We strongly believe that a holistic approach to recruitment and workforce planning is needed for healthcare, taking into account the contributions of all professional groups across primary, secondary and tertiary care in Wales. It is vital that patients are supported by the right healthcare professional with the right skills and knowledge at the right time. We believe community pharmacists, primary care pharmacists, specialist clinical pharmacists and consultant pharmacists provide opportunities across the care pathway and are a key part of turning prudent healthcare principles into reality. The Welsh Government’s national plan for primary care already refers to using the skills and expertise of the wider primary care team, including pharmacists.

We are supportive of the need to ensure a strong and sustainable medical workforce and believe that a coherent workforce strategy including all healthcare professions across all sectors should be developed. This would ensure all professionals are working at the top of their registration - a key aspiration in the Governments primary care plan and one we believe should apply equally to all sectors. We believe that workforce and recruitment strategy should be based on data that takes account the current and future need of the health care workforce and take into account new models including the roles of specialist and consultant pharmacists to provide care traditionally provided by medical consultants.

The pharmacy profession makes a significant and unique contribution to the healthcare of the people of Wales. As the third largest professional group in the NHS there is increasing recognition of the benefits of extended clinical roles for pharmacists and medicines management roles for pharmacy technicians. Their inclusion in primary and secondary care multi-disciplinary teams acts as an enabler and catalyst to ensuring better patient care. With this inclusion comes the requirement for increased multiprofessional team working.

We believe that pharmacists should be an integral part of referral systems within the multidisciplinary team, being referred to for common ailments, medicines advice and long term conditions support as well as signposting and referring directly to other health and social care professionals. Medicines are the most common interventions in the NHS today. It is essential for patients that their medicines and pharmaceutical needs are overseen and coordinated at all points of the health and social care pathway to ensure they can benefit from their medicines and suffer no harm. Direct referral arrangements would allow GPs to focus on diagnosing and more complex conditions. This would also ensure the patient journey is streamlined, reducing duplication and improving cost effectiveness and efficiency of services.

Community pharmacies in Wales should be fully integrated with GPs and hospitals, treating and caring for patients across the care pathway and in the context of their daily lives. The Welsh Government’s Efficiency Through Technology Fund investment in choose pharmacy provides a significant opportunity to deliver greater integration of the pharmacy profession into models of care. The IT platform which allows community pharmacists access to appropriate parts of the Welsh GP patient records has the potential to allow pharmacists to play a greater role in patient facing care. We hope that this investment will be fully utilized with the development of more services through community pharmacy to better support patients with their medication and health needs. By focusing on the medication management of long term conditions for example, the pharmacy profession can help to ease pressures on other primary care professionals, including GPs. In order to make prudent healthcare happen in Wales it is essential that our highly-educated and skilled health professionals are used appropriately, spending time on work that cannot be undertaken by other, less expensive members of staff.

The development of 64 cluster networks, tasked with ensuring that the health and social care needs of their local population are met, provides new opportunities to think differently about how health and social care is delivered in Wales. Many of the clusters have funded new clinical roles for pharmacists to work alongside their doctor and nurse colleagues in general practice. These new models not only provide new opportunities for patient to be supported but also new ways of working for healthcare professionals which could be very appealing in the recruitment of GPs, knowing that they will have the opportunity to work in a multidisciplinary team, where they will have the capacity to focus on what only they can do.

There is currently a lack of multi-disciplinary educational funds to facilitate learning programs across healthcare teams which we envisage would encourage multidisciplinary working. We appreciate current educational funding streams from WEDS are available but are concerned these are only accessible by the managed hospital sector for both pharmacists and pharmacy technicians and there is no investment in up-skilling the community pharmacy team to enable new professional services to be offered to patients. We are also concerned that primary care clusters are not releasing educational funds to pharmacy. We recommend that either a directive to ring fence monies or to re-allocate the funds to WEDS or a similar body would provide a helpful solution to enable the pharmacy team to be incorporated into funding streams for multidisciplinary training. GPs and pharmacists must be given the opportunity to develop specialisms that support the complexity of conditions within their clusters. There is currently no central funding for foundation programmes for community pharmacists to further develop their skills and to provide protected time to support community pharmacists in offering new clinical services for patients.

We are supportive of new and innovative approaches to attract high calibre healthcare professionals to Wales and feel that this should be done on a multidisciplinary basis. As with other professions, pharmacy also faces recruitment challenges, particularly in rural and deprived areas of Wales and have relied on European pharmacists to fill this gap. We are concerned that the Brexit process may have an adverse effect on recruiting from Europe in the future.

I trust this information is helpful. Please do not hesitate to get in touch if you require any further information.

Yours sincerely

Suzanne Scott-Thomas, Chair, Welsh Pharmacy Board

The Royal Pharmaceutical Society (RPS) is the professional body for pharmacists in Great Britain. We represent all sectors of pharmacy in Great Britain and we lead and support the development of the pharmacy profession including the advancement of science, practice, education and knowledge in pharmacy. In addition, we promote the profession’s policies and views to a range of external stakeholders in a number of different forums.