Written question WQ89949

In 2023, through the Planned Care Programme and as part of the commitment in planned care recovery, the NHS has commenced the All Wales Health and Care Pathways Programme. This is where primary and secondary care clinicians jointly plan and agree evidence-based referral pathways into secondary care.

Through the recent unified GMS contract 1st October 2023, Wales is the first devolved nation to contractually require all GPs to manage every patient “after consideration of relevant nationally agreed clinical guidance or pathways”.

This national work will bring consistency of approach, allow for more joint understanding of clinical pathways and identify the most appropriate pathway based on clinical evidence and need.

This is not a programme to stop referrals into secondary care as a gate keeper role, but an evidence based agreed process to ensure patients’ needs are correctly identified and dealt with appropriately.

Evidence from early work in Cardiff and Vale who have been using this methodology prior to the national roll-out have found both improved clinical outcomes and also cost savings. In some cases, this has resulted in secondary care referrals reducing, but this is appropriate reduction. It allows for pathways to enter secondary care if required at the most appropriate place such as straight to diagnostics or in some cases straight to listing for surgery.

As of October 2023, there are over 280 pathways allocated for development, 167 in progress through the NHS collaborative process. All, health boards are engaged, with local staff being trained. There is a phased formal roll out with Cardiff and Vale already operational and Hywel Dda formally launched 13th December 2023, other health boards planned for early 2024.