In Wales we are committed to transforming the contractual framework to play to the strengths of independent community pharmacists, says Andrew Evans, chief pharmaceutical officer

Independent community pharmacy understands the needs of communities because it is part of those communities – but there are very real threats to its future.

These threats are not from governments, automation, hub-and-spoke, changes in supervision, or clinical pharmacists in GP practices – believe it or not, these are opportunities. The threats don’t even come from Brexit.

The real threat is a change in consumer behaviour and a failure of pharmacies to adapt to that change. We are mistaken if we believe citizens will continue to access pharmacies in the same way and for the same reasons they do now.

In the future citizens won’t access services from their pharmacy opportunistically when they collect their prescription; they will collect their prescription when they visit the pharmacy to access services. That is a subtle but important shift in emphasis.

That is why in Wales we have committed to transforming the contractual framework to recognise, value and remunerate contributions that play to the strengths of pharmacy professionals.

Five key changes

That transformation will be built around five key changes – what I call the five Cs:

• Capacity: We must create time for professionals in pharmacies to deliver the clinical care that is needed to improve outcomes and reduce harm
• Competence: We must develop a workforce that is really capable of delivering improvements in health and whose skills and training are recognised and appreciated by commissioners, other health professionals and patients
• Continuity: Patients benefit from continuity of care – seeing the same professional over time improves health outcomes. We must value continuity and reward those pharmacies that deliver it
• Collaboration: Good health is the product of integrated and seamless healthcare
• Community: Understanding the needs of our communities allows us to plan and deliver services capable of meeting their needs.

So, in Wales in the immediate term, we are promoting pharmacies as part of the solution to the challenges citizens face in choosing and accessing the appropriate urgent and unscheduled health services in a timely way.

Our common ailment service is now available in over three-quarters of all pharmacies and will be enhanced by plans to roll out rapid antigen testing for sore throat and independent prescribing from community pharmacies.

In the medium term we must ensure pharmacies do more to tackle medicines-related harm. This is a shared problem in which prescribers and dispensers are complicit and it needs to be addressed.

In the longer term, pharmacies must get serious about prevention, by which I mean seriously taking every opportunity to change people’s behaviours in a positive way.