Achievements, feedback and challenges


This project completed the pre-adoption preparatory activities by March 2020, and went live in April 2020 (one month later than planned). Progress during COVID-19 with some pauses in adoption activities and supporting the GP Practices. Here are some of the major achievements made in the project:

  1. Cluster Presentations favourably received with funding provided to Monmouthshire, Llwchwr & Caerphily.
  2. Switch to virtual meetings successful in Monmouthshire, Caerphily and Llanelli.
  3. Development of a consistent Safeguarding Policy across Cluster practices.
  4. Development of a Safeguarding Database & recording systems in practices.
  5. Complex Case discussions took place with multidisciplinary team including Social workers, Health Visitors, Safeguarding Lead Nurse attending.
  6. Consistently good attendance with a broad variety of topics discussed including domestic violence, All Wales Advance & Future Care Planning Strategy Group (AFCP), Covid-19 in Care Homes, and adult safeguarding.
  7. Active Whats-App groups & E-mail correspondence.
  8. Between meetings discussion about challenging cases.


All GP Practices experienced a substantial increase in workload during the last year due to COVID-19. These were unanticipated and unplanned disruptions to the project, and here are some of the main points:

  1. The timing of the first set of travel and lockdown restrictions coincided with the first set of face to face meetings and so this resulted in no face-to-face meetings taking place. Face to face meetings have since been disbanded for the duration of the project given the social distancing and other restrictions.
  2. There was uncertainty, feeling of being overwhelmed, loss of enthusiasm and the focus on other COVID-19 activities.
  3. The workload in primary care increased significantly and their roles in mass vaccination programmes and switching to different ways of working to support the patients required all the GP surgeries to prioritise COVID-19 activities.
  4. Some of the staff members had to self-isolate under the shielding rules, or were unable to to work due to ill-health
  5. There were changes to practices, including practice mergers which involved significant increase in administrative and clinical work, and this was exacerbated by pressures of the pandemic. A GP Practice dissolution resulted in 4,000 patients from a deprived area being re-registered in the remaining practices in their local areas.


The meetings have consistently positive feedback with examples such as:

  • ‘Excellent opportunity to discuss difficult cases in a safe environment.’
  • ‘Peer support and friendly atmosphere highly useful.’
  • ‘Face-to-face meeting with expert makes later contact less daunting.’
  • ‘Increases awareness in consultations.’
  • ‘Really good sized group for challenge and discussion – excellent informative meeting.’

Swansea University collaborated with the pilot for a research project to assess the impact of the group. 47% of group members responded:

  • 100% saying that their practice had benefitted from being part of the group
  • 60% saying that the learning had changed their practice
  • 100% of respondents reported increased confidence, were more aware of safeguarding issues and more pro-active in their management of them.
  • All respondents felt there was merit in scaling the idea out across Wales.

Find out more about the Bevan Exemplar Project that Rowena Christmas completed in 2019

A short video was recorded to give more information about the project when it was first tested as a Bevan Exemplar innovation.

Rowena started supporting new adoption sites in January 2020 and COVID-19 had a significant impact.