Gwasanaethau fferyllol cyffredinol: Ebrill 2023 i Fawrth 2024

This annual statistical release presents information on community pharmacy activity in Wales, with new data published for the financial year 2023-24. 

Community pharmacies are those commonly found on high streets, in supermarkets or within GP surgeries. While dispensing prescription items remains their primary role, they have offered a range of additional NHS patient services over many years, which were enhanced by contract reform in April 2022. The reforms created a National Clinical Community Pharmacy Service that enables nearly all pharmacies to provide treatment for common minor ailments, access to repeat medicines in an emergency, annual flu vaccinations, and some forms of emergency and regular contraception.

When these services are provided, the pharmacy submits a claim for payment for providing the service to NHS Wales Shared Services Partnership (Primary Care Services). The statistics in this release are based on information collected through those claim submissions. Further information is available in the quality report.

• Following long-term stability, the number of community pharmacies decreased by 19 (or 2.7%) over the year to 689 on 31 March 2024.
• As the number of items dispensed increased and the number of community pharmacies decreased, the average number of items dispensed per pharmacy increased by 3.3% from the previous year, to 115,005.
• On 31 March 2024, nearly all (685 out of 689) pharmacies were accredited to provide the clinical community pharmacy service (CCPS), comprising of common ailments service, seasonal flu vaccinations, emergency medicine supply and contraception services.
• The strong upward trend in the number of common ailments consultations provided in the year continued; there were just more than 344,000 consultations, an increase of 44.1% from 2022-23 and more than 4.5 times as many consultations as five years ago.
• There were nearly 38,000 consultations for the newly established sore throat test and treat service which resulted in just over 30,000 point of care tests (National Institute for Health and Care Excellence (NICE)) carried out in the year. 
• Just over 108,000 seasonal flu vaccines given to people eligible for NHS-funding, a 33.0% decrease from the previous year, but largely explained by a change in eligibility criteria (NHS).
• The number of emergency medicines consultations continued its strong upward trend, with nearly 102,000 consultations provided in the year, an increase of 25.0% from the previous year and more than a four-fold increase (332.1%) from five years ago.
• The number of contraception consultations remained broadly stable over the long-term; there was an increase of 2.7% from the previous year, partly explained by the inclusion of recently introduced bridging contraception for the first time.
• Outside of the priority CCPS services, the number of discharge medicines reviews continued to increase with just more than 18,300 reviews performed in the year, an increase of 24.9% from the previous year and an increase of 57.7% from five years ago.

Figure 1: Number of pharmacies by type on 31 March each year, 2015 to 2024

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Description of Figure 1: Following a long period of stability, the total number of pharmacies decreased between 2023 and 2024. This was due to a decrease in multiple (chain) pharmacies, though some chain pharmacies that closed were taken over as independent pharmacies during the year, which resulted in an increase of the total number of independent pharmacies. 

Source: C20, Pharmacy Services - NHS Wales Shared Services Partnership

Community pharmacies by local health board on StatsWales

 On 31 March 2024, there were 689 community pharmacies in Wales, 19 (or 2.7%) fewer than on 31 March 2023 and 27 (or 3.8%) fewer than on 31 March 2015.

Of these, 457 were multiple (chain) pharmacies, 6.0% fewer than on 31 March 2023 and 1.9% fewer than on 31 March 2015. 

232 were independent pharmacies, 4.5% higher than on 31 March 2023, but 7.2% lower than on 31 March 2015.

The main data source for prescriptions data is the primary care prescriptions statistical release, which complements this community pharmacy release. The primary care prescriptions release provides detailed analysis on items prescribed by all primary care contractors that were dispensed in the community. It includes statistics on items prescribed by pharmacists working in community pharmacies and by pharmacists who work in general practices.

79.2 million prescription items were dispensed in community pharmacies in 2023-24, a 0.5% increase from the previous year. This number excludes items dispensed by dispensing doctors and personally administered items prescribed and administered by a member of the general practice (which are included in the primary care prescriptions statistics). 

