Wales

Owned by Federica Andreoni
Last updated: Nov 03, 2024 by Mohammad Al-Ubaydli
8 min read

The health of Welsh coal miners is the cornerstone of Archie Cochrane’s research, the foundation of evidence-based medicine. This work with Welsh miners deepened his commitment to the use of randomized controlled trials to evaluate medical interventions, as he observed firsthand the limitations of unproven treatments offered to miners (Cochrane, 1972).

After considerable thought I wrote out my slogan: “All effective treatment must be free”.

Country’s healthcare system in a nutshell

Residents of Wales, like all UK residents, have access to public healthcare, which is primarily funded through taxation. In the UK, responsibility for healthcare is transferred from the central government to each of the devolved nations, meaning that the National Health Service (NHS) in Wales is managed by the Welsh Government (Chang et al., 2011).

The latter 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@phr4gov.org

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Source: The World Bank.
The pink column refers to the public expenditure as a % of the country’s total healthcare expenditure. The blue dot is the country’s expenditure on health per capita, expressed in international dollars at purchasing power parity.

 

The national PHR


History

In recent years, NHS Wales' Digital Services for Patients and the Public (DSPP) programme has embarked on a significant project: the creation of Wales' version of England’s NHS App. Welsh requirements included adding the Welsh language, and different functionality.

DSPP programme awarded the app development to Kainos, a software company which was also involved in the development of the NHS app in England.

Private beta with a thousand patients at 10 GP surgeries started in November 2022. At that stage, DSPP priority was to ensure GPs comprehended the app's implications for their patients and take ownership of its integration into their practice.

Public beta testing started in April 2023: the App 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). (Welsh Government, 2023)

Features

For a patient to be able to use the following features, the GP practice must enable them: booking appointments, re-ordering repeat prescriptions, and viewing a summary of a patient’s GP health record. The app also provides access to national information services, such as NHS 111 and organ donation services, where available.

Appointments:

  • patients can request an appointment with their GP (the GP practice decides which appointment types are available).

  • patients can cancel appointments with their GP through the app.

GP Prescriptions:

  • patients can order a prescription

  • patients can view their existing repeat prescriptions

  • patients can view both current and past medicines

Depending on the health board or GP practice, patients may also be able to see:

  • medicines prescribed by their GP.

  • any allergies or allergic reactions recorded by their GP.

  • test results from their GP.

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

  • "About me and my care", which is a form where patients can describe their healthcare needs, preferences, and plans.

  • the app also provides information on organ and blood donation services.

     

Patients Know Best

Similar to the NHS App in England, the NHS Wales App integrates services and features developed by various private companies. Notably, it relies on Patients Know Best (PKB) to provide patients with access to their test results, a library of health resources, symptom tracking, measurements, journal entries, care planning, and messaging. Additionally, the app includes a direct link to PKB, allowing users to access all other PKB features from within the platform. While the core functionality of the NHS Wales App enables patients to access their GP records, the integration with PKB allows them to also view data from other healthcare providers.

This integration is still in progress and is currently available only in regions where PKB has been designated as the Patient Held Record (PHR) provider. In these regions, patients can access parts of their PKB record within the NHS Wales App and use the NHS login’s encrypted single sign-on for secure access.

Challenges and areas for improvement

The budget allocated by the Welsh government for the development of the NHS Wales App is smaller than the budget provided for the NHS App in England. As a result, there will be fewer features, and the development process has been and will continue to be slower by comparison.

The government's special health authority Digital Health and Care Wales (DHCW) has locked down both the use of NHS Login and access to the NHS Wales App.
Agreements will be between Health Boards and DHCW on behalf of apps or private sector providers rather than those providers getting single approval for use across Wales which means that integration rollout will be slowed and will lead to less private sector collaboration.
While the NHS Wales App should function as a single entry point for digital health and care services for all patients, this will result in unequal access across health boards during these slow rollouts


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

  • 3,169 appointments have been booked through the app

  • 15,855 repeat prescriptions have been ordered

  • 48,519 GP health records have been viewed

Screenshots

 

PKB inside the NHS Wales app

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On the Messages Page, patients have two options for managing their communications. They can either click to view more details about their visits, treatments, and clinical documents, as well as send messages to their healthcare professionals, or they can select the option to view messages received from health services and the NHS Wales App.

 

NHS Wales App screenshots

 

 

 

Bibliography

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