Cynulliad Cenedlaethol Cymru | National Assembly for Wales

Y Pwyllgor Plant, Pobl Ifanc ac Addysg | Children, Young People and Education Committee

Y 1,000 diwrnod cyntaf| First 1,000 Days


FTD 01


Ymateb gan: Fferylliaeth Gymunedol Cymru

Response from: Community Pharmacy Wales



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:  How Community pharmacy could support

3.           Flu vaccination is particularly important for pregnant women; pregnant women have an increased risk of developing complications if they get flu, particularly in the later stages of pregnancy. If a pregnant woman is infected with flu this could mean the baby is born prematurely or has a low birthweight, and can even lead to stillbirth or death in the first week of life. 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 and the wider cluster teams to target those patients that do not routinely attend for vaccination

4.           Smoking cessation is the most beneficial health intervention that can be undertaken. Smoking in pregnancy increases the risk of miscarriage, stillbirth, birth defects (including cleft lip and palates), premature birth and increases the risk of placental abruption which can be dangerous to both the baby and mother. Babies that are small due to smoking are more likely to have health problems when young and in later life. Passive smoking in pregnancy also has additional risks including stillbirth, premature birth and their growth can also be affected.

Children and babies who live in a home where there is a smoker are more prone to asthma, and ear, nose and chest infections; have an increased risk of sudden infant death syndrome and are more likely to become smokers themselves when older.

Community pharmacies have been providing a smoking cessation enhanced service for ten years (in parts of Wales), however commissioning of services across the seven local health boards and publicity of these services to the public is variable.

5.           Drinking alcohol in pregnancy is another serious risk, not only of miscarriage but can also lead to learning difficulties and behavioural problems. Heavy drinking in pregnancy can also lead to foetal alcohol syndrome which has more serious health consequences for the child. However it is not just reduction of alcohol within pregnancy that can make a difference, as alcohol abuse was recorded as present in the household in 14% of Adverse Childhood Experiences in Wales

There is a large body of international evidence confirming that early identification of inappropriate alcohol consumption and the delivery of brief advice can be very effective in reducing people’s drinking to a lower risk level. Community pharmacists and their teams have successfully demonstrated their ability to reach large numbers of people and to support people to make healthier lifestyle choices. Services have been developed elsewhere in the UK for pharmacists to provide brief intervention and advice in relation to alcohol and these could be utilised in Wales.

6.           Community pharmacies could be better utilised to support the workload of some hospital based services and GP services by helping 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. The widespread commissioning of the Common Ailments service would also help to support this.

7.           An early years pharmacy project was run as a pilot within BCUHB during 2013. The project aims were to:

  1. Encourage the use of the community pharmacy as first port of call for advice on healthy lifestyles and family health needs
  2. Support the “Choose Well” campaign by encouraging patients living in areas of deprivation to use community pharmacies as a source of advice and service provision rather than GP services (or out of hours/ accident & emergency departments etc)
  3. Increase levels of smoking cessation referrals either to the pharmacy stop smoking service or to SSW.

Pharmacy teams were upskilled in a variety of topics in relation to health in the early years. The project was evaluated by Public Health Wales and was felt to have been effective in increasing the profile of community pharmacies as providers of advice on health and healthy lifestyles, it was felt that the project demonstrated the potential for community pharmacies to play a key role on providing a high quality and accessible service that enables people to take responsibility for their own and their family’s health, and to use NHS services wisely.

Part 3:  Conclusion

In conclusion CPW believes that the community pharmacy network across Wales could support during the first 1,000 days of a child’s life by the better use of community pharmacy within the Public Health agenda in relation to prevention and self care particularly within: