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Country’s healthcare system in a nutshell

Healthcare in the United Kingdom operates as a devolved matter, meaning that England, Northern Ireland, Scotland, and Wales each manage their own healthcare systems, which encompass both public and private sectors, as well as alternative and complementary treatments. Due to the distinct policies and priorities in each country, there are differences between their healthcare systems. Despite these differences, all UK residents have access to public healthcare, and the healthcare system in the UK is primarily funded through taxation (Chang et al., 2011).

In Wales, the Welsh Government establishes the strategic framework and health and social care policies that NHS Wales and its partners follow. The NHS in Wales operates through seven Local Health Boards, three NHS Trusts, and two Special Health Authorities. In particular, the Local Health Boards are tasked with planning and ensuring the delivery of a range of services, including primary, community, and secondary care, as well as specialist services such as dentistry, optometry, pharmacy, and mental health. They work to improve health outcomes, promote wellbeing, and reduce health inequalities across their populations (NHS Confederation, 2021).


Public vs private

Unfortunately, we couldn’t find any statistics about healthcare spending in Wales, but only for the UK. If you have access to this information or can put us in touch with someone who has, please contact us at book@patientsknowbest.com

Screenshot 2024-02-09 at 10.08.44.png

The national PHR


History

In recent years, NHS Wales' Digital Services for Patients and the Public (DSPP) programme- led by Stephen Frith - has embarked on a significant project: the creation of Wales' own version of the NHS App. This initiative followed the realisation that the NHS App in England did not align with Welsh requirements, particularly as the app needed to be bilingual, but also because of different functionality requirements, including giving wider access to health and care services across Wales.

The contract for the app development was awarded to Kainos, which worked with the DSPP programme to build the app. Towards the end of 2022, the app went into private beta with a thousand patients from 10 different GP surgeries trialling the app.

The beta testing was originally due to run until Christmas 2022 but had been extended until the end of March 2023, as it became evident that the intricate network of diverse systems and suppliers within the NHS presented a complex support model.

Nevertheless, the DSPP programme has chosen not to do a public campaign about the app, but rather prioritise support for GP practices, gradually and consistently introducing the app. This strategy, distinct from England's approach, is designed to ensure GPs comprehend the app's implications for their patients and take ownership of its integration into their practice. There will be a national publicity campaign about the app in the Spring of 2024.

In terms of technical maintenance, the supplier, Kainos, will oversee the app's operation and support for the initial 12 months. Thereafter, the operational system support may pass to Digital Health and Care Wales (DHCW). (Evenstad, 2023)

On April 17th of 2023, the app started public beta testing: it was published on Apple and Google app stores for download, and it also started to be available at NHS Wales App website (English) and Ap GIG Cymru (Cymraeg). This wasn’t the final version of the app, as new functionalities are being released as soon as they are developed. (Welsh Government, 2023)

Features

At the release date, some app functions, such as in-app access to 111 and organ donation online services, were available to all. Other functions are due to be available later, once a person’s GP practice has enabled the functionality, this is the case of appointment booking, repeat prescription re-ordering, and viewing a summary of a GP health record.

It is important to note also that many of the features that the app will display will be provided by a third-party provider, namely Patients Know Best (PKB). The integration of PKB and the NHS Wales app was initially planned to happen in December 2023, but at the latest update, it has been delayed at 2024. These functionalities are: test results, library, symptoms, measurements, journal, care plans and messages, and a direct link to PKB to access all other features. While the NHS Wales App allows patients to access GP records, thanks to the integration with PKB, patients will be able to also view their data from other healthcare providers.

Appointments:

  • patients can ask for an appointment with the GP(the GP practice decides what appointment types are available)

  • patients can cancel appointments with the GP through the app

GP Prescriptions:

  • patients can order a prescription

  • patients can view your existing repeat prescriptions

  • patients can view current and past medicines

Depending on the health board or GP practice, patients may see:

  • medicines the GP has prescribed

  • any allergies or allergic reactions patients have told their GP about

  • test results from their GP

  • "My health timeline" which is a collection of all the patient’s health records and events that is searchable by date and record type

  • "About me and my care" which is a form that helps patients describe their healthcare needs, wishes, and plans

  • organ and blood donation services information


Challenges and areas for improvement


Published outcomes - statistics

At the beginning of December 2023, the NHS Wales app had:

  • 202 GP practices onboarded (52% of all practices in Wales), with a plan to
    onboard the remaining 48% within March 2024

  • Over 50.000 app downloads by patients via App Store or google play store

  • 3169 appointments have been booked through the app

  • 15855 repeat prescriptions have been ordered

  • 48519 GP health records have been viewed

Bibliography

Chang, J., Peysakhovich, F., Wang, W. and Zhu, J., 2011. The UK health care system. The United Kingdom, 30, p.2019. Available at: link (Accessed 2 August 2024).

Evenstad, L. (30 Mar 2023). Wales is building a dragon of an NHS app. Computerweekly . Available at: https://www.computerweekly.com/news/365534184/The-Welsh-are-building-a-dragon-of-an-NHS-app . (Accessed: 18 December 2023).

NHS Confederation, 2021. About the NHS in Wales. [online] 12 May. Available at: https://www.nhsconfed.org/articles/about-nhs-wales [Accessed 2 August 2024].

Welsh Government. (17 April 2023). Cabinet Statement: Written Statement - The new NHS Wales App, by Eluned Morgan MS, Minister for Health and Social Services. Available at: https://www.gov.wales/written-statement-new-nhs-wales-app . (Accessed: 18 December 2023).

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