During his visit to Ysbyty Gwynedd on 27 February 2017, Vaughan Gething, Cabinet Minister for Health, Well-being and Sport met with the CARTREF Project Group to receive an update on the pioneering work being undertaken by clinicians in North West Wales.
The CARTREF project uses video technology to help frail and elderly people in rural communities access outpatient appointments with consultants.
In 2014, Betsi Cadwaladr University Health Board was successful in being chosen as one of only four Royal College of Physician (RCP) Future Hospital development sites. This prestigious UK-wide pilot programme aims to bring medical specialist care closer to the patient wherever they are, in hospital or in the community.
The CARTREF project uses telemedicine – through the use of virtual clinics – to link patients from Ysbyty Alltwen near Porthmadog, Dolgellau Hospital, and Ysbyty Bryn Beryl near Pwllheli with doctors in Bangor.
Since launching in September 2014, over 200 patients have used the service and saved an average travel distance of more than 60 miles per consultation through the use of the audio-visual appointments.
Dr Chris Subbe, a Consultant BCUHB and Clinical Senior Lecturer in Medical Sciences at Bangor University, said: “It’s been a really exciting project, and a great way to link patients living in rural communities with consultants.
“We have put the patient at the centre of this, and that is one of the project’s main principles – by using modern technology, we come to them, rather than the other way round.”
Staff Nurse Miriam Williams, based in Bangor, said: “Patients were initially quite nervous when we explained they would be seeing the doctor over a video link, but once the conversation began they would relax and forget the doctor was on the screen.
“We also had a digital inclusion officer working with patients and staff to familiarise them with the technology. Some of the stand-out examples include one patient seeking consultation on severe chronic respiratory disease who felt so comfortable with her first video consultation that she initiated a discussion about end of life questions. We also had a 104-year-old patient who was completely un-phased by the new technology.”
Dr Olwen Williams, a Consultant Physician leading the CARTREF Project, said: “This is an amazing project. Everyone who has been involved, whether a user or carer, have said that this is the way forward to enable people to receive care closer to home, to adopt modern technology, and also to be environmentally friendly.
“We have had great feedback from patients using the project to date, with 82 per cent giving an excellent or very good rating and 86 per cent saying they would recommend virtual consultations to their friends and family.”
Dr Gareth Llewelyn, RCP Vice President for Wales, said: “This is exactly the kind of project that we need to roll out across Wales. The RCP wants to see more specialist care delivered in the community, closer to people’s homes – as hospital doctors, we want to work with our primary care colleagues to provide high-quality patient care. This is vitally important because we desperately need to break down the barriers between hospitals and the community.
“We’re delighted to welcome the Cabinet Secretary to this RCP Future Hospital development site where he will see first-hand the benefit of investing in exciting new technology that helps us to provide the right care, in the right place, at the right time.”
Dr Mark Temple, RCP Future Hospital Officer, said: “The RCP in London is delighted that the innovative telemedicine programme in North West Wales has been recognised by Welsh Government. This site is the only RCP Future Hospital development site in Wales.
“Since 2014, staff and patients in the CARTREF project have worked together to extend the reach of specialist care into rural communities using telemedicine, greatly reducing travel time for patients.”
The CARTREF team are currently extending the project to increase access to patients through a virtual hub, which would connect nursing homes in rural locations to their nearest GP surgeries and assessment units at Ysbyty Gwynedd. The increased service will further reduce travelling times for patients and avoid unnecessary hospital admissions.
The CARTREF project was funded through the Welsh Government’s Health Technology Fund, an investment in new technology and telehealth to improve patient care.
Cabinet Minister for Health, Well-being and Sport, Vaughan Gething said: “This project is bringing real benefits, cutting travel times while ensuring patients can access specialist care. Technology can bring the NHS into your home, overcoming the challenges of providing healthcare in rural areas.”
“Technology can help us to address some of the challenges in providing healthcare in North and Mid Wales. We are now working closely with the NHS to develop proposals that will help us to exploit technology so that we can provide more services locally and at home so patients can enjoy greater independence and well-being.”
Dr Salah Elghenzai Consultant Physician Care of the Elderly and Area Medical Director expressed his enthusiasm for the project, stating that there was considerable interest from other organisations across the UK and that the work will be presented at Medicine 2017 RCP Conference and the European Healthcare Design Congress. The project was highly commended in the 2016 HSJ Value in Healthcare Awards’ Telehealth category.