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Our six key principles are guiding the way in Wales

Andrew Evans, chief pharmaceutical officer for Wales, speaking at the recent Independent Pharmacy Awards at the House of Commons, described the excellent progress pharmacy is making in Wales

When I spoke at the Independent Pharmacy Awards four year ago, capitalising on pharmacy’s strong sense of Community was one of the five key principles I explained the future of community pharmacy needed to be built around.

The others were Capacity – making time for pharmacies to deliver outstanding care; Capability – ensuring professionals working in community pharmacy have the skills they and the NHS need; Continuity – recognising the intangible value of seeing the same pharmacist in the same pharmacy; and Collaboration – integrating the role of community pharmacy with that of other NHS providers.  

In the intervening period we actually added a sixth C – Connectivity – to ensure pharmacies are digitally connected to the NHS, sharing patients’ medical information to support pharmacists to deliver great care and communicating what pharmacists do with other health professionals.

Sweeping reforms

I was delighted at the end of last year when we agreed with Community Pharmacy Wales a sweeping set of reforms to the contractual framework for the 712 community pharmacies across Wales. These reforms are true to those
six principles and will rapidly expand the clinical role of pharmacists, incentivise workforce development, and make sure the increasing investment the Welsh Government is making in the community pharmacy network, including an additional £6m in this financial year, encourages and rewards pharmacies that do more of the things the NHS needs.

To do that, in April we implemented our nationally directed Clinical Community Pharmacy Service, enabling every pharmacy in Wales to provide our national common ailments, seasonal influenza, emergency contraception and emergency medicine supply services, improving continuity of access to these services by requiring that every pharmacy providing one of these services is providing them all. Before the end of this year, the service will be expanded to include provision of bridging and quick-start contraception. 

“In those 130 pharmacies where a prescriber is available there are as many as 5,000 consultations each month”

The changes create a new universal minimum level of service that all pharmacies provide and support our wider efforts to promote the appropriate use of NHS services, helping the public really understand the role pharmacies play within the NHS without the vagaries and variability of local commissioning.

Prescribing service

We are rapidly rolling out a nationally directed independent prescribing service. Since April any pharmacy employing a suitably qualified and competent pharmacist independent prescriber can prescribe for a range of extended minor illnesses not covered by the Common Ailment Service and routine contraception. One in five pharmacies in Wales are now providing independent prescribing services and there are plans to take us to one in three by early next year, half of all pharmacies by 2025 and every pharmacy well before the end of the decade.

To support that, around 100 pharmacists are accessing financial support for independent prescribing training every year. We are incentivising recruitment, training and retention of pharmacy technicians, and we are helping community pharmacy professionals to improve their capability through advanced practice funding and protected learning time pilots.

The sector’s response has been incredible – on the back of record numbers of flu vaccinations, common ailment consultations are three times pre-pandemic levels, saving between 200,000 and 250,000 GP appointments in Wales this year within five months of the start of the independent prescribing service. In those 130 pharmacies where a prescriber is available, there are as many as 5,000 consultations each month which otherwise would present elsewhere in the NHS. 

And all of this is underpinned by a comprehensive reform of funding, which is increasing the investment in clinical services in absolute and relative terms. By 2025 over a third of fees and allowances will be going directly into clinical service provision, more than £50m, representing a more than five-fold increase in the 10 years we have been on the journey to transform community pharmacy in Wales.

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