Figure 2: Average number of prescription items dispensed per community pharmacy, 2014-15 to 2023-24

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Description of Figure 2: Line chart showing the number of items dispensed by community pharmacies has increased steadily over the last 10 years.

Source: PD1 Reports, Pharmacy Services - NHS Wales Shared Services Partnership 

Average number of items prescribed per community pharmacy by LHB on StatsWales

As the number of items prescribed by general practitioners and other authorised prescribers has increased over time, the number of items dispensed per community pharmacies has also increased. The increase in items dispensed per pharmacy for the latest year was higher than usual as the number of pharmacies decreased by more than in previous years. 

In 2023-24, the average (mean) number of prescription items dispensed by community pharmacies was 115,005. This is an increase of 3.3% from 2022-23 and an increase of 12.5% from 2014-15.

While many pharmacies offered various clinical services for many years, a new systematic, Wales-wide clinical service was implemented in April 2022. This service enables consistent service provision across Wales, initially across four priority services: common ailment, contraception services, emergency medicines supply and seasonal influenza vaccination. The common ailments service was extended further in 2023-24 to a include sore throat, test and treat service.

All pharmacies can provide the CCPS subject to meeting standards in relation to premises and training and all four priority services must be provided, or pharmacies must opt out of the service altogether. 

On 31 March 2024, 685 (or 99.4% of) community pharmacies were accredited to provide CCPS.

Figure 3: Number of consultations provided through the four priority services included in the clinical community pharmacy service (CCPS), 2014-15 to 2023-24 [Note 1]

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Description of Figure 3: Line chart showing a large upward trend in common ailment services consultations, which accounted for the large majority of CCPS consultations in 2023-24. The number of seasonal flu vaccines decreased following a change in the eligibility rules 2023-24, while emergency medicines supply consultations continue to increase year-on-year and contraception service consultations remain stable.

[Note 1] Common ailments service and emergency medicines supply data only available from 2017-18 onwards.

Source: Claims made to Pharmacy Services - NHS Wales Shared Services Partnership

Clinical Community Pharmacy Service - number of consultations provided through priority services on StatsWales

Analysis for each of the four priority services is provided in the following sections.

The common ailments service is designed for patients to access appropriate health care in their community, who may have otherwise gone to their GP or emergency department for advice or treatment (Welsh Medicines Advice Service). In 2023-24, the service allowed patients to access free advice and where appropriate, the supply of medicines to treat 26 different common ailments. In 2023-24, the service allowed patients to access free advice and where appropriate, the supply of medicines to treat 26 different common ailments.

Just more than 344,000 consultations for common ailments occurred in 2023-24. This is an increase of 44.1% from 2022-23 and more than 4.5 times (351.8%) as many consultations as five years ago.

Nearly 267,000 different people used the service during 2023-24. The large majority (79.9%) had one consultation in the year, but 18.2% had two or three consultations and 1.9% had four or more consultations. 

Figure 4: Reason for common ailments service (CAS) consultations, 2023-24

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Description of Figure 4: Bar chart showing the most common reason for a CAS consultation was conjunctivitis (eye infection) with more than 51,000 consultations. Hay fever was the second most common reason with more than 48,000 consultations.

Source: Claims made to Pharmacy Services - NHS Wales Shared Services Partnership

Common ailments service - number of consultations per ailment, by local health board on StatsWales

Over half (50.9%) of all consultations were for four conditions; conjunctivitis (15.0%), hay fever (14.0%), sore throat and tonsilitis (11.6%), and dry skin/dermatitis (10.3%).

There were more consultations in 2023-24 than in 2022-23 for all conditions apart for chicken pox which decreased by 7.7%. The largest percentage increase was for scabies (157.9%), followed by colic (100.0%) and back pain (96.5%).

Figure 5: Number of common ailments service (CAS) consultations by month, 2023-24

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Description of Figure 5: Bar chart showing the number of CAS consultations varied by month, ranging from a high of nearly 40,000 consultations in June to a low of just more than 23,000 in September.

Source: Claims made to Pharmacy Services - NHS Wales Shared Services Partnership

Common ailments service - number of consultations per month, by local health board on StatsWales

While the overall demand for CAS consultations has increased as awareness of the service increased, the number of consultations has varied during the year. In 2023-24, the monthly trends broadly reflected the seasonality of the most common conditions which are eligible for treatment through CAS.

The number of consultations peaked in June 2023, where over a third (or 17,100) of all hay fever consultations occurred. 

There were further peaks in February and March 2024, where over a quarter (or 11,200) of all sore throat and tonsilitis consultations occurred and nearly a quarter (or 6,500) of all threadworm consultations occurred.

Figure 6: Distribution of common ailments service (CAS) consultations by age and sex, 2023-24

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Description of Figure 6: Population pyramid chart showing that a high concentration of consultations were for children. There were also peaks for females aged close to 20, aged between 30 and 40, and in their late 50s. The peaks for male consultations were around similar ages, but less prominent than for females.

Source: Claims made to Pharmacy Services - NHS Wales Shared Services Partnership

Common Ailments Service consultations by age band and sex on StatsWales

In 2023-24, a little more than a quarter (26.3%) of all consultations were for children aged under 16. Just over half (54.7%) of these were for female children and just under half (45.3%) were for male children. 

There were nearly twice as many consultations for adult (aged 16 or older) females as there were for adult males: in 2023-24, there were a little more than 165,200 (65.1%) consultations for adult females compared to nearly 88,600 (34.9%) consultations for adult males.

The number of consultations for female adults peaked between ages 30 to 45, which accounted for 30.6% of all adult female consultations. For adult males there was broadly less variation in the number of consultations by age, but there was a peak between ages 70 to 79 which accounted for 12.8% of all male adult consultations, compared to 9.5% for females in the same age group.

In 2023-24, a new service called sore throat test and treat was introduced for patients who had a CAS consultation for sore throat and tonsilitis. The STTT service enables pharmacists to employ point of care tests as part of the assessment to support clinical decision making and the supply of appropriate treatment. The use of point of care tests can help identify whether a streptococcus bacterial infection is the cause of the symptoms and prevent the unnecessary use of antibiotics.

Of the 689 community pharmacies in Wales, 545 (or 79.1%) were providing the STTT service on 31 March 2024. 

Data published on StatsWales shows that nearly 38,000 STTT consultations and just over 30,000 point of care tests were carried out in 2023-24.

Community pharmacies can provide the NHS vaccination against seasonal influenza. Statistics in this release only include those eligible for a seasonal flu vaccine funded by the NHS, who received it at a community pharmacy. It does not include anyone who was eligible and had it provided through a general practice or anyone who paid for a vaccine privately at the pharmacy. 

Just fewer than 108,000 seasonal flu vaccinations were administered to patients eligible for NHS-funded flu vaccines. This was a 33.0% decrease from the previous year, but 68.1% higher than five years ago. 

In response to the COVID-19 pandemic, the eligibility criteria for seasonal flu vaccines were extended to include patients aged 50 to 64, between 2019-20 and 2022-23. This criterion was removed in 2023-24, so patients aged 50 to 64 were no longer eligible for NHS-funded flu vaccines based on their age alone. In 2022-23, more than 66,000 patients were eligible and had seasonal flu vaccines because they were in this age group, therefore the decrease in 2023-24 is largely explained by the change in eligibility criteria. 

In 2023-24, nearly 11,600 people who received the vaccine at a community pharmacy had not received a flu jab before. 

Of those people who had also received a seasonal vaccine in the previous year, a third (34.4%) had it provided through their GP practice in the previous year.

