Country’s healthcare system in a nutshell

All UK residents have access to public healthcare, and the healthcare system in the UK is primarily funded through taxation. Healthcare in the United Kingdom operates as a devolved matter so the National Health Service in Wales run by Welsh government (Chang et al., 2011).

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

Open

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' own version of England’s NHS App. Welsh requirements included adding Welsh language, and different functionality.

DSPP programme awarded the app development to Kainos.

Private beta with a thousand patients at 10 GP surgeries started in November 2022. DSPP prioritised ensuring 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: 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). (Welsh Government, 2023)

Features

Functions are enabled by GP practices: appointment booking, repeat prescription re-ordering, and viewing a summary of a GP health record. The app also provides access to national information services ie 111 and organ donation online services, were available to all.

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

Patients Know Best

Patients Know Best (PKB) will provide additional features, similarly to the model in England with the NHS App. 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.

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 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

Open Messages page. Patients have 2 options: click to see more details of their visits and treatments, clinical documents, message their professionals; or click to view messages from health services and the NHS Wales App.

NHS Wales App screenshots

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).