1. in support of Primary Care Clusters :
COMMUNITY PHARMACY: IN SUPPORT OF PRIMARY CARE CLUSTERS _ Anglesey & Arfon July 2016
Community Pharmacy:
in support of Primary Care Clusters :
Anglesey & Arfon
Presentation is designed to be an overview of how community pharmacy can support and become integrated within Primary care clusters.
Intention is to look at the identified needs/ targets of the cluster and be solution focused as to how community pharmacy can support those needs, in particular outlining activities that can decrease GP workload.
The Face & Voice of Community Pharmacies in Wales
Wyneb a llais o fferyllfeydd cymunedol yng Nghymru

2. Welsh Community Pharmacy Basics
COMMUNITY PHARMACY: IN SUPPORT OF PRIMARY CARE CLUSTERS _ Anglesey & Arfon July 2016
Welsh Community Pharmacy Basics
716 community pharmacies
35 million patient visits each year
74 million prescriptions dispensed
96% of pharmacies have private consultation rooms
The Face & Voice of Community Pharmacies in Wales
Wyneb a llais o fferyllfeydd cymunedol yng Nghymru

3. Medicines Issues 30% - 50% of medicines not taken as intended
COMMUNITY PHARMACY: IN SUPPORT OF PRIMARY CARE CLUSTERS _ Anglesey & Arfon July 2016
Medicines Issues
30% - 50% of medicines not taken as intended
4%-5% of hospital admissions due to preventable adverse effects of medicines
Pharmacists as “experts in medicines”.
Pharmacist training is a 4 year Masters degree followed by a year of supervised pre-registration training and then a further exam before qualifying.
Pharmacists are required to undertake mandatory Continuing professional development throughout the careers and further accreditation requirements are needed to carry out Advanced Services (Medicine use Reviews and Discharge Medicine Reviews) plus some Enhanced services.
The Face & Voice of Community Pharmacies in Wales
Wyneb a llais o fferyllfeydd cymunedol yng Nghymru

4. Community Pharmacies Can Help
COMMUNITY PHARMACY: IN SUPPORT OF PRIMARY CARE CLUSTERS _ Anglesey & Arfon July 2016
Community Pharmacies Can Help
Helping People Live Healthier Lives
Supporting People to Self Care
Supporting People to live independently
Optimising use of medicines
The Face & Voice of Community Pharmacies in Wales
Wyneb a llais o fferyllfeydd cymunedol yng Nghymru

5. Medicines Optimisation
COMMUNITY PHARMACY: IN SUPPORT OF PRIMARY CARE CLUSTERS _ Anglesey & Arfon July 2016
Medicines Optimisation
Dispensing & Repeat Dispensing
Medicines Use Reviews
Hospital Discharge Medicines Service
Safe Disposal of Unwanted Medicines & Diabetic Sharps
Palliative Care “Just in Case” Boxes
Emergency Supply Services
Possible Future Services
Management of Chronic Conditions
Polypharmacy : STOPP/START
70% of Medicines use reviews are required to be in targeted groups, these include respiratory patients and additional services have been developed in some LHB areas (or this LHB area…… expand as required)
Existing services could be used better e.g. collaborative approach to refer patients for MUR who would benefit
The Face & Voice of Community Pharmacies in Wales
Wyneb a llais o fferyllfeydd cymunedol yng Nghymru

6. Supporting Patients to Self Care
COMMUNITY PHARMACY: IN SUPPORT OF PRIMARY CARE CLUSTERS _ Anglesey & Arfon July 2016
Supporting Patients to Self Care
Existing Services
Self Care Advice
Self Limiting Conditions
Long Term Conditions
Signposting to other healthcare providers (contractual obligation)
Over the Counter Sales
Future Services
Choose Pharmacy Common Ailments Service (roll out)
Triage & Treat Services
Further information about CAS and Triage and treat
The Face & Voice of Community Pharmacies in Wales
Wyneb a llais o fferyllfeydd cymunedol yng Nghymru

7. Supporting Independent Living
COMMUNITY PHARMACY: IN SUPPORT OF PRIMARY CARE CLUSTERS _ Anglesey & Arfon July 2016
Supporting Independent Living
NHS Repeat Dispensing Service & support for ordering repeat medicines
Provision of Multi-Compartment Compliance Aids & MAR Charts
Medicines Delivery Services (not contractual)
Signposting to Additional Resources & Support
Pharmacist responsible for undertaking assessment with patient in relation to compliance aids etc.
The Face & Voice of Community Pharmacies in Wales
Wyneb a llais o fferyllfeydd cymunedol yng Nghymru

8. Supporting People to Live Healthier Lives
COMMUNITY PHARMACY: IN SUPPORT OF PRIMARY CARE CLUSTERS _ Anglesey & Arfon July 2016
Supporting People to Live Healthier Lives
Healthy Lifestyle Advice
NHS Dispensing & MUR Services
Six Public Health Campaigns per year
Locally Commissioned NHS Services
Stop Smoking
Substance Misuse
Flu Vaccination
Emergency Contraception
Public health campaigns form part of community pharmacy contract – currently 3 are national campaigns with up to 3 organised by the LHBs – potentially in future the LHB campaigns could be done at cluster levels.
The Face & Voice of Community Pharmacies in Wales
Wyneb a llais o fferyllfeydd cymunedol yng Nghymru

9. Supporting People to Live Healthier Lives
COMMUNITY PHARMACY: IN SUPPORT OF PRIMARY CARE CLUSTERS _ Anglesey & Arfon July 2016
Supporting People to Live Healthier Lives
Possible Future Services
Health Checks
CV Screening
Dementia Screening
Diabetes Screening
COPD Screening
The Face & Voice of Community Pharmacies in Wales
Wyneb a llais o fferyllfeydd cymunedol yng Nghymru

10. The Local Position: North Wales
COMMUNITY PHARMACY: IN SUPPORT OF PRIMARY CARE CLUSTERS _ Anglesey & Arfon July 2016
The Local Position: North Wales
156 Community Pharmacies in North Wales
Consultation Rooms in 152
13 commissioned services available which could be further utilised to :
Take pressure off GP Services
Help Improve Health & Wellbeing across the Locality
Discussion about the specific primary care cluster presenting to.
The Face & Voice of Community Pharmacies in Wales
Wyneb a llais o fferyllfeydd cymunedol yng Nghymru

11. The Local Position: Anglesey & Arfon
COMMUNITY PHARMACY: IN SUPPORT OF PRIMARY CARE CLUSTERS _ Anglesey & Arfon July 2016
The Local Position: Anglesey & Arfon
13 Community Pharmacies in Anglesey
10 Community Pharmacies in Arfon
All have designated consultation rooms
13 commissioned services available which could be further utilised to :
Take pressure off GP Services
Help Improve Health & Wellbeing across the Locality
Discussion about the specific primary care cluster presenting to.
The Face & Voice of Community Pharmacies in Wales
Wyneb a llais o fferyllfeydd cymunedol yng Nghymru

12. The Local Position Existing NHS Services available in Anglesey & Arfon
COMMUNITY PHARMACY: IN SUPPORT OF PRIMARY CARE CLUSTERS _ Anglesey & Arfon July 2016
The Local Position
Existing NHS Services available in Anglesey & Arfon
Advanced Services
Medicines Use Reviews
Hospital Discharge Medicines Reviews
Enhanced Services
Smoking Cessation Level 3 Service
Palliative Care Services – 2 available
Needle & Syringe Exchange
Supervised Consumption
EHC
Flu Vaccination
Diabetic Sharps Boxes
Respiratory Service
Emergency Supply to Temporary Residents
Emergency OOH Supply Service
Common Ailments service
Rota services
Explanation of what is there currently – all funded by NHS.
Briefly touch on what the services are.
The Face & Voice of Community Pharmacies in Wales
Wyneb a llais o fferyllfeydd cymunedol yng Nghymru

13. The Local Position Priorities Priority:
COMMUNITY PHARMACY: IN SUPPORT OF PRIMARY CARE CLUSTERS _ Anglesey & Arfon July 2016
The Local Position
Priorities
Priority:
Smoking Cessation
Community Pharmacy could support by:
Smoking Cessation Level 3 Services in all pharmacies:
Active Referral to pharmacies
Smoking Cessation Level 2 Service commissioned in pharmacies
How community pharmacy could support the cluster on their identified priorities.
These were all cluster priorities stated by a cluster.
Other clusters – dementia, alcohol, obesity – all give potential for other options. Plus some clusters have serious difficulties with GP numbers so services that support GPs such as INR testing, Common ailments, triage and treat may be of interest
The Face & Voice of Community Pharmacies in Wales
Wyneb a llais o fferyllfeydd cymunedol yng Nghymru

