WP 05

Ymchwiliad i barodrwydd ar gyfer y gaeaf 2016

Inquiry into winter preparedness 2016/17

Ymateb gan: Fferylliaeth Gymunedol Cymru

Response from: Community Pharmacy Wales

 

 

 

 

                                  

 

 

 

 

 

A Response

 

Health, Social Care & Sport Committee’s inquiry into the

winter preparedness 2016/17

 

 

 

 

 

 

 

9 September 2016

 

 

 

 

 

 

Contact Details

Russell Goodway

Chief Executive

Community Pharmacy Wales

3rd Floor, Caspian Point 2

Caspian Way

CARDIFF, CF10 4DQ

Tel: XXXXXXXXXXX

E-Mail XXXXXXXXXXXXXXXXXXXXXXXXXXX

 

 

__________________________________________________________________________

 

CPW agrees that the content of this response can be made public. CPW are happy to provide further information as required by the Committee either by additional written or oral evidence or to facilitate a Committee visit to a community pharmacy. CPW welcomes communication in either English or Welsh.

 

 

Part 1:  Introduction

 

 

1.           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 based NHS services and to shape the NHS Community Pharmacy Contractual Framework (CPCF) and its associated regulations.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’.

 

2.           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:  Considerations for the Committee

 

Role of Community Pharmacy in reducing Unscheduled Care

3.           Primary Care contractors have a significant role to play in reducing the pressures facing unscheduled care services. CPW believes that community pharmacies have a major role in helping to maintain a sustainable health service going forward. For community pharmacies to be able to successfully do this, there is a need for the development of core services to be available from every community pharmacy 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.

4.           CPW welcomes the national implementation of the Choose Pharmacy IT application across Wales following the successful pilot of the platform across 46 community pharmacies in Gwynedd, the Cynon Valley and Cardiff; and the opportunities that the platform will provide for pharmacies in delivering services for the general public and releasing capacity in general practice. However, CPW believes that the roll out of the platform currently proposed for 400 pharmacies needs to be extended to all 716 community pharmacies in Wales as soon as is practicable, as the implementation is an essential step in moving towards a cohesive, electronic and fully integrated healthcare system enabling consistent sharing of patient information across sectors to not only deliver seamless and safer patient care, but to allow pertinent information to follow the patient wherever care is provided.

5.           Up to 18% of general practice workload and 8% of emergency department consultations are estimated to relate to minor ailments, reducing the time spent by GPs on managing minor ailments by the use of a community pharmacy based Common ailments service would enable them to focus on more complex cases and could reduce patient waiting times. The Choose Pharmacy application provides community pharmacies with the ability to deliver the Common Ailments service; however the service currently requires local commissioning by Health Boards, CPW would like to see the Common Ailments Service available as a national service available through all community pharmacies.

6.           Up to 30% of calls to NHS Out of Hours services on a Saturday are for urgent requests for repeat medication. A third of those calls are referred directly to GP OOH services for an appointment to arrange a prescription. Other patients may attend A&E departments for a request for a repeat prescription which represents significant inefficient use of NHS resources. In some areas of Wales there is also a significant pressure on GPs to prescribe for temporary residents visiting an area who have failed to bring their medication with them. The development of the community pharmacy Emergency Medicines Service has significantly reduced this burden, however commissioning is variable across the Health Boards and CPW would ask the Committee to review this as part of their inquiry. Emergency Medicines Service is also a module planned to be added to the Choose Pharmacy platform which will provide community pharmacies in Wales with access to a summary of the Welsh GP Record (WGPR)  reducing the need to refer any patient’s back to other, less appropriate NHS services because a patient’s medication cannot be verified, as well as improving patient safety.

7.           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

Prevention and Self Care

8.           Community pharmacies have been commissioned to provide NHS flu vaccination for several years, however there is variability in commissioning and CPW would like the service to be available to all community pharmacies across Wales. Community pharmacy should be included in the flu planning proposals for all LHBs at an early stage to allow community pharmacy contractors enough notice to ensure that pharmacists are trained and vaccines are available to deliver the service. Community pharmacies would also like the opportunity through the primary care clusters to work with GP colleagues to target those patients that do not routinely attend for vaccination.

9.           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

Supporting Dischargeove points 8,9,10, 11 here??MACY REVIEWo look at primary care clusters. future. s scheduled review. We believe pharmacy has a m

10.        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.

11.        The Discharge Medicines Review Service (DMR) provides for a patient’s community pharmacy to undertake medicines reconciliation of a patient’s medicines at discharge with those prescribed by their GP and for them to identify and resolve any unintended discrepancies. An evaluation of the service found that for each £1 invested £3 was saved by NHS Wales through avoided A&E attendances, hospital admissions and reduced medicines waste. However despite the service being launched in 2011, there has been issues in relation to patient identification as community pharmacies are not routinely informed when patient’s have been in hospital. CPW welcome the inclusion of DMR within the Choose Pharmacy application as this will allow for electronic discharge information to be transferred from hospitals using the Medicines Transcribing and e-Discharge (MTeD) system to a patient’s nominated community pharmacy and for the pharmacy to undertake an electronic DMR, however CPW would like the Committee to review the use of MTeD in hospitals across Wales to ensure that this valuable information can be shared electronically with both GPs and community pharmacies for all Welsh patients.

Integration with Primary Care Clusters

12.        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

 

Part 3:  Conclusion

 

In conclusion CPW believes that the community pharmacy network across Wales is a hugely under-exploited healthcare asset which could help to support the Welsh NHS in dealing with winter pressures in particular by reviewing: