Thank you, Deputy Presiding Officer. We all know about the crisis that is facing general practitioner recruitment, especially in rural areas. Just last week, we had reports in the media that not a single person had applied for a job vacancy to work as a GP in a Pembrokeshire surgery in the last nine months. There are plenty of further examples from my own constituency of posts being advertised and not being filled for years. I’m therefore delighted to introduce this short debate to highlight an innovative approach to the delivery of healthcare that is serving to alleviate pressure on GPs in my own constituency. It’s a very innovative proposal, which, as far as I can see, and as far as I am aware, is unique to Wales, and only in Llanidloes is this approach being taken. I hope the Cabinet Secretary will agree that what I’m about to say today will demonstrate a practice that could transform primary healthcare across Wales.

Results from my own health survey across Montgomeryshire last year indicated that while patients are generally pleased with their GP practice, there is specific concern about how long patients have to wait to receive an appointment. So, at the end of last month, I was delighted to sponsor an event for Assembly Members here in the Senedd, at which we heard from Dylan Jones, principal pharmacist at the Dudley Taylor pharmacy in Llanidloes, to learn more about how a new model of delivering healthcare has served to combat this issue, looking at workload pressures on GP practices, which are currently facing, of course, the GP crisis that we are aware of, and allowing consultations for minor self-limiting conditions to be effectively managed in community pharmacies, and increasing capacity also, of course, and reducing costs.

GP practices are experiencing an unprecedented increase in demand, and A&E services are also under severe pressure. Indeed, nine out of 10 GPs say that their workload has had an adverse impact on the quality of patient care, with four out of five GPs also concerned about the sustainability of their practice. So, given the difficulties associated with the recruitment of GPs and other practice-based healthcare professionals, I would suggest that continued investment in community pharmacist independent prescribers would represent a valuable use of NHS resources.

With the number of GPs decreasing and practices often run by locums, pharmacies are ideally placed, I would say, to take the pressure off GPs, who deal with 57 million consultations for minor self-limiting conditions every year across the UK, 18 million of which could be effectively managed in community pharmacies. Indeed, you have to wonder why some of these conditions are dealt with by the GP at all, with pharmacies being better placed to deal with sore throats, chest infections, ear disorders and so on. So, in association with the medical practice in Llanidloes, Dylan Jones and Dudley Taylor pharmacy in Llanidloes have pioneered an independent prescribing service, which has recently won UK-wide recognition at the prestigious C+D awards. It is important also to note that Dudley Taylor pharmacy, Powys Teaching Local Health Board and Dylan Jones took a big risk, and they should, I think, be congratulated for the commitment that they have shown in making this success a reality.

Supported by the health board, and the GP prescribing lead at the medical practice, Dr Raynsford, Dylan has qualified as an independent prescriber and the new independent prescribing service began at the pharmacy last December, enabling Dudley Taylor pharmacy to treat patients with acute illness within the pharmacy and reducing the need to visit a GP.

So, it is clear that close collaboration between all parties was key to get this service off the ground. As a prescribing lead at the medical practice in Llanidloes, Dr Raynsford has been integral to the trial, from the very beginning agreeing robust information sharing and referral protocols, which has also allowed the new service to secure access to GP health patient records from within the pharmacy. Communications between the pharmacy and the practice regarding availability and capacity is effective, and this close working relationship has delivered big improvements in patient care.

The service that the Dudley Taylor pharmacy and the medical practice are providing ensures that primary care treatment and advice is quickly available to local people from the community pharmacy on the high street, alleviating, of course, the pressure on GPs and providing a more convenient service for patients, and helping to provide a greater choice for patients, particularly as the pharmacy is able to offer a prescriber service on Saturday, when the GP practice is not open—a service that is highly valued by patients. Patients are directed to the most appropriate provider more quickly, reducing pressure on GPs and increasing GP availability for more appropriate patients, whilst boosting footfall, of course, and supporting the viability of local pharmacies.

The new service in Llanidloes has also resulted in a sustained reduction in the number of patients using emergency appointments at the GP practice. On average, there has been a 23 per cent reduction in GP appointments compared with the same period the year before, and when considering the impact that the service has had on the GP workload, and the pressure at the practice, Dr Raynsford believes that evening surgeries in particular have been much less busy as a result. This has allowed the practice to consider extending the number or increasing the duration of routine appointments, and also allocating more time to providing care outside of surgery, such as home visits to palliative patients, for example. So, by offering patients an alternative to a traditional GP appointment, the evidence suggests that the pharmacy service facilitates a more appropriate use of GP time and allows for a greater focus on patients with complex care needs. In this regard, Dr Raynsford believes that the pharmacy service has been unequivocally successful in meeting its initial objectives, and represents one of the most important primary care service developments of recent years. Feedback from patients has also resulted in universal satisfaction with the service and the quality of care they have received. All respondents indicated that they would recommend the service to a family member, and the pharmacy has also had feedback from patients that has also been very positive, saying that it makes a real difference to them as patients.

The figures also speak for themselves. Ninety per cent of patients have effectively considered or already made an appointment at the GP practice, and 65 per cent would have made an appointment at the GP practice if the pharmacy service was not available. The service is now considered an integral part of the local primary care service in Llanidloes, and is highly valued by the local community. The new service has also impacted on patients’ perception of pharmacy services, with an increasing positive relationship proving to be professionally rewarding.

As a result of the success in Llanidloes, I would ask the Cabinet Secretary whether he would join me on a visit to both the pharmacy and GP practice to see and hear first-hand about the service, to see whether it would be possible to develop this model further, to provide the same accessibility, but also for a greater range of ailments, in a way that truly integrates the GP practices to offer more accessible treatment, care and advice.

However, for all the new initiatives to be a success, a commitment will be required from central Government on whether you and your department will financially support our community pharmacists to pursue additional training to become independent prescribers. Given that the community benefits extend beyond the pharmacy, I would be interested in hearing from the Cabinet Secretary about whether he feels that there is potential for this kind of service to be allocated from a separate pot of money via the primary care innovation fund, so that the benefits are not limited by the size of an individual pharmacy budget, and also so that the new service isn’t top-sliced from existing pharmacy or GP budgets.

Deputy Presiding Officer, in conclusion, I firmly believe that this has the potential to pay for itself over and over again, and it would transform the way in which healthcare is delivered, particularly in rural areas. Delivering cost-effective, high-quality healthcare for the most appropriate provider will benefit the whole NHS, and I look forward to hearing your views on this, Cabinet Secretary, and the potential for rolling this out across Wales.