14. The Local Position Priorities Priority:
COMMUNITY PHARMACY: IN SUPPORT OF PRIMARY CARE CLUSTERS _ Anglesey & Arfon July 2016
The Local Position
Priorities
Priority:
GP Capacity Issues
Community Pharmacy could support by:
Common Ailments service
Repeat Dispensing
Chronic Conditions Management
Better integration and understanding of priorities (QOF etc)
How community pharmacy could support the cluster on their identified priorities.
These were all cluster priorities stated by a cluster.
Other clusters – dementia, alcohol, obesity – all give potential for other options. Plus some clusters have serious difficulties with GP numbers so services that support GPs such as INR testing, Common ailments, triage and treat may be of interest
The Face & Voice of Community Pharmacies in Wales
Wyneb a llais o fferyllfeydd cymunedol yng Nghymru

15. The Local Position Priorities Priority:
COMMUNITY PHARMACY: IN SUPPORT OF PRIMARY CARE CLUSTERS _ Anglesey & Arfon July 2016
The Local Position
Priorities
Priority:
Palliative Care
Community Pharmacy could support by:
Just in Case Boxes
In hours palliative care service
How community pharmacy could support the cluster on their identified priorities.
These were all cluster priorities stated by a cluster.
Other clusters – dementia, alcohol, obesity – all give potential for other options. Plus some clusters have serious difficulties with GP numbers so services that support GPs such as INR testing, Common ailments, triage and treat may be of interest
The Face & Voice of Community Pharmacies in Wales
Wyneb a llais o fferyllfeydd cymunedol yng Nghymru

16. The Local Position Priorities Priority:
COMMUNITY PHARMACY: IN SUPPORT OF PRIMARY CARE CLUSTERS _ Anglesey & Arfon July 2016
The Local Position
Priorities
Priority:
Medicines Management topics
Community Pharmacy could support by:
Falls Prevention service
Polypharmacy
Respiratory Service
Domiciliary Support
AKI - MURs
How community pharmacy could support the cluster on their identified priorities.
These were all cluster priorities stated by a cluster.
Other clusters – dementia, alcohol, obesity – all give potential for other options. Plus some clusters have serious difficulties with GP numbers so services that support GPs such as INR testing, Common ailments, triage and treat may be of interest
The Face & Voice of Community Pharmacies in Wales
Wyneb a llais o fferyllfeydd cymunedol yng Nghymru

17. Unscheduled Care Priority: Community Pharmacy could support by:
COMMUNITY PHARMACY: IN SUPPORT OF PRIMARY CARE CLUSTERS _ Anglesey & Arfon July 2016
Unscheduled Care
Priority:
Patients attending A&E
Re-admittance to hospital
Pressure on Out of Hours
Community Pharmacy could support by:
Choose Well Promotion
Referral to pharmacies
Triage and Treat
Discharge Medicines Review
Chronic conditions Management
Emergency supply service
Temporary Resident service
Common Ailments Service
How community pharmacy could support the cluster on their identified priorities.
These were all cluster priorities stated by a cluster.
Other clusters – dementia, alcohol, obesity – all give potential for other options. Plus some clusters have serious difficulties with GP numbers so services that support GPs such as INR testing, Common ailments, triage and treat may be of interest
The Face & Voice of Community Pharmacies in Wales
Wyneb a llais o fferyllfeydd cymunedol yng Nghymru

18. Primary Care Pharmacists in GP Clusters
COMMUNITY PHARMACY: IN SUPPORT OF PRIMARY CARE CLUSTERS _ Anglesey & Arfon July 2016
Primary Care Pharmacists in GP Clusters
Employed Pharmacists Working in GP Practices and across cluster/ locality
Support Prescribing Initiatives
Community Pharmacies can support this work and reinforce patient messages
How can we work together to deliver improved patient outcomes?
Setting up regular dialogue between employed pharmacists and community pharmacists to develop integration and better relationships.
The Face & Voice of Community Pharmacies in Wales
Wyneb a llais o fferyllfeydd cymunedol yng Nghymru

19. COMMUNITY PHARMACY: IN SUPPORT OF PRIMARY CARE CLUSTERS _ Anglesey & Arfon July 2016
Next Steps ?
Community Pharmacy involvement in Locality / Cluster Teams – as well as LHB pharmacists
Identify areas where community pharmacy can support locality priorities - integrated working
The Face & Voice of Community Pharmacies in Wales
Wyneb a llais o fferyllfeydd cymunedol yng Nghymru