What is a Practice boundary?

All GP Practices operate within a designated GP boundary.  GP Practices must register patients who live inside their practice boundary but have no legal requirement to register patients who live outside their boundary.

Why are these changes being proposed?

Healthy Prestatyn Iach (HPI) is currently one of the largest GP practices in North Wales in terms of both the geographical area it covers and the number of patients it serves. HPI was formed 10 years ago through the merger of three separate GP practices and is directly managed by Betsi Cadwaladr University Health Board (BCUHB).

Since the merger, the practice has continued to provide care across a very large area spanning parts of North Denbighshire and Flintshire. However, operating services across multiple sites and such a wide geographical footprint creates increasing operational and workforce pressures.
The proposed boundary changes are therefore being considered as part of a wider review of primary care services across the area. The aim is to ensure GP practice boundaries enable effective service provision and allow services to be delivered closer to home wherever possible.

Some neighbouring practices have said that taking on more patients could help strengthen their long-term sustainability and may allow them to offer a wider range of services in the future.

Overall, the proposals are intended to make it easier for patients to access care closer to home, better match practice populations with local service capacity, support long-term stability of GP practices, and make sure healthcare resources are used fairly across the area.

Has a final decision been made?

No. This is currently a proposal.
We are undertaking a formal period of engagement to gather feedback from patients, staff, community representatives and stakeholders to inform our decision. All feedback received during the engagement process will be carefully reviewed and will help inform the final recommendations.
Any proposals will also be subject to formal review processes within BCUHB before implementation.

Final decisions made by BCUHB regarding this process will be published on the practice website.

Will I have to change GP practice?

If the boundary changes are supported, patients living outside any revised HPI practice boundary would be transferred to an alternative local GP practice.  This would happen automatically and affected patients would be informed of their new GP Practice in advance of the transfer.

At this stage, no immediate changes are taking place. If any changes are agreed, affected patients will receive clear information, support and guidance throughout the process.

When would the change happen?

If any changes were agreed, the decision should be taken by the end of July 2026.  Any changes would then most likely happen between January and March 2027.

Why can’t I stay registered with HPI?

GP practices operate within agreed contractual practice boundaries. These boundaries help practices safely manage home visiting responsibilities, patient access and service delivery.  If a practice boundary is formally changed, patients living outside the revised boundary may no longer be eligible to remain registered with that practice on a permanent basis.

The proposals are being considered to help create more sustainable and efficient GP services across the area while supporting patients to access care closer to home.

Will my care be disrupted?

Our aim is to minimise disruption as much as possible.  If the proposals proceed, any patient transfers would happen gradually and in a carefully managed way, and support would be available for anyone requiring assistance.
All relevant clinical information will be transferred securely to patients’ new GP practices to support continuity of care. For patients with more complex needs, additional briefing notes will be added to their records to help ensure a safe and smooth transition. Established communication channels already exist between practices, and these will continue to be available should the new practice require any further information or clarification about a patient’s care needs. Existing medications, ongoing treatment plans and referrals would continue to be managed appropriately during any transition period.

What support will be available for vulnerable patients?

Patients with additional needs, including those receiving palliative care, individuals with complex health conditions, older adults, frail patients, patients with disabilities or mobility difficulties, and individuals requiring advanced support, will be considered carefully throughout the process.
Additional assistance and personalised support will be available where required to ensure vulnerable patients continue to receive safe and appropriate care. An option available is for patients with extremely challenging circumstances not to be moved from HPI.

How will this improve services?

The proposals aim to improve how GP services are organised across the area.
By aligning patients more closely with practices nearer to where they live, the changes may help improve access to local services, reduce travel demands for clinicians carrying out home visits, improve efficiency across practices, support workforce sustainability, and help neighbouring practices strengthen and grow their services.
The overall objective is to help ensure local GP services remain safe, sustainable and accessible for the long term.

How can I share my views?

Feedback gathered during the engagement period will be reviewed before any proposals are formally considered.  You can provide feedback by attending one of the engagement or drop-in events, speaking directly with representatives from the project team, writing to the practice or Health Board, contacting Llais, and using the dedicated feedback channels as outlined in this letter.

Feedback can also be submitted by email to: bcu.denbighshireprimarycare@wales.nhs.uk

You can also contact us via telephone on 03000 851860. The phone line will be staffed between 10am and 2pm Monday – Friday.  Outside these hours, you will be able to leave a voicemail message.

Will nearby GP practices be able to take additional patients?

BCUHB is working closely with neighbouring GP practices as part of this process.
Some local practices have expressed an interest in increasing their patient numbers as a way of strengthening the sustainability of their services and supporting future service development.
Any proposed changes would only proceed if there was confidence that practices could safely support additional patients while continuing to provide high-quality care.

Why is BCUHB involved in this process?