Figure 7: Number of seasonal flu vaccinations (SFV) by sex of recipient, 2014-15 to 2023-24

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Description of Figure 7: Line chart showing a large upward trend in the number of vaccines given to both males and females between 2014-15 and 2021-22, followed by a slight decrease in 2022-23 and a further decrease in 2023-24 due to changes in eligibility criteria. 

Source: Claims made to Pharmacy Services - NHS Wales Shared Services Partnership

Seasonal Flu Vaccinations provided by community pharmacies by sex on StatsWales

In 2023-24, 59.0% of seasonal flu vaccines were given to females and 41.0% to males. These percentages have remained consistent since 2014-15, the first-year data was collected. 

Figure 8: Number of seasonal flu vaccinations (SFV) by primary eligibility reason, 2023-24 [Note 1]

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Description of Figure 8: Bar chart showing the large majority of vaccines were provided because the patient was aged 65 or over in 2023-24. 

[Note 1]: A person may be eligible for more than one reason, but from 2023-24, only the main reason for eligibility was recorded. The main reason is determined by the clinician administering the vaccine, with age group taking precedence over all other reasons. 

Source: Claims made to Pharmacy Services - NHS Wales Shared Services Partnership

Seasonal flu vaccinations provided by community pharmacies by patient eligibility criteria on StatsWales

In 2023-24, just more than six out of ten (61.2%) patients who received NHS-funded seasonal flu vaccines in community pharmacies were eligible for NHS-funded vaccination because they were aged 65 or older.

One in ten (10.2%) were eligible because they had a chronic respiratory disease; while around one in twenty (5.7%) were eligible because they were informal/unpaid carers.

The emergency medicine supply service enables a pharmacist to supply a patient with their regular prescription-only medicines in emergency situations. This includes times when a patient may have run out, lost, damaged, or is otherwise unable to obtain a prescription before their next dose is due, and in the opinion of the pharmacist it would be detrimental to the patient’s health if they missed a dose of the medicine.

Emergency medicines were supplied on nearly 102,000 separate occasions during 2023-24. This is an increase of 25.0% from the previous year and almost 4.5 times (332.1%) higher than five years ago. 

Figure 9: Reasons for requesting an emergency medicines supply, 2023-24

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Description of Figure 9: Bar chart showing the reasons why emergency medicines were requested ranged from 48,000 requests where items were not ordered in time, to nearly 5,000 requests from patients who were unable to collect items from their usual pharmacy. 

Source: Claims made to Pharmacy Services - NHS Wales Shared Services Partnership

Emergency medicines supply - reasons for consultation on StatsWales

Nearly half of requests (or 46.8%) for emergency medicines were due to the patient not ordering items from their GP in time, while just over a quarter (28.2%) of requests were because the items were not available for collection at the general practice. 

One in ten (10.7%) requests were from patients who misplaced their medication and another one in ten (10.0%) requests were made by people who went on holiday without their medication. 

Figure 10: What the patient would have done if the emergency medicine was not provided, 2023-24

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Description of Figure 10: Bar chart showing the large majority of patients would have gone without medication had emergency medicines not been provided, while many would have contacted the GP or out of hours services. 

Source: Claims made to Pharmacy Services - NHS Wales Shared Services Partnership

Emergency Medicines Supply action if no medicines supplied on StatsWales

Had the emergency supply of medicine not been given, more than 61,000 patients (or 59.9%) would have gone without their medication, while 22,500 (or 22.1%) would have contacted their general practice. 

Just over 1,000 (or 1.1%) patients would have visited an emergency department. 

Figure 11: Most frequently supplied items through emergency medicines supply, 2023-24 [Note 1]

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Description of Figure 11: Bar chart showing the 10 most frequently supplied items through the emergency medicines supply ranged from just more than 4,400 Amlodipine (5mg, 28 tablets) to just more than 2,300 Ramipril (2.5mg, 28 capsules) in 2023-24. 

[Note 1] Items are recorded with their strength and volume, therefore the same medicine name may be recorded multiple times in different strengths and volumes. 

Source: Claims made to Pharmacy Services - NHS Wales Shared Services Partnership

Nearly 158,000 items were prescribed and dispensed through the emergency medicines supply, 20.2% more than in the previous year and almost 4.5 times more than five years ago. 

In three quarters (74.8%) of consultations, one item was prescribed and dispensed. In nearly one in five (18.5%) consultations, either two or three items were prescribed and dispensed, while four or more items were supplied in 6.7% of all consultations. 

2.8% of all items prescribed and dispensed were for Amlopidine (5mg, 28 tablets). This is most commonly used to treat high blood pressure and was the medicine most frequently supplied by pharmacies in an emergency. 

Other frequently supplied emergency items included Omeprazole (20mg, 28 capsules) most commonly used to treat acid reflux; and Sertraline (100microgram and 50mg) which is generally used an anti-depressant.

Other items most frequently supplied include medicines to treat and prevent stomach ulcers, to reduce cholesterol levels, and to treat asthma.

Community pharmacies are able to provide sexual health advice and some methods of contraception that include emergency contraception, bridging contraception (an initial 3-month supply of the progestogen-only pill), or a mixture of both. 

There were just over 32,000 contraception consultations in community pharmacies in 2023-24. This was an increase of 2.7% from the previous year, but a decrease of 8.9% from five years ago. In 97.1% of these consultations some form of contraception was supplied. 

The large majority of consultations (97.0%) were for emergency contraception only, a long-established community pharmacy service. 

Data for bridging contraception was collected for the first full financial year in 2023-24 (StatsWales). In this year 398 (1.2%) consultations were for this service only, while 555 (1.7%) were for both emergency contraception and bridging contraception. 

Figure 12: Reason for requesting emergency contraception, 2023-24

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Description of Figure 12: Pie chart showing that in 2023-24, the majority of emergency contraceptives were given because no contraception was used. This was followed by failure in the contraceptive method used.

Source: Claims made to Pharmacy Services - NHS Wales Shared Services Partnership

Contraception Service - reason for consultation by age band on StatsWales

In 2023-24, three out of five (62.2%) recipients of emergency contraception reported that they had not used contraception. This is broadly unchanged from the previous year. 

Just over a quarter (28.8%) reported their contraception method failed; 4.2 percentage points higher than in the previous year. One in twenty (5.4%) reported they had missed a dose of the daily contraceptive pill, a decrease of 6.9 percentage points from the previous year.

The discharge medicines review service (DMR) aims to provide support to patients recently discharged from hospital by ensuring that changes made to their medicines are enacted as intended in the community.

Of the 689 community pharmacies in Wales on 31 March 2024, 684 (or 99.3%) were accredited to provide discharge medicines reviews.

Figure 13: Number of discharge medicines reviews, per financial year, 2014-15 to 2023-24

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Description of Figure 13: Line chart showing the number of discharge medicines reviews has increased markedly over time, more than doubling between 2014-15 and 2023-24. 

Source: Claims made to Pharmacy Services - NHS Wales Shared Services Partnership

Discharge Medicine Reviews (DMRs) by local health board and year on StatsWales

In 2023-24, just fewer than 18,300 discharge medicines reviews took place in community pharmacies, an increase of 24.9% from 2022-23 and an increase of 57.7% from five years ago.

The data is provided by NHS Wales Shared Services Partnership (Pharmacy Services). Further information is available in the quality report.

Accredited Official Statistics status

The United Kingdom Statistics Authority has designated these statistics as Accredited Official Statistics (formerly known as National Statistics), in accordance with the Statistics and Registration Service Act 2007 and signifying compliance with the Code of Practice for Statistics (UK Statistics Authority).

This status means that official statistics meet the highest standards of trustworthiness, quality and public value.

All official statistics should comply with all aspects of the Code of Practice for Statistics. They are awarded Accredited Official Statistics status following an assessment by the Office for Statistics Regulation. The authority considers whether the statistics meet the highest standards of code compliance, including the value they add to public decisions and debate. 

These statistics were designated as Accredited Official Statistics in June 2012 following a full assessment against the Code of Practice by the Office for Statistics Regulation.

Since the latest review by the Office for Statistics Regulation, we have continued to comply with the Code of Practice for Statistics, and have made the following improvements:

• Included additional open data, with more detailed breakdowns, on our StatsWales website
• Sourced claim-level data to allow for more rigorous data validations and some reproducible analytical pipelines
• Included further insights into patients who received CCPS consultations, including analysis of:
  • Gender of the patient
  • Age group of the patient
  • Reason for consultation
  • What patient would have done without consultation
  • Seasonal flu eligibility criteria
• Updated key quality information and refreshed commentary throughout the release, including longer time comparisons of data.

Statement of compliance with the Code of Practice for Statistics

Our statistical practice is regulated by the Office for Statistics Regulation (OSR). OSR sets the standards of trustworthiness, quality and value in the Code of Practice for Statistics that all producers of official statistics should adhere to.

All of our statistics are produced and published in accordance with a number of statements and protocols to enhance trustworthiness, quality and value. These are set out in the Welsh Government’s Statement of Compliance.

These accredited official statistics demonstrate the standards expected around trustworthiness, quality and public value in the following ways.

Trustworthiness

The published figures are compiled by professional analysts using the latest available data and applying methods using their professional judgement and analytical skillset. 

These statistics are pre-announced on the Statistics and Research area of the Welsh Government website. Access to the data during processing is restricted to those involved in the production of the statistics, quality assurance and for operational purposes. Pre-release access is restricted to eligible recipients in line with the Code of Practice for Statistics.

Quality

Statistics published by Welsh Government adhere to the Statistical Quality Management Strategy which supplements the Quality pillar of the Code of Practice for Statistics and the European Statistical System principles of quality for statistical outputs. 

Where there are data quality issues, they are stated in the release and on StatsWales. 

Value

The purpose of this statistical release is to inform users about the main components of NHS community pharmacy services including the activity performed and the patients treated. 

These statistics are published annually in November, based on the reference period ending in March of the same year.

Well-being of Future Generations Act (WFG)

The Well-being of Future Generations Act 2015 is about improving the social, economic, environmental and cultural wellbeing of Wales. The Act puts in place seven wellbeing goals for Wales. These are for a more equal, prosperous, resilient, healthier and globally responsible Wales, with cohesive communities and a vibrant culture and thriving Welsh language. Under section (10)(1) of the Act, the Welsh Ministers must (a) publish indicators (“national indicators”) that must be applied for the purpose of measuring progress towards the achievement of the wellbeing goals, and (b) lay a copy of the national indicators before Senedd Cymru. Under section 10(8) of the Well-being of Future Generations Act, where the Welsh Ministers revise the national indicators, they must as soon as reasonably practicable (a) publish the indicators as revised and (b) lay a copy of them before the Senedd. These national indicators were laid before the Senedd in 2021. The indicators laid on 14 December 2021 replace the set laid on 16 March 2016.

Information on the indicators, along with narratives for each of the wellbeing goals and associated technical information is available in the Wellbeing of Wales report.

Further information on the Well-being of Future Generations (Wales) Act 2015.

The statistics included in this release could also provide supporting narrative to the national indicators and be used by public services boards in relation to their local wellbeing assessments and local wellbeing plans.

We welcome any feedback on any aspect of these statistics which can be provided by email to: stats.healthinfo@gov.wales

Ystadegydd: Craig Thomas
E-bost: ystadegau.iechyd@llyw.cymru

Media: 0300 025 8099

SFR 108/2024

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