P 47

Ymchwiliad i’r Adolygiad Blaenoriaethau ar gyfer y Pwyllgor Iechyd, Gofal Cymdeithasol a Chwaraeon

Inquiry into the Priorities for the Health, Social Care and Sport Committee

Ymateb gan: Fferylliaeth Gymunedol Cymru

Response from: Community Pharmacy Wales

Community Pharmacy Wales response to the Health, Social Care and Sport Committee’s consultation into the priorities for the Committee during the Fifth Assembly

1 September 2016

Contact Details

Russell Goodway

Chief Executive

Community Pharmacy Wales

3^rd Floor, Caspian Point 2

Caspian Way

CARDIFF, CF10 4DQ

Tel: XXXXXXXXXXXX

E-Mail: XXXXXXXXXXXXXXXXXX

Part 1: Introduction

Community Pharmacy Wales (CPW) represents community pharmacy contractors on NHS matters and seeks to ensure that the best possible services, provided by pharmacy contractors in Wales, are available through NHS Wales. It is the body recognised by the Welsh Assembly Government in accordance with Sections 83 and 85 National Health Service (Wales) Act 2006 as ‘representative of persons providing pharmaceutical services’.

CPW is the only organisation that represents all 716 community pharmacy contractors in Wales. It works with Government and its agencies, such as local Health Boards, to help protect and develop high quality community pharmacy services and to shape the NHS Community Pharmacy Contractual Framework (CPCF) and its associated regulations.

CPW represents a network of of community pharmacies across Wales which provide essential and highly valued health and social care services at the heart of local communities. Community pharmacies operate in almost every community across Wales, including in rural communities, urban deprived areas and large metropolitan centres. It is currently estimated that on an average day the network of community pharmacies across Wales will, between them, deal with more than 50,000 individual patients.

Part 2: Priorities for the Committee

REVISITING THE COMMUNITY PHARMACY REVIEW

CPW would encourage the Committee to review and build on the work undertaken by the Health and Social Care Committee in the fourth Assembly through its Inquiry into the contribution of community pharmacy to NHS services in Wales. The inquiry, completed 2012, produced seven recommendations which centred on making more extensive use of community pharmacists and community pharmacies as a health service resource all of which were adopted by Welsh Government. It would useful to understand the extent to which these recommendations have been implemented and the obstacles and reasons for any failure to implement them. Furthermore, the previous Health Committee recommended that its report be revisited at a later date to measure progress.

HEALTH AND SOCIAL CARE WORKFORCE

CPW welcomes the intention of the Committee to examine the sustainability of the health and social care workforce and will be submitting evidence. CPW believes community pharmacies have a major role to play in helping to maintain a sustainable health service going forward. Despite widespread recognition of the massive potential of the community pharmacy network across the political and health professional spectrum, for reasons unknown it remains a hugely under-exploited healthcare asset, with a wide variation in commissioning of community pharmacy services across Wales. Although CPW understands the need for planning care locally, it feels there is a need for the development of core services to be available from every community pharmacies in Wales in order to increase the awareness and confidence of the general public in relation to the full range of community pharmacy based services in order to reduce pressures elsewhere in the primary and secondary care sectors.
Community pharmacies could make a significant contribution to releasing GP colleagues to focus on those patients that really do need to be seen by a doctor. For example, community pharmacy based common ailments services and emergency supply services can reduce the pressure on GP practices by releasing the need for these patients to otherwise require appointments. Chronic conditions management services and associated medicines management services can support people to live with a condition which could otherwise result in the requirement of hospital admission and treatment. This will also help to reduce the number of expensive hospital beds and secondary care treatments needed to support an ageing population. An important part of the development of these services would also be a relaunch and re-focus of the under-utilised “batch” prescribing service which forms part of the current community pharmacy contract as the Repeat Dispensing Essential Service. Taken together, these measures could have a significant impact on the GP practice workload.
Community pharmacy services could be further transformed by utilising community pharmacist’s skills in medication adherence and reducing polypharmacy.
The workload of some hospital based services and GP services could also benefit from using the capacity of the community pharmacy network to triage and signpost patients to the most appropriate health care professional. Making community pharmacies the first port of call for patients accessing NHS services would make a massive contribution to the delivery of a prudent healthcare regime.
CPW welcomes the integration of health and social care services and would like to seek to understand what opportunities there are for community pharmacies to work closer with social care to support the development of domiciliary care medication support to preserve a patient’s independence and allow them to remain in their own home. Community pharmacy services are currently only commissioned through Local Health Boards but local authorities too could benefit from the support that community pharmacy could provide to those in receipt of social services care.
CPW has previously developed an enhanced service template in relation to the support that community pharmacies could deliver to care homes as well as working with the Royal Pharmaceutical Society Wales in relation to the production of their policy “Improving medicines use for care home residents”. CPW would encourage the Committee to understand what progress has been made in relation to the use of antipsychotic use in care homes and where community pharmacy could support this further.
CPW believes that hospital discharge and outpatient services could benefit from the dispensing of related hospital prescriptions in a community pharmacy. This could make a significant contribution to releasing capacity in hospital based pharmacy services as well as leading to significant improvements in releasing hospital beds and in the overall patient experience.

PRIMARY CARE CLUSTERS

The Committee might in the future like to look at the development and operation of primary care clusters. CPW understands the importance that primary care clusters have in transforming primary care. CPW would like to see the role of all primary care contractors become an integral part of primary care cluster working. Community pharmacy contractors can significantly support the primary care agenda helping to support the long-term sustainability of primary care by using pharmacists’ skills and abilities according to the prudent healthcare principles and releasing capacity in GP practices and in A&E departments. Community pharmacies have the largest daily footfall of all the stakeholders within a primary care cluster and as such should have a significant role to play in relation to supporting the health and wellbeing needs of the local community they serve. However, to date the integration of community pharmacy within the 64 primary care clusters across Wales has been variable and in the majority of cases is unfortunately so far non-existent

PUBLIC HEALTH IN WALES

The Committee may be minded to review the delivery of public health services in Wales. Community pharmacies are pivotal to both the delivery of the Public Health agenda nationally in Wales and at local primary care cluster level. The ability of the NHS to cope with future demands on its resources is heavily dependent on the Governments ability to tackle diseases and illnesses related to lifestyle choices. The community pharmacy network arranged as 716 High Street Healthy Living Centres as the channel for organised public health campaigns and offering the full range of services aimed at changing lifestyles and improving public health would make a substantial contribution to achieving existing Government targets.
Community pharmacies in the provision of Medicine Use Reviews and other services currently engage with people in discussions relation to their lifestyle, including physical activity. CPW would be interested to understand with the inclusion of sport in the health portfolio how community pharmacies could be better utilised, potentially in the national exercise referral scheme

Part 3: Conclusion

CPW believes that the Committee could during the current Assembly term :

Review the progress made in relation to the implementation of the recommendations included into the report produced by the Assembly Health & Social Care Committee in the fourth assembly following its inquiry into the potential contribution of community pharmacy to NHS services;

Expedite the planned review of health and social care workforce;

Examine the development, operation and enhancement of primary care clusters;

Review Public Health services in Wales including the potential contribution of community pharmacy.

CPW agree that the content of this response can be made public.

CPW welcomes communication in either English or Welsh.

For acknowledgement and further Contact: