Pharmacy: Delivering a Healthier Wales

2025 Goals

Foreword

Enhancing Patient Experience
Developing the Pharmacy Workforce
Seamless Pharmaceutical Care
Harnessing Innovation and Technology

Foreword

Pharmacy: Delivering a Healthier Wales (P:DaHW) is the pharmacy professions’ 10 year vision, showcasing how pharmacy will contribute to maximising the health and wellbeing of citizens in Wales.

Following the initial publication of the vision for pharmacy in 2019, the world was changed in ways that were difficult to envisage before the Covid-19 pandemic began in March 2020. The dedicated work of the profession against a backdrop of uncertainty and fear has been truly inspirational. Despite the pandemic and in the face of adversity, a great deal has been achieved in delivering change for pharmaceutical care in Wales as a direct result of the vision. We are now embarking on the next important phase for P:DaHW which will play a key role in delivering patient care as the health service looks to recover from the impact of the pandemic.

A Healthier Wales,² the Welsh Government’s long-term vision for health and social care, the vision to date, has set out long term goals (2030 goals) and principles, and short-term building blocks (2022 goals) required to transform the role and contribution of pharmacy teams across Wales.

Welsh Government supported the creation of the P:DaHW Delivery Programme Board, consisting of frontline pharmacy professionals, to facilitate and coordinate the implementation of the vision in delivering the goals outlined.

This document sets out the 2025 goals, which are further stepping stones in our ambitions to reach the 2030 aspirations articulated in the vision. As with the overarching vision, these goals have been developed through collaboration with hundreds of pharmacy professionals across Wales, wider members of the pharmacy team, other health and social care professions and patient representative groups.

P:DaHW focuses on four key themes: Enhancing Patient Experience, Seamless Pharmaceutical Care, Harnessing Innovation and Technology, and Developing the Pharmacy Workforce. The vision is focused on ensuring patients receive innovative and high quality pharmaceutical care in the most appropriate setting.

The 2025 goals continue with the overarching aim of breaking down boundaries between care settings to ensure patients benefit from the expertise of the pharmacy team wherever and whenever they need it. The aim is that patients will experience seamless care as they move between care settings, and pharmacy teams will lead on the medicines’ aspects of transitions in care.

Pharmacy will offer more dynamic, progressive and varied career pathways; many pharmacy professionals are now actively seeking a portfolio career, working across different settings. By 2030, a core generalist role for both pharmacists and pharmacy technicians will be developed to enable this flexible portfolio working.

This 2025 goal document illustrates a collaborative, innovative and progressive approach to the delivery of pharmaceutical care through which we will maximise the impact of pharmacy teams to meet the needs of the health service and the people in Wales now and for future generations.

¹https://www.rpharms.com/Portals/0/RPS%20document%20library/Open%20access/Policy/Pharmacy%20Vision%20English.pdf?ver=2019-05-21-152234-477

²https://gov.wales/sites/default/files/publications/2021-09/a-healthier-wales-our-plan-for-health-and-social-care.pdf

1 Enhancing Patient Experience

Putting patients at the centre of their care has remained a key focal point of P:DaHW since its publication in 2019. The ambition to shape pharmaceutical care by harnessing the skills of the pharmacy team, expanding professional collaboration and increasing efficiencies in patient access to pharmacy services across all settings continues to be the core components of the pharmacy vision. Wrapping services seamlessly around patients and meeting patient need effectively in the most appropriate setting is where pharmacy services continue to be headed in Wales.

Despite the challenges facing the NHS from the Covid-19 pandemic, significant progress has been made in implementing the P:DaHW goals set for 2022.

Changes to the Community Pharmacy Contractual Framework ¹, introduced in April 2022, have laid important foundations for increasing the number of clinical services available to patients in their localities. Increasing numbers of Pharmacist Independent Prescribers will continue to be available in community pharmacies across Wales to deliver enhanced services that build on the already well establish Common Ailment Service (CAS) and offer support for a wider range of health conditions.

