National Assembly for Wales
Health and Social Care Committee

 

Follow-up inquiry on the contribution of community pharmacy to health services

 

Evidence from Hywel Dda University Health Board – CP 2

 

 

 

 

 

 

The National Assembly for Wales’ Health & Social Care Committee

 

Inquiry on the contribution of community pharmacy to health services

 

Follow-up inquiry on -  

Evidence of progress in relation to the recommendations made in the 2012 Report, and where progress is still required.

 

 

Recommendation 1

The Committee recommends that the Welsh Government provides a clear national lead for the future development of community pharmacy services to ensure that the necessary policies and structures are in place to secure its delivery.  This should include nationally agreed priorities for the service and a centrally driven direction for its development.

Feedback:   

1.1  The direction in 2012 from the Chief Medical Officer to include community pharmacies in the delivery of NHS influenza vaccinations was a clear lead regarding the part that pharmacies can play in contributing to the Welsh NHS.  To support the influenza vaccination service, national documentation was issued, which allowed for some element of local implementation.  The only other service prior to this which was established nationally was the Emergency Hormonal Contraception (EHC) enhanced service. 

 

1.2   National lead on agreed priorities where pharmacies could make a contribution to the health and wellbeing of the population would be welcomed by this University Health Board. The caveat however, is that where nationally identified priorities are directed for community pharmacies, consideration must also be given to the funding necessary to implement any additional national enhanced services.
 
 

 

 

 

 

 

 

 

 

 

 

 

 

 

 


Recommendation 2

The Committee recommends that the Welsh Government promotes further enhanced services with a national specification for community pharmacy, including a national Chronic Conditions Service, and follows the incremental model proposed for the introduction of the National Minor Ailments Scheme to ensure robust monitoring, evaluation and improvement of services.  The Committee recommends that where there are clearly national health conditions, the service should be nationally specified, but that some continuing scope should be allowed for the volume and location of such services to be determined locally.

 

 

Feedback: 

2.1     The Influenza vaccination service is an example of central promotion of a new enhanced service.  This started in a limited way for the 2012/13 flu season (17 Pharmacies in Hywel Dda) but increased considerably in the 2nd year of the service to 43 Pharmacies.  It is anticipated that the number of Pharmacies participating in 2014/15 flu season will further increase. 

 

2.2   Aware that there is a national common ailments scheme being tested within a limited number of Health Boards.  Little feedback received on progress of common ailment scheme testing to date.
 
 

 

 

 

 

 

 

 

 

 

 

 


 

2.3         There is agreement that where there are national health conditions, which result in the introduction of supporting services within Pharmacies these should be specified nationally.  However the provision to allow for local adaptation in respect of volume and location for any such enhanced services must be afforded to Health Boards.

 

2.4         All new national enhanced services include the requirement to input data (to allow for monitoring, evaluation and claiming) via the National Electronic Claim and Audit Form (NECAF).  This is an important element of any service and is welcomed by Pharmacists.  However, many existing services e.g. Just in Case boxes continue to require paper claims, as no priority has been given to transferring long established services onto NECAF.  Progress on this would be welcomed by Hywel Dda (and our Community Pharmacists)

 

 
 

 

Recommendation 3

The Committee recommends access by community pharmacists to summary patient records where patients are registered with a community pharmacy.

 

Feedback:

3.1         Not aware of progress to date on this recommendation.

 

3.2     Having access to summary patient records is a vital step in developing innovative services that can be delivered by Community Pharmacies e.g. Independent Prescribing schemes.

 
 

Recommendation 4

The Committee recommends that the consistent participation of community pharmacies across Wales is secured for the next round of public health campaigns, whether national or local.  Close monitoring of community pharmacy’s participation is required by Local Health Boards to ensure that those failing to deliver on their contractual obligations are called to account for their non-compliance.

 

Recommendation 5

The Committee recommends that the Welsh Government improves the communication mechanisms it uses to inform the general public about the services available at any individual community pharmacy.  To this end, we recommend that the Welsh Government makes it an obligation for all community pharmacies to place a prominent notice in their premises identifying the range of services available in that pharmacy.

 

 

 

Recommendation 6

The Committee recommends that the Welsh Government should take the opportunity afforded by the recently announced national minor ailments scheme to consider changes to the way in which community pharmacies are remunerated, including a transition to capitation-based payments, underpinned by a patient registration system.

 

 

 

 

 

 

Feedback:

6.1         This recommendation is far reaching in its ambition, and would require an extensive overhaul of the current remuneration system.  Progress on this is not expected in the short to medium term due to the scale of change required.

 

6.2         However, until a greater proportion of a Community Pharmacies income is generated from means other than prescription activity there is no incentive for Pharmacies to invest in their infrastructure and equipment to deliver more innovative enhanced services.  Staff mix within Pharmacies and the role of accredited Pharmacy Technicians is also an important factor in the development of future enhanced services.         

 
 
 

 

 

 

 

 

 

 

 

 

 

 

 


Recommendation 7

The Committee recommends that the Welsh Government and Local Health Boards prioritise taking proactive action to address issues of cooperation and joint working between community pharmacist and GPs, both in rural and urban areas.