GWENT'S urgent primary care services - commonly known as GP out-of-hours - have been praised following a review, for the way nursing and other roles have been developed, and for the dedication of staff.

Urgent primary care services across Wales were peer reviewed last year, to identify good practice to share across the country, to provide support for improvements, and to help ensure such services are sustainable in a changing NHS.

The peer review panel included clinical, medical and primary care directors, and representatives of the 111 Programme (the single number advice and treatment line service being introduced in Wales), Health Education and Improvement Wales, the Royal College of GPs, and the Welsh Government.

An Aneurin Bevan University Health Board report states that panel chairman Dr Chris Jones commented following the review of its service, that he had been impressed "by the ongoing dedication and commitment that was demonstrated by staff, and their continued focus on delivering high quality care to patients within out-of-hours".

The way the health board engages with clinical staff in the area's urgent primary care services - through a monthly clinical reference group - is considered "an exemplar that all health boards should aim to implement".

The panel also highlighted that the health board is a leader in developing nursing roles in out-of-hours services, that its "home grown" approach to developing nursing staff is welcomed, and that "some exceptional and highly skilled nursing staff" have been nurtured.

The review also recognised that the setting up of a clinical hub for Gwent (linked to the proposed roll-out of the 111 programme in the area, now postponed until later this year), has developed clinical lead roles and introduced pharmacists to work alongside other clinical staff. This has resulted in extra capacity for the triage of patients, with pharmacists able to oversee the management of appropriate cases.

The introduction of mental health practitioners into the hub is also seen as a positive development for triage, signposting and advice to patients, which helps free up GPs' time.

Investment in 24/7 district nursing also helps ease the burden on other out-of-hours teams. The review panel praised the benefits of this approach, and "particularly commended the philosophy and model adopted for Verification of Death and last rights for patients, and the wider support the district nursing teams offer to families of the deceased", states the health board report.

"There was evidence that individuals go 'above and beyond' what a normal service would offer, and was seen as exemplary practice which should be viewed as a blueprint for NHS Wales to adopt."

The panel identified issues - including a higher than average home visiting rate in Gwent, and a need to better co-ordinate triage of calls between teams and bases, particularly at times of peak demand - which require action. The health board has produced a plan to address these.