM UHB there is a population size of around 460,000 people, of which 2.5% of the population are living with a COPD diagnosis. Bridgend West Primary Care Cluster area has a population size of 34,519 people with 2.5% of the population living with a COPD diagnosis; this is higher than the Bridgend average (2.36%) and the same as the CTMUHB average (PHM Unit, 2022).
The project recruited patients from two GP practices situated with the Bridgend West Cluster area for spirometry testing.
A scoping exercise was completed initially resulting in a list of patients being produced in Porthcawl Group Practice using PSRS data, identifying patients who:
Both GP practices taking part in the project held a list of patients that they suspected would be eligible for spirometry testing based on their medical history/previous consultations within primary care. 84 patients were identified by Porthcawl Medical Centre and 74 patients were identified by North Cornelly Surgery. These patients were added to the list of patients who were identified for testing using PSRS data giving a total of 218 patients eligible for testing within this project.
From the 218 patients who were suspected of having a respiratory condition and clinically suitable for spirometry testing to confirm the diagnosis:
As a result of this project this now ensures that these patients are captured in future respiratory related activities, such as eligibility for vaccinations, winter respiratory projects, and treatment and management reviews.
Newly diagnosed patients with a respiratory condition will now be able to access appropriate treatment plans for their condition and are now identified appropriately within the practices.
Children & Young People Resilience Project - The Cluster and Valleys Steps are working with the two local Comprehensive Schools in the delivery a 6 week ‘Building Resilience Course’ to pupils of Year 10 followed by a 6 week ‘Mindfulness Course’.
The aim is to give students a toolbox of skills to help them improve their resilience and overall wellbeing.
Mental Health Project - GP Practices offer frontline service for patients suffering with mental health issues. Such issues have become increasingly prevalent, particularly due to reduction in stigma associated with mental health and the impact of Covid so it’s crucial that Practices are more equipped to offer the best possible service and care to patients.
Following an audit carried out by one of the Cluster GP Practices this Practice trialled a dedicated face to face weekly mental health clinic, the aim of which was to try and reduce emergency crisis calls.
Following the success of this pilot the Practice now have a dedicated weekly clinic for patients suffering with mental health issues. The clinic allows for longer appointments with the GP. The Practice continues to update the Cluster as to the effectiveness of its dedicated clinic, sharing lessons learnt. The Practice also aim to with both BAVO and Bridgend West Integrated Team who can offer these patients, if appropriate, additional support with their unmet needs.
Special Families Project - Ty Elis (Porthcawl Counselling Service) provide therapeutic counselling for adults within families accessing support from the Special Families Project in Maesteg. Funding was given via a grant of £5,000 as a start-up pilot which funded a 16-week provision. This enabled partnership working between Ty Elis and Special Families to offer 6-week counselling interventions to adults and/or couples for their members.
Ty Ellis submitted a request the West Cluster to secure on-going funding Jan-March 2023 to meet the needs of these vulnerable families living in the West.
Paediatric Pulse Oximeters - Investing in additional paediatric pulse oximeters for Cluster Practices to assist with diagnosis of RSV in young patients attending surgery. Having additional paediatric pulse oximeters within the practice helps with timely consultations and also assist with accurate diagnosis especially during the winter months when pressures within primary and secondary care can be unprecedented.
Dance to Health - Dance to Health is a falls prevention class through dance for older people. The sessions combine evidence-based exercise with the creativity, energy and sociability of dance. The programme was devised and is managed by Aesop (Arts Enterprise with a Social Purpose).
The West Cluster agreed to act as the partner health organisation for the application for funding. The Cluster members were keen to get involved as there are great benefits to its patient population.
Dance to Health classes run in Porthcawl, North Cornelly and Pyle/Kenfig Hill area.
COPD Project - this project is the second phase of a respiratory project, following phase one; the aim of which was to deliver a project to increase spirometry testing (and subsequent diagnosis of respiratory conditions) in all three GP Practices within Bridgend West during the 24/25 financial year.
Phase 2 will use Population Segmentation data to case-find patients with identified COPD and mitigate increased healthcare demands over the winter period. The primary objective of the project is to improve the management of a patients COPD condition through identifying, reviewing, assessing and referring patients to preventive interventions to promote better self-management of their COPD.
We will continue to use Population Segmentation/Risk Stratification data to aid specific Cluster projects which meet is cluster population health needs.
Making Every Contact Count (MECC) training for all Primary Care Staff, to support healthy behaviour conversations with individuals on smoking, alcohol, physical activity, healthy eating and immunisation.
This will ensure Cluster members are maximising contact opportunities with patients to deliver health promotion messages on:
Flu’s - Continue to improve influenza vaccination rates for the children aged 2 and 3yrs old and uptake for those patients at risk aged 6 months to 64 years.
Communication - To continue to discuss a cluster communication strategy for cluster projects/messages. One area of focus of this will be increasing Cancer Screening uptake by improving patient/public awareness of the Cancer Screening Services available.
Date of next review 01/09/2025
Cluster lead update 17/10/2024