Multi-Disciplinary Team




Wellbeing Co-ordinator:

The cluster commission a full time Wellbeing Co-Ordinator for signposting, advocacy and Community Development purposes. Our Wellbeing Co-Ordinator can offer you support on:

  • Befriending, counselling and other support groups
  • Housing, benefits and financial support
  • Social Activities
  • Arts, gardening and creative activities
  • Health and Wellbeing activities and courses
  • Education and Learning
  • Employment, training and volunteering

The role of the Wellbeing Co-ordinator has evidently supported patients to improve their emotional wellbeing, tackling isolation and loneliness, and helping patients to generally feel healthier through supporting lifestyle changes.


Cluster Pharmacist

As part of the GP practice team, pharmacists provide specialist advice for patients particularly the elderly, those taking multiple medicines (polypharmacy), and those with multiple conditions. Through taking responsibility for patients with long-term conditions, clinical pharmacists can free up GPs for other appointments and so help to reduce the numbers of people presenting at A&E departments.


Occupational Therapist

The role of Occupational Therapist has been rolled out throughout the cluster to develop primary care services. Occupational Therapists reduce demand on GPs by addressing and resolving underlying functional issues that are the root cause of multiple and regular contacts with the practice.

With unique & expert knowledge to enhance the cluster, Occupational Therapists work successfully within the cluster and an overall primary care setting, transforming services and working proactively in areas such as frailty, social prescribing, self-management of chronic conditions, mental health and fitness for work


Cwm Taf Care & Repair

The Cluster have built relationships with Cwm Taf Care & Repair with representation at every cluster meeting. A charity which helps older people in Wales live independently in their own homes, they offer practical help to create safe, warm and accessible homes. This help can range from delivering major modifications for people most in need, to offering advice and recommendations to people who need reliable professionals to carry out work.

Care & Repair complete a full Healthy Homes Check, which involves visiting the patient at home and looking around their property for any signs of wear and tear, repairs, aids and adaptations needed to ensure they are warm, comfortable, safe and secure. Furthermore, Care & Repair offer a number of additional services;

  • Discuss benefits to ensure all patients are getting the income they should be and refer to DWP when required.
  • Discuss energy efficiency, and whether or not the patient is having difficulty with bills. This is to ensure the client is heating their home appropriately in the winter months, and Care & Repair have partnerships with Citizens Advice Bureau and the Energy Advisor in Rhondda Cynon Taf CBC who visit all patients which are referred by them to look at tariffs.
  • Care & Repair also refer patients to Welsh Water, to lower the rates of pay, and ensure they are getting the Warm Home Discount that the Government give for everyone on a particular benefit. 
  • Fire Safety, ensuring there are sufficient working smoke alarms in the property. If not, patients are referred to the Fire Service as they install alarms free of charge.
  • Discuss loneliness and isolation, and refer to the Community Coordinators or other third sector organisations that could alleviate this.
  • Safety & security and ensure all locks to windows and doors are in good working order. If not, Care & Repair have an internal scheme to get locks repaired and renewed.
  • Partnership working with Priority Service Registers with Wales & West Utilities and Western Power. These services are free of charge and ensure priority is given to patients should there be a gas leak or power cut. Wales & West Utilities also supply free Carbon Monoxide detectors that Care & Repair can give to patients.

Patient feedback has been fantastic across Cwm Taf UHB, and comments have been received such as;

“C&R have been excellent. The workmen who came to our home were marvellous and you cannot fault them. Our home is warmer and I find that now the cold does not affect my breathing as much as it used to. It could get quite chilly but now it’s nice and warm at a constant temperature. It’s so much easier to control the heat in each room. We even have a wireless thermostat. C&R have helped us no end. Thank you so much.’


Community (District) Nurses

The District Nursing service provides direct care in a patients’ home.  District Nurses help manage a patient’s condition effectively at home, offering treatment, advice and support in a bid to avoid the need for unnecessary hospital admissions or A&E attendances. They also work closely with other healthcare professionals such as GPs, social care and voluntary groups to provide patient care and support.


Who is it for?

The District Nursing service is for people who are unable to attend a healthcare premise to receive treatment (patients who are housebound).  The service also supports patients when they are being discharged from hospital  to allow them to return home swiftly and safely.


What to expect

District Nurses provide:

  • Health and well-being support to help patients live independently and cope with a chronic illness or disease
  • Nursing assessments to assess eligibility for continuing health care funding
  • Information and support to families and signposting to further information if needed
  • Assessment, management and prevention of leg ulcers
  • Continence and management of incontinence information
  • Pain management and symptom control in palliative and terminal care and in chronic disease management
  • Support for other specialist nursing care where patients may have complex care needs e.g. tracheotomy
  • Education in self-medication

Contact Telephone: 01443 444069 (24 hours a day) - Use of this service is by referral and all referrals are assessed to ensure that they are suitable.