After the funding cuts were announced in England, Welsh health minister Vaughan Gething committed to invest in community pharmacy in Wales – and, crucially, to not reduce the sector’s funding. In the longer term, maintaining the current level of funding will be conditional on pharmacies providing a greater range of clinically focused services.
The Welsh government and local health boards are also promoting joint working between community pharmacists and GPs. We need to work better with GPs to deliver better patient outcomes, so we can maintain and improve the funding to our pharmacies.
For my pharmacy business, a good example of collaboration between pharmacists and GPs this year has been the flu service.
The Welsh government and health boards have targets to increase the number of people in at-risk groups who are vaccinated against flu every winter. Last year, the vaccination rates in Wales were less than 67% for over-65s and less than 47% for under-65s in at-risk groups. The target for these groups is 75%.
Community pharmacies are in an ideal position to help increase these vaccination rates, especially for patients under 65 in at-risk groups, because many visit our pharmacies to collect their prescriptions every month.
However, there is often conflict between GPs and community pharmacists around the flu service, when the professions can appear to be in competition over the same patient. This makes joint collaborative working a challenge.
GPs pre-order their vaccines and may allocate blocks of time to vaccinate patients, with projected numbers based on the number of patients they vaccinated in previous years. They have genuine concerns that money and time could be wasted if pharmacists were to “compete” for their regular flu clinic attendees.
Flu vaccine uptake could be increased if community pharmacists worked with GPs to identify which of the pharmacy’s at-risk patients didn’t regularly attend flu clinics. Pharmacists could then vaccinate those patients when they attend the pharmacy.
We produce a report from our patient medication records (PMRs) to list at-risk individuals who are taking medicines from the BNF categories for respiratory disease, diabetes, heart disease and Parkinson’s. We share this report with our local surgeries, who identify which of these patients don’t regularly go to the surgery for their flu jab.
We add a flag to the PMR system that highlights these patients to us when we are labelling their medicines. The flu vaccine is then offered and administered while the patient is waiting for their prescription.
Not only has this approach helped to increase vaccination rates, but it has built and strengthened our relationships with our GPs. By demonstrating clearly that working collaboratively greatly improves patient outcomes, we should be able to build the range of clinical services envisaged by the Welsh government, and secure the future of community pharmacy in Wales.
Paul Mayberry is managing director of the Mayberry Pharmacy Group, based in South Wales