Tony Gravett MBE (Healthwatch Plymouth) delivered the ‘Pharmacy Patient Experience Report’ to the Committee, and highlighted the following points-

1)    Healthwatch had produced the report in response to a request for information from Public Health Plymouth, during the drafting of the Pharmaceutical Needs Assessment 2022-25;

2)    It had been surprising to note the high level of feedback received regarding Plymouth’s pharmacy services, in comparison to those in Devon and Torbay;

3)    Community pharmacy was increasingly alleviating pressure from General Practise and Emergency Department services however, ongoing staffing issues were limiting capacity and potential.

In response to question from the Committee, it was reported that-

4)    The report had been shared with the Public Heath teams in Devon, the Local Care Partnership Boards, the Devon Local Pharmaceutical Committee, and NHS Devon ICS;

5)    Healthwatch were aware of regular supply issues for certain medications however, this did not regularly feature in survey responses. Instead, responses had often highlighted prescription delays, or changes to medication dosage;

6)    Community pharmacy had significant potential to alleviate pressures on other health services, but required sufficient funding, staffing, and ongoing restructuring.

The Committee thanked Tony Gravett MBE, and-

1)    Agreed to note the report.

David Bearman and Sue Taylor Delivered the ‘Community Pharmacy Update Report’ to the Committee, and highlighted the following points-

1)    The Devon Local Pharmaceutical Committee represented all NHS community pharmacy contractors in the Devon area (224 Pharmacies);

2)    There were an estimated 1.6 million consultations provided by community pharmacies per day. Per week, pharmacies gave symptom advice to over 730,000 people, and advice about existing medical conditions to over 263,000 people. These informal consultations were estimated to save over 24 million GP appointments per year;

3)    The acuity of patient’s symptoms presenting at pharmacies for advice and treatment had risen during the Covid-19 pandemic;

4)    The current pharmacy contract (2019-24) was a ‘flat cash’ contract. This meant that pharmacies received the same funding each year, for the 5 year contract. Pharmacies were expected to expand their service provision each year, or would receive a reduction in funding. This had forced pharmacies to make efficiencies of 37-50% in order to manage the funding squeeze, inflationary pressures, and increasing demand for clinical services;

5)    Some pharmacies had outsourced prescriptions to central hubs in order to increase efficiency. This had often led to a reduction in staff numbers at local pharmacies;

6)    There was a national shortfall in pharmacists and technicians. The Southwest faced significant staffing challenges, with a very low uptake in pharmacy school applications, and no school of pharmacy in Plymouth. There were 400-500 pharmacist vacancies in the southwest, with around 91% of pharmacies experiencing staff shortages;

7)    There were increasing issues with medication stocks and supply. This had forced pharmacies to use additional staffing-hours to source medications, as well as consulting with GPs to substitute medications or alter dosages. This was consuming an estimated 5.3 hrs per pharmacy, per week.

8)    Pharmacies had experienced increased abuse and aggression towards staff, leading to difficulties recruiting and retaining staff. This had also led to additional costs of installing security measures; 

9)    There was a broad lack of public recognition towards the financial struggles of pharmacies, as well as ongoing recruitment and retention issues. In the past year, pharmacies in Devon had been open for 98% of their contracted hours, with temporary closures impacting only 2% of contracted time. This highlighted the importance and value of pharmacy services;

10)In comparison to the national average, Devon had one of the highest rates of pharmacy closures however, these trends were beginning to be reflected across the country;

11)Devon was one of the best performers for pharmacy services within their sole control. The New Medicines Service (NMS), Lateral Flow testing, blood pressure monitoring, and Ambulatory blood care monitoring were all performing above the national average. Furthermore, there had been 124,000 flu vaccinations delivered in Devon alone, last year;

12)Despite the challenges faced, there was significant potential for pharmacies to reduce inequality, improve prevention, and improve primary care access through the GP community pharmacy consultation service. Pharmacies were seeking to deliver better outcomes by expanding the New Medicines Service, and Discharge Medication Service, reducing the length of hospital stays, and likelihood of readmission. The utilisation of the electronic Repeat Dispensing Service also had potential to increase efficiency for pharmacy and general practise, reducing the demand for medication related GP appointments;

13)There were significant opportunities for efficiency and modernisation improvements in the future, with pharmacy commissioning transitioning from NHS England, to the Integrated Care Boards (ICB). This would bring potential to expand services, drive integration, and remodel pharmacy staffing.

In response to question from the Committee, it was reported that-

a)    There were 5-6 wholesalers that Devon pharmacies used for medications. Occasionally ‘out of stock issues’ effected all suppliers, leading to additional staff-hours spent sourcing alternative medications and consulting with GPs;

b)    The Devon Local Pharmaceutical Committee was working closely with Derriford Hospital to enhance the use of the Discharge Medicines Service. This had significant potential to reduce hospital-stays and provide patients with additional assistance with medications;

c)    The new commissioning service would enable pharmacies to remodel their business and service provision, providing enhanced management of workload to help alleviate staffing, demand and economic pressures;

d)    Work was ongoing between pharmacies in Devon, and the Bath Pharmaceutical School, to encourage students and graduates to pursue placements in the Southwest, thus helping to alleviate staffing pressures. The Southwest had faced significant challenges attracting pharmaceutical graduates from Bath, who tended to secure placements with acute trusts.

The committee thanked David Bearman and Sue Taylor for the report and-

1)    Agreed to note the report

2)    Agreed to request at a later date, a report from Derriford Hospital, regarding the effectiveness and ongoing expansion work of the Discharge Medicines Service.