The Wye Valley Practice is a partnership (not Ltd) of doctors providing general medical healthcare to a registered population under contract to Aneurin Bevan Local Health Board.  There are two surgery premises, one in St. Briavels, Gloucestershire and one in Trellech, Monmouthshire.

 We have moved to:  Trellech Surgery, Roman Park View, Trellech NP25 4RB our opening times  remain unchanged

With reference to enquires concerning the "Changes to your Health Service" please read below a statement from the Aneurin Bevan Health Board. Followed by a statement from the Practice.

Aneurin Bevan Health Board’s (ABHB) Policy for Out of Area Referrals to Secondary Care was introduced on the 1^st September 2012 following discussion with Monmouthshire GP’s, including St Briavels and Trellech GP Practice.  Regular engagement was undertaken during the development of the Policy with key organisations and forums such as Welsh Government, Community Health Council and the Local Medical Committee. The Commissioning Team also worked closely with ABHB clinical teams and service providers in order to ensure a robust approach to developing these new arrangements.

The Minister for Health and Social Services has stated that Local Health Boards ‘primary concern is to ensure safe and sustainable services are provided as close to the patient’s home, wherever and whenever possible’.  This concern was and continues to be shared by the Health Board and acted as a key driver for establishing the Policy.   Planning and securing services outside of the Health Board when ABHB has internal services with a funded infrastructure that potentially is under utilised is not the most effective use of the Health Board’s increasingly finite resources.  In addition, given the strategic intentions of the Health Board with such initiatives as Clinical Futures and the Welsh Government’s plan “Together for Health”, this funding could be better utilised to support the development of, and strengthen local clinical teams/services. 

English and Welsh residents who are registered with a Welsh GP fall under the Welsh NHS healthcare system, under the Department of Health/Welsh Government Cross Border Protocol Agreement 2012/2013.  St Briavels and Trellech GP Practice is a Welsh practice.  Patient choice is not the basis of our health system in Wales, and therefore Aneurin Bevan Health Board takes responsibility for securing services for patients registered with Aneurin Bevan Health Board GP practices under Welsh NHS standards and policy.  

People have expressed concerns about the detrimental effect of the new Policy on patients.  The development of the Policy was underpinned by a robust Equality Impact Assessment to ascertain whether there would be any negative effects on the local population.  No significant issues were identified; however a prior approval process was developed to allow requests for care outside the Health Board to ensure flexibility in the Policy for individual patient needs to be considered.  These requests from the patient’s GP, or clinical team, are made to the Health Board’s commissioning team and are considered on an individual basis.  Extenuating circumstances such as continuity of care, travel distance, and access to hospitals are considered for each request, enabling cross border referrals to be made, if the patient’s treatment is better served at a hospital outside of Aneurin Bevan Health Board.

Concerns have also been voiced regarding urgent suspected cancer referrals.  The Policy should reflect Welsh Government Policy and ensure there was an equitable responsive process in place in relation to urgent suspected cancers.  Therefore the Policy was developed to adhere to these principles with the flexibility of the Policy’s prior approval process to consider individual cases.  The commissioning team have put in place arrangements with ABHB clinical teams and English providers to ensure care is not delayed for these requests.

A further concern that has been raised is the differential waiting times between England and Wales.  As a Welsh NHS GP practice, St Briavels and Trellech patients are cared for under Welsh policy and standards.

The Policy provides Aneurin Bevan Health Board with the opportunity to address this inequity by investing in local services to provide additional capacity and support.  We appreciate that this may not be seen as acceptable to all, but the Health Board has a duty to use its resources as efficiently and effectively as possible to meet the healthcare needs of the population for which the Health Board has commissioning responsibility.  This sometimes necessitates difficult decisions to be made in the interests of all. 

If we treat more patients within our area, we are also ensuring that clinical skill levels are maintained.  There are many examples across the Health Board of how services have been developed locally and improved by investing in our own services and staff and clinical teams.  This has benefits for the community as a whole.

Changes to your Health Service

The doctors of the Wye Valley practice are disappointed at the decision taken by the Aneurin Bevan Health Board to restrict the majority of secondary care referrals for its patients to Welsh hospitals.   Whilst there was consultation prior to the announcement of the policy this was not a discussion but a statement of intent. The practice was not consulted on the impact assessment which has failed to recognise the considerable anxiety, frustration, confusion and inconvenience caused to all our patients but notably the English resident patients of the practice.

 The Wye Valley Practice doctors would like to emphasise their continuing desire to provide all their patients with the best possible quality of service delivered as close to home as possible. They will do all they can to continue to achieve this. If you feel strongly that you prefer to be referred to an English hospital, your doctor will complete an exceptional referral form for the ABHB Commissioning Board who will take into consideration factors such as geographical location, where you work, previous hospital attendance and so on.

What does this change mean for the patient?

·         All new consultant referrals will be undertaken at hospitals situated within Gwent

·         Subsequent treatment plans following consultation will be undertaken at Gwent hospitals.

·         Out-patient diagnostic tests i.e. x-ray, scans etc. will be undertaken at Gwent hospitals

·         Rehabilitation, respite care etc. will be provided by Gwent hospitals

Exceptions to the above:

·         Where treatment is not provided within the ABHB i.e .Orthopaedic, Ophthalmology and oral surgery

·         All existing treatment plans at hospitals outside Gwent will be honoured

·         All community based services i.e. Community Nurses, Mental Health etc.

·         Where the Patient is receiving an integrated care package between hospital and community services i.e. home nursing, social service care etc.

·         Patients who require regular treatment but due to social or work commitments would suffer hardship if they attended a Gwent hospital.

·         Emergency treatment at Minor Injury Units i.e. Lydney, Dilke, Gloucester Royal Hospital

·         Emergency admissions

ABHB will undertake individual patient reviews for out of area referrals on its own merit.  If it is appropriate your doctor will appeal to the ABHB on your behalf, however, the final decision rests with the Health Board.

For further information relating to this policy please refer to the web-site below

http://www.wales.nhs.uk/sitesplus/documents

Opening Hours:

St Briavels

Monday and Wednesday
8:30am - 6:30pm

Tuesday, Thursday and Friday
8.30am - 1.00pm

Trellech

Monday, Wednesday and Friday 
8.30am - 1.00pm

Tuesday and Thursday
8:30am - 6:30pm

On Friday afternoons the surgeries will alternate between St Briavels and Trellech Surgeries each in turn will be open for enquiries 1.00pm-6.30pm, and an open evening surgery 4.30pm-6.00pm

Repeat Prescriptions
You can now place your repeat prescription requests online. Click here.