Utilising the skills and the increasing numbers of Pharmacist Independent Prescribers will benefit patients in hospital settings, contributing to the skill mix of the wider multi-disciplinary team and offering expertise in medicines. Plans for training a new cohort of Pharmacist Independent Prescribers have been put in place by Health Education Improvement Wales (HEIW) and £4.2million of funding has been secured from the Welsh Government to train Pharmacist Independent Prescribers year on year.

As part of plans for the next three years, patients will benefit from a considerable expansion of pharmacy services building upon developments since the publication of P:DaHW. The skill mix of pharmacy teams will be transformed, allowing pharmacy technicians to undertake more patient facing roles, supporting wider public health, advising on self-care and contributing to healthy living conversations and the important illness prevention agenda.

Medicines reviews will be available through pharmacists based in GP practices, signposting to other services will be available with digital innovations supporting patients to order their medicines, as well as understanding more about what services are available. All members of the pharmacy team will have responsibilities to support patients in terms of digital and health literacy as well as making decisions jointly with patients.

By the end of 2025, patients will benefit from increased support from the pharmacy team in key clinical priority areas. New pharmacy standards to support palliative and end of life care will be in place and actively supported by the pharmacy team across Wales. A network of mental health First Aiders will also be developed across Wales, equipping the pharmacy team with the tools, understanding and confidence to deal with mental ill-health and wellbeing issues.

Patients will experience a more seamless process as they transfer between health care settings by the end of 2025. Hospital discharges will ensure the safe efficient transfer of patient information between hospital pharmacy teams and community pharmacies. Steps will be taken to build on the successful Discharge Medicines Review Service with better connectivity and processes between hospital and community will be put in place on discharge to reduce the need for dispensing the patient’s established, routine medicines.

P:DaHW will continue to be taken forward by focusing on the wider determinants of health, ensuring effective collaboration with organisations outside of pharmacy that impact on health and wellbeing. Steps to break down cultural and language barriers will be taken across the pharmacy team, ensuring patient’s experience inclusion during their interactions with pharmacy services, wherever they are accessed in Wales. The commitment to the ambitions of the Wellbeing of Future Generations (Wales) Act 2015 will ensure pharmacy can play its part in improving social, cultural, environmental and economic wellbeing of the public, now and for future generations.

2025 goals

By 2025 we will:

Goal 1: Support pharmacy teams to make every contact with a patient count

ACTIVITY We will achieve this by:	MEASURE Examples may include:
1.1 Collaborating on a public facing campaign to help the citizens of Wales understand the evolving roles of pharmacy teams and the services provided in each care setting.	A public facing campaign highlighting pharmacy services across all settings, delivered and evaluated.
1.2 Building on services available through pharmacy ensuring patients are aware of the services they can access.	Measure and evaluate uptake of community pharmacy services to embed and grow services consistently throughout Wales. Increase in medicines reviews undertaken by pharmacists within GP practices across Wales. Signposting of pharmacy services through the NHS App and evaluating uptake. Sharing of best practice across Primary Care Clusters throughout Wales.
1.3 Empowering Pharmacy Technicians to make every patient contact count including support for self-care and healthy living.	Number of services available and delivered by pharmacy technicians through the choose pharmacy platform e.g. DMR service.
1.4 Growing and championing pharmacy’s role in urgent and emergency care, highlighting the opportunities for the public to gain advice through NHS111 for example.	Inclusion of pharmacy in the development of urgent and emergency care workforce models. Number of patient engagements with pharmacists working within NHS111. Increased number of pharmacy team members supporting Accident and Emergency Departments and Urgent Primary Care hubs, contributing to the delivery of Right care, right place, first time: Six Goals for Urgent and Emergency Care ²

Goal 2: Deliver services that focus on the needs of the individual, tackling health inequalities and ensuring a sustainable health care service for today’s citizens as well as for future generations

ACTIVITY We will achieve this by:	MEASURE Examples may include:
2.1 Engaging pharmacy teams in national and local initiatives to ensure the delivery of more environmentally sustainable services across Wales.	Secondary care teams working to reduce the impact of anaesthetic gases in their hospitals or teams engaging with Green Health or One Health initiatives. Evaluating how pharmacy teams have made active changes to their practice to be more environmentally responsible e.g registering with the All Wales Greener Primary Care Framework and Award Scheme.
2.2 Supporting health literacy and digital health literacy by developing a suite of resources to equip the pharmacy team with the skills and confidence to support individuals to understand more about their medicines, health and wellbeing.	Pharmacy teams are included in the roll out of the digital capability framework for the healthcare workforce. Appropriate pharmacy team members have access to and undertake health literacy training to support patients. Pharmacy teams regularly signpost patients and ensuring they can access relevant tools including easy read and digital versions where available, reducing the use of paper copies to help reduce our environmental impact.
2.3 Making pharmacy teams inclusive, increasing understanding of diversity and equipping every pharmacy team with the skills and knowledge to overcome language and cultural barriers	Commitment by pharmacy teams to Equality, Diversity and Inclusion (EDI) campaigns including the HEIW Pharmacy Cultural Awareness Campaign. Access to and use of a basic courtesy level Welsh language learning module by the pharmacy profession. Increase in the awareness and use of NHS commissioned translation services i.e. Language Line /Wales Interpretation and Translation Service by pharmacy teams. Use of RPS EDI resources and membership of the RPS Action in Belonging, Culture and Diversity (ABCD) Group.

Goal 3: Enhance patient experience in national clinical priority areas, ensuring pharmacy services are focused on improving outcomes

ACTIVITY We will achieve this by:	MEASURE Examples may include:
3.1 Establishing and implementing pharmacy professional standards in palliative and end of life care to deliver a consistent, evidence-based and quality-driven approach to end of life and bereavement care for patients and carers	All community pharmacies initiating the application of national professional standards in palliative and end of life care to their practice. A palliative care pharmacy lead will in post in every Health Board area supported by collaborative working arrangements that enable the delivery of consistent, high quality care, utilising expertise and support across HB and regional boundaries.
3.2 Creating a network of mental health First Aiders across Wales and equipping the pharmacy team with the tools, understanding and confidence to deal with mental ill-health and wellbeing issues.	50% of pharmacy team members with general awareness of mental health first aid through completion of level 1 HEIW training. Every pharmacy team has at least one member of the team that have been supported to undertaken advanced mental health first aid training by completion of level 2 HEIW training. Wellbeing support is freely available for all members of the pharmacy team, supporting delivery of the Welsh Government’s Mental Health Delivery Plan.
3.3 Integrating the pharmacy team into clinical pathways for HIV to support individuals in all settings, including a focus on prevention.	HIV/Blood Borne Virus (BBV) lead in each HB area, working across primary and secondary care. Delivery of PREP to be commissioned via community pharmacies. Supporting delivery of the All Wales HIV Action Plan.

Goal 4: Strengthen the research and quality improvement practice of all pharmacy professionals, ensuring a focus on patient outcomes

ACTIVITY We will achieve this by:	MEASURE Examples may include:
4.1 Refreshing the Pharmacy Research Wales strategic plan to provide a framework for step change improvement in research to benefit the people of Wales.	Pharmacy research Wales leads the evaluation of the five-year strategic action plan for research in pharmacy and formulates a forward looking research and quality improvement plan for pharmacy professionals in Wales.
4.2 Encouraging pharmacy professionals to step into research focused on improving patient outcomes as part of routine practice and enhancing the contribution of practice research to service innovation.	100% of Pharmacy professionals have completed Quality Improvement Foundation training e.g. HEIW e-learning module or equivalent. 20% of the Pharmacy professionals in Wales have undertaken more advanced research training e.g. RPS NIHR research package, University led research module, etc. Engagement of the pharmacy profession with the new Health and Care Research Wales Faculty.
4.3 Increasing research collaboration between academia and frontline pharmacy professionals.	20% of clinical pharmacy undergraduate projects have practitioner involvement. A forum established to facilitate academic and practitioner national research collaborations.
4.4 Further embedding research into the career pathways of pharmacy professionals.	Formal mechanisms put in pace to collate and share best practice developed across Wales.

¹ https://gov.wales/sites/default/files/publications/2021-12/a-new-prescription-the-future-of-community-pharmacy-in-wales.pdf

² https://gov.wales/sites/default/files/publications/2022-09/six-goals-for-urgent-and-emergency-care_1.pdf

2 Developing the Pharmacy Workforce

As we look to develop the workforce to 2030 and beyond, we are cognisant of the impact of that the Covid-19 pandemic has had. The acknowledgement of the strain this has put on the profession is recognised, and learnings from the pandemic has helped reinforce and underpin our core belief in the importance of the wellbeing of the workforce. Access to wellbeing tools and active sessions, alongside continued support networks for Pharmacy teams, will be the fundamental core at the heart of a healthy and vibrant workforce.

As we reflect on the milestones of our 2022 goals, enormous progress has been made. HEIW, with the support and commitment of the profession and employers across all settings, have led significant change to facilitate the education and training of Pharmacists, following the publication of the updated Initial Education and Training standards for pharmacists.

Foundation Pharmacist training has seen great reforms. As of August 2022, all Foundation Trainee Pharmacist positions across Wales are multi-sector. The HEIW post-registration foundation pharmacist training programme, through implementation of the RPS post-registration foundation pharmacist curriculum, provides a continuum of practice for new registrants early in their career including the achievement of independent prescriber status.

Significant additional funding to support undergraduate placements in Wales has been secured. This will increase the number of placement weeks within the MPharm degree and ensure student pharmacists are able to meet the new standards, with HEIW ensuring the quality of these placements. The support and commitment of the pharmacy practice network and employers for such placements is vital and not underestimated, contributing significantly to the training and development of the workforce for the future. These collective commitments ensure Wales is the place to ‘Train, Work and Live’.

Pharmacy technicians will have the opportunity to train across three pharmacy settings for the first time. HEIW’s modern apprenticeship Pre-Registration Pharmacy Technician Training Programme equips trainees with multisector experience, leading to a more sustainable and flexible workforce who understand the patient journey across healthcare settings.

Nearly 30% of pharmacists in Wales are now prescribers, with more currently undergoing training and from 2026 all new registrants will be able and will expect to prescribe as part of their professional practise. Pharmacy technicians will continue to take on more responsibilities, with the training and development of the whole pharmacy team essential to ensure the right skill mix for the benefit of patients and the public.

With patient populations requiring more complex care, delivered seamlessly by multi-professional teams across care settings, consultant pharmacists are becoming increasingly important to provide leadership as well as senior clinical expertise in delivering care and driving change across the healthcare system. Further strategic development of consultant pharmacist posts will help to create the leadership required across Wales.

Leadership will not only be provided by those in senior posts, but through fostering a culture of leadership embedded at all levels. Integrated ways of working are supported and delivery of multidisciplinary training opportunities will continue across settings. A culture of learning and supporting others will be nurtured with the normalisation of protected learning time embedded.

Strategic leadership for pharmacy in Wales will be further enhanced through workforce intelligence and planning. Education, research, training and development will be driven and transformed to ensure that the profession has the skills necessary and is aligned to delivering the Welsh Government’s long-term vision for health and social care in Wales, A healthier Wales.

2025 GOALS

By 2025 we will:

Goal 5: Create an engaging work culture where leadership is empowered at all levels, wellbeing is prioritised, and supporting each other in learning and development becomes the norm

ACTIVITY We will achieve this by:	MEASURE Examples may include:
5.1 Encouraging all pharmacy employers to support access to non-clinical training, including leadership courses and active wellbeing sessions.	Increased number of pharmacy team members accessing courses through accredited providers or their employers.
5.2 Adopting a formalised career pathway for the profession as set out by the RPS and HEIW which actively encourages leadership as well as clinical and research development.	30% of pharmacists on their credentialing journey, post-registration foundation, advanced or consultant.
5.3 Creating an aligned approach to 5.2 for pharmacy technicians.	Formalised career pathway established for pharmacy technicians including exposure to all relevant pharmacy settings.
5.4 Ensure flexibility to train and time to train and mentor others are embedded in workplans and are protected activities.	Adoption of principles of protected learning time by pharmacy employers. Increase in number of pharmacy professionals engaging in formalised mentorship.

Goal 6: Increase the understanding of pharmacy practice in all settings for early career pharmacy professionals through a multi-sector approach

ACTIVITY We will achieve this by:	MEASURE Examples may include:
6.1 Providing all post-registration foundation pharmacists and pharmacy technicians with opportunities to develop their understanding of all pharmacy settings, shaping their early career and providing support for developing their advanced practice.	Collaborative working models led by employers for foundation pharmacists and pharmacy technicians. Trainee pharmacist places to meet workforce challenges and patient demand.
6.2 Defining, piloting and implementing entrustable professional activities to facilitate the consistent transfer of standards of practice between pharmacy settings.	Entrustable professional activities developed, piloted and implemented.
6.3 Increasing the exposure of undergraduate pharmacy students and pharmacy technicians in training to practice across all pharmacy settings.	Implementation of a clinical placement plan for undergraduate pharmacy students across all pharmacy settings.

Goal 7: Enhance services available to patients by increasing capability and consistency of skills within pharmacy teams

ACTIVITY We will achieve this by:	MEASURE Examples may include:
7.1 Expanding the services provided by pharmacy technicians as part of multi-disciplinary teams in all settings.	Inclusion of pharmacy technicians in current and new services.
7.2 Encouraging skill mix to meet patient need. This will be achieved through a clear recruitment strategy designed to increase the number of pharmacy professionals as well as the non-registered team members as required by workforce planning forecasts. Pharmacy must be considered as part of the wider multidisciplinary team in this work.	Workforce data will be available across all pharmacy settings and in every locality across Wales. Every pharmacy team in Wales will have a plan to ensure a pharmacy technician is in post by 2025 with opportunities for advanced practice clinical pharmacy technicians available. Training opportunities are made available to all pharmacy team members including non-registered pharmacy staff for delivery and expansion of their roles.
7.3 Ensuring all pharmacy professionals (employed and self-employed) committed to working in Wales are supported to access education and training and are capable of providing continuity of services for patients in Wales.	Adoption of a Charter for Pharmacy Professionals in Wales to ensure a consistent commitment to pharmacy practice by all pharmacy teams working in Wales.

Goal 8: Establish a network of consultant pharmacists to provide leadership on clinical priority areas in Wales

ACTIVITY We will achieve this by:	MEASURE Examples may include:
8.1 Introducing new consultant pharmacist positions to drive innovation and quality improvements across all pharmacy settings in response to local need and national priorities.	25 consultant pharmacists in post by 2025 working across all pharmacy settings. Areas of clinical practice will include general medicine, sexual health, substance misuse, pharmacogenomics, mental health, palliative care and pain.
8.2 Establishing support for pharmacists aspiring to become consultant-ready pharmacists through RPS credentialing.	60 pharmacists will have achieved or being working towards consultant ready status.
8.3 Utilising the expertise of consultants for patient outcomes across all sectors and developing the evidence base around the impact of consultant pharmacists on patient care and the MDT.	Areas of best practice identified and shared.

3 Seamless Pharmaceutical Care

We continue to strive for patients to experience a superior and more coherent journey as they transition across all areas of health and social care. Pharmacy teams will be integral components of a multi-disciplinary team approach, leading on medicines discharge and working across pharmacy settings.

Clinical pharmacy skills are in high demand throughout the NHS. The knowledge and skills of pharmacy professionals are central to optimising medicines use to create better outcomes for patients and making best use of resources to protect our NHS.

Through research, development and technological innovation, pharmacy teams will be at the forefront of the preparation and delivery of life-saving medicines in specialist technical services, as part of the NHS Wales programme, Transforming Access to Medicines, announced in March 2021.

Presgripsiwn Newydd, A New Prescription ¹, realises an exciting direction of travel and opportunities for community pharmacy. With a notable emphasis on clinical service delivery within local communities and a funded Pharmacist Independent Prescriber service, pharmacy teams can provide more patient care and support without the need for referral.

The establishment of the community pharmacy collaborative lead role has provided leadership and representation for pharmacies within primary care clusters and led the way for other professional collaboratives for follow. This effective collaboration with other health and social care providers aligns with the transformation and vision for clusters as part of the Strategic Programme for Primary Care², and ensures services developed to meet the needs of patients are local, convenient, and of consistent high quality.

The NHS 111 Wales service has been rolled out to all seven health board areas in Wales with pharmacy expertise integral to the service. Through accessing the website or dedicated helpline, medical advice and information is available to ensure patients access the correct service and healthcare professional. These significant developments delivered by the profession, aligns with Welsh Governments long term plan for more services to be provided closer to home, with people only going into hospital for treatment that cannot be provided safely elsewhere.

Building on and fully utilising the skills of pharmacist independent prescribers, referral pathways will be efficient and robust with patients accessing the right service from the right professional. A formulated direct referral pathway into pharmacy services will be established and pharmacist independent prescribers will have the tools to initiate requests for diagnostic testing and investigation.

2025 GOALS

By 2025 we will:

Goal 9: Increase patient access to pharmacist independent prescribers, ensuring the expertise of PIPs are fully utilised across all care settings

ACTIVITY We will achieve this by:	MEASURE Examples may include:
9.1 Increasing the number and capacity of pharmacist Designated Prescribing Practitioners by ensuring all PIPs can contribute to another’s prescribing journey.	25 PIPs each year from all pharmacy settings undertaking training through an RPS and HEIW partnership to increase confidence and capability in becoming a DPP.
9.2 Establishing a clear structure for how PIPs will be working post-graduation in all pharmacy settings, increasing access and adding value to patient care.	A clear model put in place that includes support with time to train and mentorship.
9.3 Establishing clear models for how patient care will benefit from PIPs and ensuring all pharmacists in patient facing roles are PIPs.	Models of best practice collated and shared.
9.4 Supporting more consistent access to community PIP services for patients.	50% of community pharmacies offer the PIP service for at least 50% of the time.

Goal 10: Minimise the use of medicines and minimise the risk of medication related harm for scheduled care as patients transfer between care settings

ACTIVITY We will achieve this by:	MEASURE Examples may include:
10. 1 Utilising the evidence of pharmacy technician-led initiatives to reform medicines admission services for planned hospital care.	Establishing examples of good practice.
10.2 Establishing better connectivity and processes between hospital and community on discharge to reduce the need for dispensing the patient’s established, routine medicines.	Positive trend in uptake and delivery of the DMR service.
10.3 Ensuring all hospitals can initiate a discharge medication review service digitally for individuals who are eligible.	E-discharge advice letters available from all hospitals in Wales, for all hospital admissions where medication changes have been made and accessible via the Choose Pharmacy platform.

Goal 11: Establish direct referral systems to and from pharmacy services, improving efficiencies in service delivery

ACTIVITY We will achieve this by:	MEASURE Examples may include:
11.1 Mapping existing referral pathways to determine where patient benefit can be achieved from the integration of pharmacy service.	A clear map for referral pathways to and from pharmacy services established.
11.2 Strengthening care navigation pathways at primary care cluster levels to increase collaboration and coordinated care between pharmacy professionals, other professions, and between primary, secondary and social care.	Pharmacists and pharmacy technicians are part of formal referral pathways and referral processes at primary care cluster levels.
11.3 Enhancing social prescribing and signposting approaches led and coordinated by pharmacy technicians and supported by all members of the pharmacy team.	Pharmacy teams included in social prescribing pathways.
11.4 Establishing a pharmacy diagnostic referral service, with pharmacist independent prescribers leading on requests for diagnostic testing and investigation.	At least 1 pilot pharmacy diagnostic testing referral service is completed and fully evaluated.

Goal 12: Continue Transforming Access to Medicines (TRAMS) to the most innovative and life-saving medicines including cancer therapies, intravenous antibiotics and parenteral nutrition for patients in Wales

ACTIVITY We will achieve this by:	MEASURE Examples may include:
12. 1 Robust workforce planning that invests in people to ensures a pipeline of pharmacy team members that have the opportunity to experience and develop expertise in technical services.	Number of pharmacy professionals who have undertaken training in technical services.
12.2 Creating opportunities for collaborations between the NHS and universities supporting clinical trials and research into the development of innovative products that allow medicines to be given at or closer to people’s homes, rather than in hospital.	Number of collaborative projects recorded and outcomes shared and actioned.
12.3 Closer collaboration between pharmacy services in hospital, community and primary care to ensure patients benefit from locally provided services for the most specialist treatments.	Examples of collaboration identified and shared.

¹ https://gov.wales/sites/default/files/publications/2021-12/a-new-prescription-the-future-of-community-pharmacy-in-wales.pdf

² https://primarycareone.nhs.wales/topics1/strategic-programme/

4 Harnessing Innovation and Technology

The need to embrace, embed and fully utilise technology will be realised, ensuring the best outcomes for the citizens of Wales.

During the pandemic, technology was quickly implemented to facilitate ease of interaction between patients and practitioners, with video consultations being made available routinely for pharmacy in community and primary care.

The Digital Medicines Transformation Portfolio, established by Digital Health and Care Wales, brings together the programmes and projects that will deliver the benefits of a fully digital prescribing approach in all care settings in Wales.

By 2026 this comprehensive and robust digital platform will be embedded, connecting primary, community and secondary care. The plan for transformation in prescribing will also ensure a medicines data repository is put in place to support clinical and prescribing decisions.

Electronic transfer of prescriptions and secure access to patient medication information will increase convenience, reduce prescription and administration errors and ensuring more timely supply of medicines at all points where medicines are dispensed. The plans for e-prescribing also aim to put patients in greater control of their medication through electronic applications.

Implementation of Electronic Prescribing and Medicines Administration (EPMA) systems has begun in the managed sector in Wales. EPMA is a major health system change with potential to benefit patient safety across our hospitals, and improve prescribing governance. Whilst the impacts will be across many professions, effective stewardship will be led by the Pharmacy profession in partnership with others.

Electronic prescribing solutions, automation, and digitally enhanced ways for patients to order routine medicines will be embedded in practice, creating efficiency within services and time for pharmacy teams away from administrative tasks to deliver patient-centred care.

Advances in therapeutics continue apace and this includes advanced therapy medicinal products as well as precision medicine. Pharmacists will play a leading role in advancing the pharmacogenomics revolution, allowing a personalised approach to prescribing and transforming patient outcomes. From system leadership to implementation of services, pharmacists can tailor and personalise the prescribing of medicines based on genetic information.

PGx is already benefitting patients in Wales, for example in the routine screening of all cancer patients eligible for treatment with a specific chemotherapy (fluoropyrimidine-based). The testing identifies the risk of experiencing severe side effects and enabling appropriate dose modifications or drug selection to improve patient safety.

International evidence demonstrates diverse opportunities for pharmacists in PGx across all settings of pharmacy. The potential benefits for patients are vast and include reduced medication related harm, ensuring they receive the most suitable treatment from the start, with faster and improved therapeutic response.

Through sharing innovative and best practice aligned to Welsh Government's innovation strategy for Wales, patient benefits and health outcomes will be maximised.

2025 Goals

By 2025 we will:

Goal 13: Implement electronic prescribing solutions across all pharmacy settings, including supporting patients to access pharmacy services through the NHS Wales app

ACTIVITY
We will achieve this by:

MEASURE
Examples may include:

13.1 Contributing to the development of the following Welsh Government programmes to ensure the systems built are fit-for purpose:

Secondary Care electronic prescribing and medicines administration (ePMA) Programme
Primary Care Electronic Prescription Service (EPS)
Shared Medicines Record Project
Digital Services for Patients and Public Programme i.e. NHS Wales App.

Community pharmacies are able to receive electronic prescriptions from GP practices.

Electronic prescribing and medicines administration systems are in use in hospitals across Wales.

Pharmacists and Pharmacy Technicians are able to access patients’ medication records in both primary and secondary care systems.

Patients are able to access their medicines records via the NHS Wales app, which also provides functionality to support medication adherence.

13.2 Engaging with DHCW to provide pharmacy teams with training to help them support patients in using the NHS Wales app.

Creating a suite of materials that demonstrates how the app works.

Goal 14: Medication related incidents are reported and actioned to improve patient safety

ACTIVITY We will achieve this by:	MEASURE Examples may include:
14.1 Improving the quality of pharmaceutical care by improving the culture of openness, transparency and candour within the pharmacy profession in Wales through improved reporting and learning from medication errors in all sectors.	Medication related incidents across all care settings are reported into a central repository.
14.2 Continuing to identify the most commonly reported medicines related incidents.	Action taken to improve outcomes on the most commonly reported incidents, sharing learning across Wales to prevent such incidents.
14.3 Reduce medicines related harm in hospitals by reducing the preparation of high risk medicines on wards.	Use of ready to administer preparations produced by the CIVAS unit across Wales.
14.4 Developing a proactive medicines and patient safety plan through the Medicines Safety Officers Network.	Plan developed and in place across Wales.

Goal 15: Increase capacity for pharmacy professionals to spend on patient facing activity by introducing efficiencies in the dispensing of medicines

ACTIVITY We will achieve this by:	MEASURE Examples may include:
15.1 Implementing new models that reduce the time spent on dispensing activities in pharmacy settings.	Increase in the number of CPs receiving 56 day or more prescriptions or batch prescriptions. A completely Automated dispensing system within hospital piloted in one health board area.
15.2 Implementing digital systems to help prioritise patients that will benefit most from input from the pharmacy team.	Implementing systems that help to prioritise patients that need the most medicines expertise e.g. highlight complex medicines requiring calculated dose / narrow therapeutic index / additional monitoring.
15.3 Supporting patients to order their medication through digital apps and innovative technologies to increase flexibility and empower patients to take greater control of their routine medicines supply.	Measurement of the number of patients ordering medicines via the NHS Wales app.

Goal 16: Embed elements of a medicines genomic plan into pharmacy practice

ACTIVITY We will achieve this by:	MEASURE Examples may include:
16. 1 Establishing an agreed pharmacogenomic panel service across Wales.	Service agreed and established across pharmacy settings.
16.2 Introducing medicines related genomic awareness training for the pharmacy team relevant to their practice.	20% of the pharmacy workforce have undertaken basic training about the fundamentals of pharmacogenomics e.g. attending RPS / HEIW webinars.
16.3 Embedding a competency framework for genomics in pharmacy practice.	Framework available and being utilised by a pharmacy genomic champions network.
16.4 Driving service change by establishing a workforce structure that can champion pharmacy’s role in genomics.	A consultant pharmacist in genomics in post to advise on practice and lead quality improvement at local and national levels. Creation of pharmacy genomics champion roles across Wales.