Healthy Prestatyn Iach is directly managed by Betsi Cadwaladr University Health Board (BCUHB), rather than operating as an independent contractor GP practice.
As part of its responsibility for planning and delivering sustainable healthcare services, BCUHB reviews how services are organised to ensure they continue to meet the needs of local communities both now and in the future.
The current engagement process forms part of that wider responsibility to ensure primary care services remain safe, effective and sustainable across North Wales.

What alternative GP practices may be available?

If the proposals are approved, patients who live in the affected addresses  will be automatically transferred to the care of another GP Practice, close to where they live. If patients wish to change practice after this allocation they would contact the preferred practice and complete the registration process to join their patient list.

The following practices cover the areas affected:

Will I be left without a GP?

No. If the proposed boundary changes are approved, you will not be left without access to a GP.

Patients affected by the changes would be transferred to another GP practice serving the area where they live. This process would be carefully planned and managed, and you would be told in advance which practice you had been allocated to.

You do not need to take any action at this stage. If the proposals are approved, a transfer to a new GP practice would be arranged automatically on your behalf, and you would not need to contact or register with another practice yourself.

At the moment, no decision has been made, and no changes are taking place. If the proposals are approved, you will receive clear information and support throughout the process.

Will I have to do anything if my GP practice changes?

In most cases, no.

If the proposals go ahead, patients affected by the boundary changes would be transferred automatically to a new GP practice, so you would not need to complete a registration form.

If, after your transfer, you wished to register with a different GP practice that covers your address and is accepting new patients, you would be able to do so by contacting that practice and completing their usual registration process. Further information and guidance would be provided if the changes are approved.

Will I be able to use the same pharmacy?

In most cases, yes.

Your GP practice and your community pharmacy are separate services. Changing GP practice does not usually mean you have to change the pharmacy where you collect your prescriptions.

If you are happy with your current pharmacy and it is able to continue providing your prescriptions, you should usually be able to keep using it. If any changes are needed, your new GP practice will explain your options and help ensure there is no interruption to your medication.

Will the other practices be able to cope with additional patients?

Changes would only be made if there was confidence that neighbouring practices could safely and effectively care for additional patients.

Betsi Cadwaladr University Health Board (BCUHB) has been working with local GP practices throughout the development of these proposals. The capacity of neighbouring practices has been considered as part of the planning process, and any transfers would be carefully managed and phased rather than happening all at once. If practices are unable or unwilling to take on extra patients, they will not receive them.

The aim is to create a more balanced and sustainable distribution of patients across local practices while maintaining safe, high-quality care for everyone.

What do other GP practices think about these proposals?

Neighbouring GP practices have been involved in discussions throughout the planning process.

Some local practices have told BCUHB that increasing their patient numbers would help strengthen the long-term sustainability of their services and support future service development. However, no practice would be expected to accept additional patients unless it was confident it could do so safely.

The proposals have been developed in partnership with local practices, and no final decision has yet been made. Patient feedback during this engagement period will also help inform any future decisions.

What happens if I'm waiting for a hospital appointment or referral?

Your ongoing hospital care will continue.

Any referrals that have already been made, waiting list positions, investigations and treatment plans will remain in place.

Your medical records will be transferred securely to your new GP practice, and existing medications, referrals and treatment plans will continue to be managed throughout the transition. If your new GP practice needs any additional information, established communication channels between practices will help ensure continuity of your care.

Will it be easier or harder to get an appointment?

The aim of the proposals is to improve the long-term sustainability of GP services across the area and better match patient numbers with the capacity of local practices.

No changes would be made unless there was confidence that neighbouring practices could safely care for additional patients while continuing to provide high-quality services. While appointment systems may differ between practices, the intention is that patients continue to have access to safe, timely GP care closer to where they live.

What if I need home visits?

Home visits will continue to be available for patients who are clinically assessed as needing one.

One of the reasons for reviewing practice boundaries is to better align patients with GP practices closer to where they live. This helps practices provide home visits more efficiently and enables clinicians to spend more time caring for patients and less time travelling. If you currently receive home visits because of your medical condition, your new GP practice will continue to assess and provide these where clinically appropriate.

Will I need to tell the hospital I've changed GP?

No. If your GP practice changes as part of the approved proposals, your GP registration and medical records will be updated as part of the transfer process.

Your new GP practice will receive your clinical information securely, and hospitals will be able to identify your registered GP through NHS systems. If there is anything you need to do in relation to a specific hospital appointment, you will be advised at the time, but in most cases you will not need to contact the hospital yourself.

Does this mean Healthy Prestatyn Iach is closing?

No.

These proposals relate to the practice boundary, not the closure of Healthy Prestatyn Iach (HPI). HPI would continue to provide GP services for patients living within its revised practice boundary if the proposals are approved.

The aim is to ensure GP services remain safe, sustainable and accessible for the long term by better aligning practice boundaries with where patients live and the capacity of local practices. No final decision has been made, and the proposals are currently subject to a formal public engagement process.