Ewch i’r gorllewin

By Rob Darracott

“It’s critical for the thinking about how a new contractual arrangement needs to work. If you want community pharmacy to receive investment, then it has to be an investible proposition in the eyes of government.” I’d heard those words twice in the three weeks prior to my sitting down to talk to the person who uttered them: the chief pharmaceutical officer for Wales, Andrew Evans.

He didn’t disappoint. There’s much to admire in the transformation in community pharmacy taking place in Wales. There’s a vision linked to the Welsh Government’s own priorities for health and care. You’ll find it in Pharmacy: Delivering a Healthier Wales. There’s a set of principles that drive the development of the service – six ‘C’s: community, capability, continuity, capacity, collaboration and connectivity. If Andrew did really scribble the first version of the ‘C’s down on the train to the Independent Pharmacy Awards in 2018, then kudos to my colleagues on our sister publication for providing the inspiration!

There are key building blocks, the latest of which is prescribing, now being rolled out into community pharmacy across the country. And clear ambitions for the speed of that roll out, which should see half of all community pharmacies in Wales offering an independent prescribing service by 2025 and all 710 doing so by the end of the decade. 

There’s investment in skills, not just in prescribing, but also now in pharmacy technician training – and in technology. Not just the IT platforms that connect community pharmacy to the rest of primary care and capture activities and outcomes, but in automation itself via an interventionist approach to part-funding innovation which has paid dividends. 

And, of course, there’s the key role played by Community Pharmacy Wales in making things happen, starting with accepting the reality that the public, in many spheres of life, are looking for different and better. That relying on driving income through prescription volume would deliver increasingly diminishing returns.  

Sadly for Ade Williams, he’s the wrong side of the Bristol Channel to benefit from this forming, storming, norming, performing approach to sector transformation, which was refreshed with three new goals for 2025 just as P3pharmacy was going to press. He’s also way too far south to see any change out of a similar logical approach in Scotland. The vision there, set out in Achieving Excellence in Pharmaceutical Care, also contains key strands relating to skills development, innovation, IT connectivity and independent prescribing. 

As PSNC kicks off its vision and strategy work this autumn, community pharmacy contractors in England will be hoping that the output this time resonates with the Committee rather more than the last piece of strategic work it committed to. That failed to include anything resembling a strategic plan in the final edit. Let’s also hope that the outlook for progress is better than Outsider’s pessimism would suggest. 

It remains to be seen how much leeway integrated care system (ICS) chief pharmacists and community pharmacy leads will have to make things happen across their systems. But with all 42 ICSs formally responsible for commissioning across primary care services by next year, those wanting to chance their arm, and find out how it might be done properly on their patch, could do worse than head west. Just take the fastest train to Cardiff Central and ask.