The next item is the Welsh Conservatives debate on supporting pharmacists. I call on Russell George to move the motion.

Motion NDM7971 Darren Millar

To propose that the Senedd:

1. Recognises the vital work pharmacists have undertaken throughout the pandemic, as well as their crucial role in supporting primary and secondary care. 

2. Welcomes the new National Clinical Community Pharmacy Service coming into force on 1 April 2022.

3. Is concerned by results from the Royal Pharmaceutical Society’s 2021 Workforce Wellbeing Survey, which shows that nine out of 10 respondents were at high risk of burnout and one in three had considered leaving the profession altogether.

4. Calls on the Welsh Government to:

a) urgently reduce bureaucracy by introducing e-prescriptions and providing access to medical records;

b) ensure dedicated protected learning time within working hours for wellbeing and study; 

c) invest in the pharmacy workforce to train more pharmacy staff and upskill existing staff.

Motion moved.

Diolch, Deputy Presiding Officer. I move the motion today, tabled in the name of my colleague Darren Millar.

Throughout the pandemic, we have rightly, of course, praised our key workers, haven't we, and our NHS staff for their response to COVID-19. But I don't feel that we have all championed the role of pharmacists enough, which is why I'm very proud today to lead this debate highlighting the important role that pharmacists have played throughout the pandemic and to ask the Welsh Government to go a little further in areas relating to pharmacy. Pharmacies deserve thanks for the crucial role that they have played, of course, during the pandemic, supporting primary and secondary care. They have supported the national roll-out, haven't they, of the COVID-19 vaccine, helping to get those jabs into the arms of people across Wales, so that we can get back to a degree of normality, following on from the pandemic.

And the role of pharmacists is not just, of course, limited to handing over prescriptions. We all know that, I think, hopefully, in this Chamber, but many will not realise that. Community Pharmacy Wales found that—this is quite an important stat here—if pharmacies had not been available, a staggering 53 per cent of patients reported that they would have visited their GP in the first instance, resulting in over 35,000 surgery consultations a week. Now, that's a pretty staggering stat, isn't it, really? So, to put that into some context, that's 86 appointments in each of the 410 GP practices across Wales per week. And a further 3 per cent would also have visited A&E or minor injuries units, resulting in an increase of 2,000 appointments per week. Now, unfortunately, pharmacists have been very much under pressure and huge stress, and I think it's not exaggerating to say very often at breaking point. So, I do think that they need more support, they need more investment, including a significantly increased number of training spots.

Now, I and Welsh Conservatives, we very much welcome the introduction of the national clinical community pharmacist service on 1 April, and I certainly feel that this is an innovative, wide-ranging agreement between the Welsh Government, the Welsh NHS and Community Pharmacy Wales, which will introduce a national clinical community pharmacy service. The four priority services include enabling all pharmacies to provide treatment for common and minor ailments; access to repeat prescriptions in an emergency; annual flu vaccinations; and forms of emergency and regular contraception. All fantastic steps, I think—a fantastic step forward to alleviating and helping to alleviate the pressure on GPs and NHS services. Also, I do feel as well that the public do need clear communication here—that's what we need—for the changes. And I think having that clear communication will enable communities, I think, to hit the ground running with this new system. So, I think we need to maximise public awareness. That, in turn, of course, itself will see big benefits very quickly in terms of alleviating the pressure on GP surgeries and health services. And a good example here, I think, in fairness to the Minister here, is the NHS 'Help us Help you' campaign. It's a very good example, I think, of this type of awareness campaign. So, I think this is what we need in this instance.

And as great as the new service will be, or could be, I think we still need to address the fact that pharmacy workforces are hugely under pressure. Wales-wide figures on pharmacy workforce gaps are not routinely published. However, prior to the pandemic Health Education and Improvement Wales found that the total community pharmacy vacancies reported for all job roles were 354 full-time equivalent staff, or 652 staff by head count, giving a mean vacancy rate of 7 per cent across full-time equivalent roles. So, it is disheartening, I think, isn't it, to hear that one in four respondents in community pharmacies stated that they were not offered rest breaks and over half of the respondents in hospital pharmacies stated that they were offered breaks but were frequently unable to take them. So, I and colleagues have to be very concerned about this, but what we're particularly saying is that this isn't always about pay, this is also about conditions for staff as well. And I think, in that regard, overstretched staff are then going to find themselves leaving the profession and going elsewhere. So, I think retention is obviously really important in this regard.

So, we've got to give staff in pharmacy as well, we've got to give them the time and space that they need to learn, of course, and develop. And we also need to support them via improved mental health services as well. They're under huge pressure, obviously under a significant amount of pressures during the extra burden caused by COVID-19, and therefore the extra mental health support to support the staff, I think, is also crucial as well.

So, pharmacies in Wales carry out an outstanding job in supporting the community, but they're often hampered by unnecessary bureaucracy, which is not reflected in other parts of the UK. I'm always conscious when people say, 'Reduce bureaucracy', but what does that mean? 'Give an example', I always say. So, here's my example: it is shocking that the sharing of medical records isn't routinely available in Wales. That would not only free up valuable time for pharmacists and GPs, but also provide beneficial tailored care to patients. So, I do very much of course welcome the fact that the Welsh Government is committed to rolling out e-prescribing—and the Minister is nodding; I was looking for a moment. So, I very much welcome that, but, of course, the fact that it might take three to five years, of course, is too slow. I think we need to be faster at that.

And, of course, other areas that we need to focus on as well are—. Well, if we have e-prescribing, that will reduce medication errors, of course—a huge issue as well—and reduce, then, impacts in terms of hospital admissions as well. So, pharmacies have supported the nation, supported us in Wales during the roll-out of COVID vaccines, they've helped us get those jabs into arms of people across Wales to get back to some degree of normal life. They've helped in reducing visits to GP surgeries at a time of intense pressure on them and the health service. So, I think it is time to make pharmacies a central pillar of healthcare.

No amendments have been tabled to our motion today, which I hope is an indication that the Government and all Members will be supporting our motion today. I think I saw the Minister nodding there as well. So, if that is the case, I'm very pleased with that, and may that approach long continue. So, I urge Members to support our sensible plan for the good of patients, pharmacists and for the NHS as a whole. Diolch yn fawr.

Thank you for the opportunity to make a few comments in this debate, and no, we haven't put forward any amendments, because there is a set of principles here that I'm sure that we could all support. Pharmacy is at the heart of our health services. It has to be, but it hasn't always been the case. Too often, I think pharmacy, and community pharmacy in particular, have been seen as something on the margins. Important, of course, but there, perhaps, to support the main health services rather than being a core part of those services. And we're going through a process of demanding a culture change at present, I think, in terms of how people engage with their health services, and it's something that I genuinely believe passionately in. And we have to succeed to change this culture, all of us, individuals and society as a whole, if we want to create a health service that is sustainable for the future. And one of the changes is going through this switch from people feeling that they need to see a doctor. Many people do have to see a doctor, but from that mindset, rather, to, 'How can I get the most appropriate healthcare for me or my family?' And upgrading the role of the pharmacist, our pharmacies in our communities, and enabling people to turn to a pharmacist first of all with more and more ailments is a key part of that.

And the fact that we do have this national clinical community pharmacy service coming into force this week is something that I welcome very much. We have a framework that I hope is going to push this agenda forward, drive this change of culture, but there's a great deal more that we need to do, and one of the things that we do need to see happening now is even more education for people—us included—about how to change the way that we think about our health services. The Government has invested in the communication plans about the change coming into force this week, but I think that there is a great deal more that could be done too.

And we have to go through a number of steps as well, in order to align with the introduction of the changes this week and ensure that pharmacies genuinely are at the heart of every primary care cluster in Wales, ensuring that we now deliver the digital changes that pharmacy and primary care need. I chair the cross-party group on digital, and in our meeting at lunch time today, health and care were at the heart of what we discussed, and there is an appetite now to ensure that our services, including pharmacy, can use the latest technology. There is no sense in the twenty-first century, a quarter of the way into the twenty-first century, that so many pieces of paper prescriptions are still flying around the NHS in Wales. It is something that I'm ashamed about, I have to say, and I believe that the Minister is too.

And one of the other factors that we need to consider, and the motion today reflects that, is the investment that is needed in the workforce. The well-being survey that the motion refers to is very concerning with regard to the weaknesses within the workforce at the moment. We do have to invest in that workforce. As we are having a new medical school in Wales, we need a new school of pharmacy in Wales, to ensure that flow of people through the system that is going to be such a key part of pharmacy at the heart of primary care in Wales.

Will you take on intervention?

Of course.

Do you agree with me, Rhun, that it's the job of the Welsh Government to make sure that we can actually invest in that workforce and get more people into becoming pharmacists by offering a degree apprenticeship into the pharmacy route, and that that's something that the Welsh Government should pursue with urgent pace?

I would certainly agree with that as a suggestion. I would like to think of all our health and care workers as paid apprentices in some way, learning a trade that they will be able to use, whether that is as a doctor or a care worker or pharmacist within our health and care services in Wales. We have to be innovative in the way that we look at strengthening our workforce.

I can see that time is up. It's good to see agreement on this today, but it's one thing to have that agreement on a set of principles, it's another to see the Government delivering on those things that are genuinely going to make pharmacy stronger and more sustainable for the years to come.

It may be a surprise to Members after yesterday, but I will be supporting this motion, I welcome this motion by the Welsh Conservatives today. But I must say to the Member who opened today's debate, he might be getting a little bit ahead of himself if he thinks there are going to be no amendments to future debates here. But, on cross-party support, I can see the Members for Preseli Pembrokeshire and South Wales West who have been into the Labour tie shop this afternoon, so, in the spirit of cross-party support, I certainly will be supporting today's debate. [Laughter.]

The Member who opened the debate, Russell George, did say some very good things in his opening remarks, particularly on communication. Communication is needed. We have seen examples of poor communication in the health service in recent times, and we need to make sure this is communicated better, that this new service is communicated to all residents across Wales. He also mentioned e-prescribing, as did Rhun ap Iorwerth, and I have to agree, three to five years is too slow. It is too slow, and we must do more to tackle that.

It's always a great pleasure of mine to visit and meet pharmacists across Alyn and Deeside, and I've made many visits during my time as a Member of the Senedd, and I look forward to many more of them, because we owe a great debt of gratitude to pharmacists and staff in pharmacies across Wales for the work they did throughout the pandemic, but also the work they continue to do as well.

The motion quite clearly states the worrying and shocking statistics from the survey that was carried out with regard to well-being. I just want to read out two of the stats in there—one is in the motion—that nine out of 10 respondents were at high risk of burn-out, and that seven out of 10 reported that their mental health and well-being had been negatively affected by their work or study. This is a situation that cannot continue. The impact it has on well-being is a serious risk to these workers and to their families as well, and to the future of our pharmacy services in Wales. And, of course, this also raises then, doesn't it, concerns around patient safety. Minister, inevitably, working long hours without taking a physical or mental break can lead to that increase in dispensing errors and, of course, other patient safety issues.

So, I would be grateful if the Minister could respond to those particular points: how we can tackle burn-out. I will say in closing that I do agree with James Evans on his recommendation of degree-level apprenticeships. This is something that we should be looking at a lot wider, but certainly in the pharmacy service, and if that can be supported by the Government, I would very much welcome that being addressed in your response to today's debate. But, I thank all our pharmacists and all our pharmacy staff and I do thank the Welsh Conservatives for tabling today's motion. Diolch yn fawr.

I want to thank my colleagues Russell and Darren, obviously, for bringing this debate forward today.

Pharmacies played a crucial role during the pandemic, and they have been vital, as has already been outlined, in supporting primary and secondary care. They have supported the national roll-out of the COVID-19 vaccine, helping to get jabs in arms so that the United Kingdom could get back to normal and move on from the pandemic as quickly as possible. They have, very importantly, as has already been outlined—and I think this is a crucial, crucial role—reduced the visits to GP surgeries. They've played an enormous part in that, particularly during the pandemic, at a time of intense pressure on the NHS, as my colleague Russell George outlined earlier with the stats that he provided.

And as Russell also said, I've seen first-hand the work that they've done, and as Russell said, they play an enormous role in relieving GPs and it is so vital, as other colleagues have outlined, that we have awareness of what exactly they do and all the roles that they play. They do do an incredible amount. I visited alongside Russell Goodway, who is the chief executive of Community Pharmacy Wales, the Evans Pharmacy in Cwmcarn in my region, and I was—. It became very apparent how absolutely vital the service that they provide is in that community. I also discussed the impact of the pandemic and the increasingly important roles that pharmacies play within their communities. However, we now see pharmacies, as has been said already by Jack Sargeant just now, under a huge amount of stress and some at breaking point. A recent Royal Pharmaceutical Society survey found that nine in 10 respondents were at breaking point. This obviously can't continue. Mental health, as we all know, is absolutely fundamentally important, and we need targeted and proper support and investment from the Welsh Government in this regard. 

A good start would be to significantly increase the number of training spots for pharmacists, to support them, to fill the many voids that we see popping up throughout Wales, and as my colleague James Evans just outlined, I think degree apprenticeships for them is a brilliant idea. Not only do we need to see more trained pharmacists here in Wales, but Wales's pharmacists also face levels of bureaucracy like nowhere else in the UK, and they have to cope with the most basic of technology, which I also saw on my visit. I actually worked in a pharmacy in Usk, many moons ago, myself, delivering drugs to people—the right sort. [Laughter.] Not the 'fun' ones. But I did see first-hand there that they were still using fax machines. I mean, it was just ridiculous in this day and age.

So, the technology, it's absolutely fundamental that that needs to change. But e-prescribing, as has already been said, and the sharing of medical records, for example, is not routinely available here in Wales. It's very welcome, the Government's commitment to it, as outlined by my colleagues, but, by contrast, England and Scotland had both been e-prescribing over a decade ago. It's a shame that this Welsh Government is so far behind in that regard, and I do reiterate the calls from Russell George that they are speeded up in that way. The Welsh Labour Government has failed to modernise our pharmacies and bring them into the twenty-first century. Instead, we're left with an old, bureaucratic, heavily stressed system. Quite simply, our pharmacists and patients deserve better. Our communities need our local pharmacies. Thank you.

I want to focus on one element of the motion: e-prescribing. Arguing about IT systems within the health service is one of those anachronistic things, isn't it? The health sector breaks new ground on almost a daily basis with technology, but the IT systems are still in the last quarter of the last century. Some surgeries are still reliant on fax machines. If I was to talk about faxes to my children, they'd have no idea what I was on about. Indeed, they'd tell me off for swearing, probably.

Laura Anne Jones mentioned earlier that England and Scotland introduced e-prescribing 10 years ago. Denmark started e-prescribing back in the 1990s. The first e-prescription was sent in Sweden in 1983, and a number of other nations operate e-prescribing successfully.

I want to pay tribute at this point to the excellent work that pharmacists on the Llŷn peninsula do in Dwyfor Meirionnydd. Fferyllwyr Llŷn have prepared the ground many times. We heard recently about the prescription lockers that have been introduced by Fferyllwyr Llŷn. They broke new ground by providing prescriptions for illnesses themselves, taking great pressure off surgeries and releasing them to focus on more serious cases. And, of course, Fferyllwyr Llŷn were the first providers to provide COVID vaccinations. There's a saying in English that necessity is the mother of invention, and that is certainly true of rural communities. And our rural communities have often had to find alternative and better ways of operating, as we have seen with Fferyllwyr Llŷn.

In the same way, the D Powys Davies Pharmacy in Blaenau Ffestiniog, part of Fferyllwyr Llŷn, has started the process of digitising prescriptions, showing that that internal process makes things smoother for the patient and better for the pharmacy too. But it’s also led to fewer errors when patients collect their medicines and better quality control. This is central to the demand for e-prescribing. Indeed, according to research from the University of Oxford, 17 per cent of hospital visits occur as a result of errors in medicine, and around half of them are avoidable. The argument, therefore, for safeguarding people’s health by providing e-prescriptions is clear, but we need a central system in order to make the most of the technology available to us.

COVID and the social changes that we have seen as a result of the COVID—. Therefore it’s about time that we saw the transfer of prescribing to the digital realm as people work from home, including GPs, and they can’t necessarily work from home at the moment. Or if you go on holiday, you could pick up a prescription in another city without having to go to your home pharmacy. Consider us here today. I've had to travel down from north Wales to Cardiff. If I needed to collect an asthma pump, I could do that in Cardiff without having to travel back home. So, there are clear benefits.

I want to conclude with one word of warning. We’ve already heard that there is hope of having e-prescribing within the next three to five years, which is to be welcomed—I’m sure that the Minister will expand on this—but to do it properly, we need to ensure that you do it in full co-operation with community pharmacies. There is a risk, of course, that this could push more and more pharmacies online and that as we see more e-prescribing, online pharmacists will benefit from it. This would not only be a risk to the viability of community pharmacies, but this would also break the personal link, which is so often necessary, as pharmacists know most of the patients and customers in their community, and that link will continue to be important for the future. So, in developing these new systems, you must do that in full collaboration with community pharmacies, ensuring that they will continue to be central to the process of distributing medicines. I look forward to hearing what the Minister has to say in terms of what consultation she has held with community pharmacies in ensuring that they are central to that process. Thank you.

It's a pleasure to take part in our debate this afternoon. I would like to put on record my thanks to all the community pharmacists for the amazing work they did and continue to do during the pandemic and beyond. The arrival of COVID on these shores exacerbated the issues that have been facing primary care for years. We simply haven't been training enough GPs to meet the health and care needs of Wales. Thankfully, pharmacists have been able to fill the gap in taking pressure off not only primary care but also secondary care, and pharmacists across Wales are able to deal with common ailments and queries about prescription medication. And, thanks to the Choose Well campaign, more and more people are aware of the role pharmacists play in the nation's healthcare.

Our excellent community pharmacies save tens of thousands of GP appointments each week and divert thousands from the doors of our accident and emergency and minor injury departments. They have also played a crucial role in dealing with COVID-19. Not only have they provided vital supplies of COVID tests, masks and sanitisers, but many have also helped with the roll-out of vaccines. During the summer, I had the pleasure of visiting Rowlands Pharmacy in my hometown of Prestatyn. Rowlands, in addition to their usual services, also doubled up as a vaccination centre for the community, building upon their considerable expertise in delivering the annual flu jab. They helped ensure Prestatyn residents got their COVID vaccination, and I have no doubt they will play a key role in delivering future COVID boosters, as it's highly likely we will need annual jabs. 

Sadly, the strain on primary care will continue to bite, due in no small part to an ageing workforce. The demands on our community pharmacies will continue to rise. However, our pharmacies are facing their own workforce issues. In my local health board alone, Betsi Cadwaladr, there are over 152 full-time equivalent vaccines—vacancies. I got my vaccines and vacancies mixed up there. [Laughter.] That equates to one vacancy per pharmacy across north Wales. The pressure this is placing staff under is immense, and according to the industry bodies, around 90 per cent of staff are at risk of burnout. The Welsh Government must give greater priority to the training and recruitment of community pharmacists. They must also tackle barriers to smarter working. A move to e-prescribing, which has been mentioned a few times during this debate so far, in three to five years is simply not good enough, particularly when we've got GPs still using paper prescription pads and fax machines, as the Member for Dwyfor Meirionydd rightly said, in the national health service.

Most of the other UK nations dropped this archaic prescription pad in favour of electronic prescriptions over a decade ago, and there's even reference to e-prescribing coming in as far back as the 1990s in Denmark. It goes to show how we are falling behind in that sense. A Birmingham NHS trust has just completed the roll-out of their second generation electronic prescribing and medications administration software. Built on cloud technology, it grants patients and healthcare professionals easy and secure access to patient and medication records. The trust covers a similar population to Wales, and they're already moving their e-prescription service to the cloud, but ours still remains a pipe dream in Wales. We're small enough to be agile, as well, but as with everything in the public sector, it's overcomplicated by red tape, bureaucracy and a silo mentality. We only have to look at the roll-out of the 111 service to get an idea of how badly we need to perform in modernising our healthcare. If we truly value our community pharmacy services and patient care, we have to get a grip on this issue right now. 

I would first like to echo the comments of other Members in recognising the outstanding contribution that pharmacists have made during the COVID pandemic. Without their commitment and willingness to keep their doors open, our country would have suffered a great deal more and undoubtedly more lives would have been lost due to COVID-19. I believe everyone here would agree that the trust we place in our pharmacists is well placed, and we should not be fearful of expanding their role within the healthcare sector, in particular the roll-out of the clinical community pharmacy service and the ability of pharmacists to independently prescribe medication for common ailments. I welcome, and I know residents in my region welcome, community pharmacies because it increases the ability of some patients to better access appropriate care without the need to visit a GP. While this has the benefit of taking pressure off other parts of the healthcare system, it also means that pharmacy services can be better adapted around patients' needs, and, quite significantly, pharmacy teams have more interaction with patients, which translates into improved patient understanding of the medicines they take. 

This is where I'd like to pick up on my first point. In Wales, we have a significant increase in the dispensing of opioids, which, as we all know, are a class of drug found in the opium poppy plant, are generally prescribed for pain relief and are highly addictive. Some here may be unaware, but opioid prescribing has increased by an average of 30 per cent in Wales in the last 10 years, with almost 1.6 million opioid items being prescribed in Wales just before the pandemic. In Powys alone, they have seen a monumental rise of almost 95 per cent in 10 years. Persistent pains, which much of this opioid prescribing is for, is more prevalent in areas of greater deprivation, as is depression and anxiety, which all add to the pain burden. While persistent pain is not fixed by these analgesics, it is also not fixed by removing them. A significant number of people presenting with pain are not usually aware of the numerous problems with these analgesics, most notably that most of them aren't very effective long term. 

With this in mind, I see that the community pharmacy model presents a major opportunity for the healthcare system to help address this rise in opioid use. Pharmacies could become the first port of call for those suffering pain, which may provide other pain relief pathways without the need for opioids. And given significant training and upskilling of staff, community pharmacies could also be used to effectively review patients who are using opioids as a feedback mechanism for GPs. This may help the healthcare system to better understand the effects that opioids have on patients. I'm sure that health boards and the Royal Pharmaceutical Society are more than capable of discerning this point for themselves, so I'm therefore interested to know if there have been any active steps in assessing the capacity of community pharmacies to become the first port of call for those suffering with pain.

The next point I would like to pick up is that whilst the community pharmacy model has massive potential to expand into areas like pain relief, it only really works if there are sufficient pharmacists to take on the role. I understand that there is some debate within the pharmacy community, because some corporate pharmacists say that they cannot fill all their vacancies due to the shortage of pharmacists, and may have to reduce opening hours or close pharmacies. There are, indeed, sufficient numbers of registered pharmacists to fill all roles, and I understand that this issue is more to do with the unacceptable terms and conditions of some pharmacy contracts, and pharmacists suffering, as already mentioned, burn-out from overwork. Given the disappointing results of the recent Pharmacists' Defence Association safe working environment survey, I think the Welsh Government needs to apply considerably more pressure to ensure that high standards of fair pay and fair working conditions are met by pharmacies, and that meeting fair pay and fair working conditions standards should be a prerequisite if they are to keep their NHS contracts. 

Finally, I want to address the issue of dispensing at a loss. In real terms, pharmacies have had big cost increases, particularly with the expense of personal protective equipment, which I understand they have not been reimbursed for by the Welsh Government, and also with higher energy prices and increasing costs of drugs. I'm aware that the cost of these drugs, such as certain antidepressants and hormone replacement products, are outstripping the amount the NHS pays the pharmacy for them, which is already predetermined. Unfortunately, this is having major implications, because it reduces the money available for pharmacies to reinvest in services, to pay their staff better wages, and it also creates a possibility that pharmacies may not be able to afford to dispense these drugs, which would have wider knock-on effects as patients may not be able to get the medicines they need. Whilst larger and busier pharmacies may be able to weather this storm of rapid cost increases, smaller independent practices may not, and this means that, inevitably, there is greater potential for these closing, putting more stress and anxiety on people who are already suffering because of illness. I think given the potential knock-on effects of dispensing at a loss, it would be pertinent to know if this Government has any plans to support these pharmacies financially when they're exposed to these significantly higher drug costs. Thank you, Dirprwy Lywydd. 

I call on the Minister for Health and Social Services, Eluned Morgan.

Diolch yn fawr. Firstly, can I thank the Conservatives for raising today's motion? Isn't it refreshing to be able to agree on something for a change? I certainly welcome the debate, which provides an opportunity, and has provided an opportunity, for all Senedd Members to put on record our recognition of the contribution of pharmacy teams throughout the pandemic. It also provides an opportunity for me to lay out the comprehensive plans we have in the Welsh Government for community pharmacy in Wales. But also I want to thank you for helping us raise the profile of this important issue in this important week, when we are changing the relationship with our community pharmacies. 

Before I continue, I'd like to take a moment to recognise the significant contribution of pharmacy professionals in all parts of the NHS. Pharmacy teams have played a significant role in supporting millions of people, helping keep pressure, as so many have pointed out, off the GPs and hospitals and other public services during this critical time. They've managed shortages of medicines, they've led the introduction of new treatments for COVID-19, and they've used their expertise to ensure the success of Wales's remarkable COVID vaccination programme. 

I recognise the impact COVID-19 has had on individuals in pharmacy teams, and I'd like to thank everyone for the dedication and the commitment shown to patient care during these incredibly challenging times. I understand the workforce has been under immense pressure. I'm delighted our contractual reforms, which come into force later this week, will ensure community pharmacists in Wales practise in a way that is professionally rewarding and delivers the best possible outcomes for the people of Wales. Our reforms will ensure we properly utilise pharmacists' knowledge and skills. They provide for a collaborative, innovative and progressive approach to the delivery of pharmaceutical care, maximising the skills of community pharmacy teams to meet the needs of the NHS and people in Wales now and, we hope, for future generations. From April, every community pharmacy in Wales will be able to provide an extended range of clinical services available consistently, offering convenient, accessible NHS services to more people closer to their homes. 

Burnout is a concern across all health and social care professions, and we've committed funding for a renewed all-Wales contract for mental health support for our workforce. This was previously known as Health for Health Professionals Wales, and that's now been rebranded as Canopi. The service will provide an equitable, whole-system approach to mental health and well-being support, and pharmacists, pharmacy technicians and pharmacy staff will have full access to the support that Canopi provides. Before I set out the steps we're taking to support community pharmacy, it's also important to make it clear that it's not for Government alone to resolve these issues, and I'm concerned in particular to hear that so many in pharmacies are not offered rest breaks. We're making record investment and have a compelling vision for community pharmacy. Government is playing its part, and so must employers. The vast majority of pharmacy owners support our reforms, investing in their businesses and, importantly, in the people they employ. 

Will the Minister take an intervention?

Of course. 

I thank the Minister for taking an intervention. You were talking about the Government playing a part, but employers have to play a part. The Member from the Welsh Conservatives before mentioned working conditions. Does the Minister agree with me that the best way to have better working conditions is by joining a trade union?

It is absolutely the best way to improve your conditions. I was very pleased to meet with the pharmacy union very recently to discuss some of these very issues.

I want to be clear that pharmacy owners who choose to divest—and I know of many, one in my own community—will not benefit from our reforms. But we will continue to reward those pharmacy owners who work with us to deliver better access and outcomes for the people of Wales. [Interruption.] I'm happy to take an intervention. 

As someone who represents the Cardiff and Vale health board area, they have been lamentable in commissioning services in the community through pharmacists. Would you agree that there needs to be greater orientation around the contract so that more services can be contracted to pharmacies, especially in the public health agenda? Because if I look further west, I can find those services in pharmacies in Neath Port Talbot, but I can't find them in Cardiff and the Vale of Glamorgan.

So, that's precisely what we're doing. This week, we've got a new framework, we have a new contract, and they'll have to sign up to providing those services, and there's a whole list of services that they sign up for, but this is a new contract that's starting this week. So, this is a new start where we're all clear about what they need to deliver, and they'll get paid for it. We're putting a substantial amount of funds into this. I know and I've heard—my God, I've heard—the urgency around the need to deliver e-prescribing, and I know that you know that I'm incredibly keen to see this rolled out. That work is being led by Digital Health and Care Wales, and progress is being made across four areas of e-prescribing, and that review was published last year, including for primary care. Our plans—and I can reassure you—make sure that that digitalisation of prescriptions is covered in all primary care settings, including community pharmacy. And I expect a pilot, with GPs and community pharmacies, to start very, very soon, and I can assure you that I'm doing all I can to speed up the process. The limiting factor, I'm afraid, is skills, and it's not an issue just for us. I know—. For example, my brother is head of IT in Sony; they're having trouble recruiting people with the technology skills. So, it's not lack of commitment, it's not lack of money. It's about how we recruit more people with the skills, and obviously we need to do a lot more work to make sure that we can recruit the right people with those skills, but that's not something that can be done overnight.

We recognise how important it is to ensure that learning time for the pharmacy workforce is protected. By working with Health Education and Improvement Wales, we've funded a pilot for protected learning time for community pharmacists this year. The work of evaluating these schemes will be completed during the coming months, and the result of that work will influence the arrangements for the future.

Finally, in terms of developing the workforce, a great deal of work is being done by Health Education and Improvement Wales. Wales is already acknowledged as an excellent place for pharmacists to train, live and work. Here in Wales we have the highest rate of filling posts for trainee pharmacists, and the highest rates of success in registration exams for pre-foundation pharmacists across the whole of the United Kingdom.

Even though they're not part of the contractual arrangements for community pharmacists, we are working very closely with Health Education and Improvement Wales to ensure that things do improve. We have ensured that the training and development opportunities that have been planned by them align closely with our contractual reforms. Specifically, Health Education and Improvement Wales will provide opportunities for community pharmacists to train as independent prescribers. There will also be opportunities for pharmacy technicians to take part in modern apprenticeships every year from 2022-23 onwards, so I can acknowledge that apprenticeships are already coming into force, but I do think it's worth looking into whether degree apprenticeships could be provided in this field.

The Welsh Government will provide financial support for that training. Up to £3,000 will be provided to every pharmacist, and £2,000 will be available for every pharmacy technician. We're also investing in services to support this service and this training.

Funding for prescribing services and independent services in community pharmacies will increase from £1.2 million to £4.2 million from April of this year. This will support our new national service for independent prescribing by pharmacists. So, hopefully, you will see that change that you want to see in the communities because of this new contract. 

Minister, you will have to come to an end, please.

I am pleased that I can accept today's motion, and I agree with that ambition, over the long term, to improve the situation in our pharmacies across Wales.

