National Assembly for Wales
Health and Social Care Committee

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

Evidence from Boots UK – CP 11

Llinos Madeley

Committee Clerk

Health and Social Care Committee

National Assembly for Wales

Cardiff Bay

Cardiff CF99 1NA

2 May 2014

Dear Ms Madeley,

Follow-up inquiry into the contribution of community pharmacy to health services in Wales

Boots UK is pleased with the steady progress being made to develop community pharmacy services that will help improve the health of the population of Wales, and we believe that the Health and Social Care Committee’s report has helped maintain the Welsh Government’s focus on this.

Since the Committee’s report was published, we have seen progress being made on the development of the Common Ailments Service (CAS), “Choose Pharmacy”, which we are pleased to have up and running in our pharmacies in the early adopter areas.

As one of the largest community pharmacy chains in Wales, we are particularly pleased that this new service is being commissioned to a single specification. Our patients expect a consistency of service from our stores. Having a single all-Wales specification will allow us to train a wide pool of staff to maintain a consistent service throughout our opening hours. We trust that the Committee will maintain its prominent support for more nationally agreed enhanced services to be delivered through community pharmacies.

For example, we would like to see greater consistency in the commissioning of influenza vaccinations provided through community pharmacies for the forthcoming 2014/15 season. In the past, variations by Local Health Boards (LHBs) in which patients in their areas might be eligible to use pharmacies, and/or which pharmacies would be allowed to provide the service (by location or times), has led to confusion among patients. Such local variations undermine the national advertising and awareness campaigns needed to help the NHS in Wales achieve the WHO-mandated 75% vaccination target for at-risk populations.

We are also delighted by the Welsh Government’s decision earlier this week to continue with the Discharge Medicine Review (DMR) service. An independent evaluation showed that it was producing a return of three times the money invested in it, which highlights how community pharmacies are delivering value for the NHS and the people of Wales.

We believe that the Welsh Government should now be encouraged to build on the successful introduction of CAS and DMR by making more visible progress on a nationally specified enhanced service for chronic conditions management. This service should be introduced and funded in a way that supports a quick roll-out and does not increase complexity.

Work that Boots has been involved with (alongside The Co-operative Pharmacy, LloydsPharmacy and Rowlands Pharmacy) through the Community Pharmacy Future project (www.communitypharamcyfuture.org.uk) has demonstrated the value that community pharmacies can bring to supporting patients with long-term conditions, such as chronic obstructive pulmonary disease (COPD) and for older patients using multiple medicines.

These services have shown that pharmacist interventions can reduce hospital admissions caused by disease exacerbations, medicine-related falls or adverse drug incidents. Regular support from pharmacy teams, delivered in local pharmacies when patients are collecting prescribed medication, improves adherence to medicines and patients’ quality of life as well as building better professional relationships between pharmacists, patients and other health professionals, including GPs.

We believe that the Committee would be particularly interested in the benefits pharmacies have demonstrated in improving outcomes and quality of life for COPD patients, in the light of “Together for health – a respiratory health delivery plan” launched by the Welsh Government earlier this week.

The results of our work have been submitted to a peer-reviewed academic journal and we would be pleased to share more details with Committee members following publication.

Wales is making an excellent start on its journey to improving the health of patients in Wales by delivering services through community pharmacies. We feel that the Committee should now challenge the Welsh Government to pick up the pace on these successful developments, especially in regard to chronic conditions.

Improving the underpinning IT platform for pharmacy services will be a key part of this increased pace. The announcement of funding of £280,000 for NHS Wales Informatics Services to support this is very welcome in this context. Electronic sharing of discharge medicines information should be seen as a stepping stone towards full access by community pharmacies to summary patient records.

It is not just that pharmacists would benefit from being fully informed about patients’ medical histories when providing support related to medicines; other healthcare professionals would also benefit from having comprehensive details relating to how patients are using their medicines and any issues they are encountering.

Community pharmacies continue to provide an efficient, effective and safe service to patients in Wales, dispensing around 70 million items a year. We believe that there is much more yet to be achieved and we want to work with the Welsh Government and the National Assembly to make this happen for the benefit of the people of Wales.

We hope that you will find these comments helpful. We would always be pleased to arrange for Committee members to visit one of our pharmacies to discuss any of these matters in more detail.

Yours sincerely,

Sian Wilton

Head of Region, Wales

Boots UK

About Boots UK in Wales

There are 101 Boots stores in Wales, of which 99 have registered pharmacies. In Wales, our business employs around 2,000 people, including:

o 180 pharmacists

o 280 healthcare assistants

o 30 trainee pharmacists (one-year posts)

Boots pharmacies are well distributed across Wales and are located in places where people live, shop, work and travel, with many open well beyond normal office hours and at weekends. Our chain encompasses those which serve small, local and rural communities, including some of the most deprived locations in the country, through to high streets and those which are part of the largest retail and destination shopping centres.