While it would have been impossible to predict that a global pandemic was about to hit, the timing of the acute conditions service developed by independent pharmacy Fferyllwyr Llyn Cyf, Wales, could not have been better.

After 18 months of planning with the health board and bespoke training in independent prescribing and minor illness, the team began to roll out the service in September 2019. Having had the backing of local GPs from the start, their first sessions took place in general practice with a GP on hand to answer any queries, explains superintendent pharmacist Steffan Rhys John.

“It also worked the other way around – that the GP practice staff understood which conditions we could see and how we work so eventually when the service started, they could refer on to us,” he explains.

Over autumn 2019, the scheme rolled out to pharmacy’s sister branches in north Wales. A fourth branch in Abersoch that was purchased the following March also began to offer the service.

“It was good timing that we started just before the pandemic because we had experience of how to run the service,” Mr John says. “So, when a massive barrage of people started turning up at the pharmacy, we could actually deal with them quite comfortably.”

The scheme was such as success that the Fferyllwyr Llyn Cyf team scooped not one but two trophies at the C+D Awards 2020 in the Business Innovation and Independent Pharmacy of the Year categories. Here, Mr John explains how the service works and why it's been such an important offering to the local community.

 

How does the service work?

 

Under the scheme, patients can walk in, phone for an appointment or be referred by their GP. They can be seen in a matter of minutes for a range of minor ailments including skin conditions, migraines or headaches, and urinary tract infections. While respiratory infections have not been included under the service following the pandemic, they are set to make a return as long as a patient has had a polymerase chain reaction (PCR) test prior to the consultation, Mr John explains.                                                                                       

To meet the early demand of more than 100 patients a month – although this July saw a high of 481 patients – the pharmacy team decided to invest in automated patient medication record (PMR) technology for the Fferyllwyr Llyn Cyf branch, freeing up the pharmacists' time to spend the majority of the day seeing patients. The whole team has been upskilled so dispensers and pharmacy technicians can take on more responsibility.

The demand for the service is now so high that an additional pharmacist is needed in the branch most days, Mr John says.

 

What’s next for the team?

 

The team are always finding new ways to expand their offering. They were the first pharmacy team in Wales to deliver a COVID-19 vaccination service and have signed up to do booster vaccinations this autumn. They are currently considering introducing a new contraceptive service.

“The [acute illness] service has now been expanded to include temporary residents as well. So particularly on the Llyn Peninsula branches, they've been very, very busy seeing temporary residents. And we got some additional funding to put a second pharmacist there to try and take a little bit of pressure off the GP practice there,” Mr John explains.

This summer in Blaenau, they too the service even further due to a massive shortage of GPs. “There were days when there was only GP cover for half a day," he says. "So we had an agreement with the surgery that we would put a second pharmacist in the community pharmacy on those days and they would book patients in for us, and give shared record access as well."

This winter will be difficult, they admit, with the usual flu vaccinations on top of pandemic pressures. “It’s been hard work over the summer and I think it's going to be a tough autumn. There’s a lot of things going on,” he says.

But it is the gratitude from the patients that keeps them going: “The patients say they have been struggling recently with accessing GP services, so they're really, really, kind to us and really grateful we’re actually there and accessible on the high street giving high quality advice and treatments.

“You get tough days or you get a couple of cases where you've struggled and you go home sometimes thinking 'is it worth it?' But it’s just something about being so appreciated that keeps you going.”

Now, all new pharmacists to the team are trained as independent prescribers. For anyone else wanting to emulate what they have done, Mr John’s advice is to have conversations with local GPs first to look at demand and get the right team around you.

He says: “You need to get your team excited about the changes and what's going on and you may need to invest in new technologies and upskill your support staff.”

And it is precisely this attitude that C+D Awards judges recognised, who commented: “By upskilling the pharmacy team and providing training to pharmacists to increase their clinical skills...it has demonstrated that community pharmacies are ideally placed to offer high quality, timely healthcare to patients thereby reducing the pressure on GP practices.”

The C+D Awards 2021 will take place at London's Intercontinental O2 Hotel on November 19. See here for more information.