I call on Sam Rowlands to respond to the debate.

Thank you, Deputy Presiding Officer. Could I first of all start by thanking Members from right across the Chamber today for making some fantastic contributions to our important debate and recognising the exceptional role that pharmacies and pharmacists carry out, and how we can do our part in helping them to enhance their work even further, making the lives of our residents even better. As point 1 of our motion states, pharmacists have carried out vital work throughout the COVID-19 pandemic; that's been acknowledged by everybody in the Chamber here today. But not only this, their crucial role in supporting primary and secondary care, which Members highlighted today as well. Whilst many in society and many of us were able to work from home, pharmacists, many of them, were on the front line, continuing to provide that support and care face to face for people who needed it at the time. And in addition to this, as Members have highlighted, in particular Russell George at the start, but all Members, they were at the forefront supporting the fantastic national roll-out of the COVID-19 vaccine. I'm sure there's a continued role for them to play in that in the future as well.

It was really refreshing today—many have mentioned it—the cross-party recognition for this good work, and we can all thank the incredible work that pharmacists have carried out. I'm sure all Members have also had the pleasure of visiting our brilliant pharmacists, something that Gareth Davies mentioned. I've seen first-hand the exceptional role that they carry out in a broad range of services.

So, while closing our debate today, I'd like to focus on three key issues that I think have been highlighted and discussed here today. And the first, as I outlined in point 3 of our motion today: it's clear that our pharmaceutical workforce is under pressure, and near breaking point. Jack Sargeant mentioned this and so did Laura Anne Jones. It's the Royal Pharmaceutical Society's 2021 workforce well-being survey that found that 90 per cent of respondents were at high risk of burn-out, and sadly, one in three had considered leaving the profession altogether. I'm sure Members across the Chamber agree that these statistics are extremely concerning, and now is the time to take action to rectify this. I'm grateful to the Minister for acknowledging that and outlining some of the work that is going to be carried out to deal with these issues.

The second key issue highlighted today is actually that the national clinical community pharmacy service—quite a snappy title there—outlined in point 2 of our motion comes into force on 1 April. And across all benches and encompassed, I believe, in Joel James's contribution, many hope this will alleviate some of the pressures facing pharmacies and pharmacists at the moment. And Russell George in his opening also highlighted that this service has been an innovative wide-ranging agreement between Welsh Government, Welsh NHS and Community Pharmacy Wales. This service will be based on four key themes: expand the clinical role of community pharmacists, skills development, quality, and integration within primary care, and the funding element as well, which has been highlighted by many Members in the Chamber today. It's hoped that this service will tackle workforce issues, alleviate pressure on GP services and increase vital communication within our communities.

And a third area, I believe, was highlighted here today, and has been clear in the debate. It's outlined in point 4(a) of our motion, and a number of Members highlighted this, including Rhun ap Iorwerth and Mabon ap Gwynfor, and Gareth Davies again, about the need to speed out the roll-out of technological advances here in Wales. Technology here is basic at best. E-prescribing, the sharing of medical records, not routinely available—many Members mentioned that—mean that our pharmacists and GPs spend less time with patients. And this contrast was highlighted by Members also with England, Scotland and further afield, both having—England and Scotland—having e-prescribing there for over a decade, and I'm sure we all agree that this simply isn't right, and has a negative impact on the interest of both patients and staff. And, again, I thank the Minister for the commitments being made in this regard, and the desire to see this delivered as quickly as possible.

So, to conclude, Deputy Presiding Officer, our motion today highlights the exceptional role that pharmacists carried out during the pandemic, from supporting primary and secondary care into supporting the fantastic national roll-out of the COVID-19 vaccine. Today's been a great opportunity for us to come together to celebrate their work and to thank them across our parties. Nevertheless, it has become clear from today's debate that pharmacists are still under extreme pressure and stress and more needs to be done to reduce bureaucracy, reduce the burden on staff, and ultimately lead to a better service for those who need it. And in light of this, I'm delighted to hear and to see that both the Government benches, Labour, and Plaid Cymru haven't amended today's debate. I'm grateful for their contributions throughout this as well and I'm looking forward to seeing the cross-party support. Once again I thank all Members for their contributions in today's debate, along with the many practical and real solutions being offered. Diolch yn fawr iawn.

The proposal is to agree the motion without amendment. Does any Member object? Once again, I haven't heard an objection. Therefore, the motion is agreed in accordance with Standing Order 12.36.

Motion agreed in accordance with Standing Order 12.36.