Community pharmacy services: April 2022 to March 2023
Data on pharmacies, prescriptions dispensed and pharmaceutical services offered for April 2022 to March 2023.
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Introduction
This annual statistical release presents information about community pharmacies in contract with health boards in Wales. Community pharmacies are those commonly found on high streets, in supermarkets or within GP surgeries.
While dispensing prescriptions remains their primary role, community pharmacies have offered a range of additional NHS services over many years, and these functions have been enhanced by contract reform in April 2022. The reforms created a national clinical community pharmacy service enabling 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. New data for these services are summarised for 2022-23.
Statistics in this release are based on data provided by NHS Wales Shared Services Partnership (Primary Care Services). Further information is available in the quality report.
Main points
In 2022-23 there were:
- 708 community pharmacies in Wales, 4 (or 0.6%) fewer than on 31 March 2022 and 6 (or 0.8%) fewer than on 31 March 2014.
- An average of 111,330 items dispensed per community pharmacy, an increase of 2.3% from 2021-22 and an increase of 11.7% from 2013-14.
- Just more than 14,630 discharge medicines reviews, an increase of 5.4% from 2021-22 and twice as many (101.8% increase) from 2013-14.
- 704 pharmacies eligible to provide the newly established clinical community pharmacy service.
- Nearly 240,000 consultations for common ailments, an increase of 73.9% from 2021-22 and more than a five fold increase (453.9%) from five years ago.
- Just over 160,000 seasonal flu vaccines given to people eligible for NHS-funding, a 3.6% decrease from the previous year, but nearly three times higher (196.4%) than five years ago.
- More than 81,500 consultations for emergency medicines, an increase of 54.6% from the previous year and more than a four fold increase (357.6%) from five years ago.
- A little more than 31,000 emergency contraceptives issued, a decrease of 2.6% from the previous year and a decrease of 13.6% from five years ago.
Pharmacies
Figure 1: Number of pharmacies by type on 31 March each year, 2014 to 2023
Description of Figure 1: Line chart showing that the overall number of pharmacies has remained stable in Wales between 2014 and 2023, with a marginal decrease in the latest year. Over the same time period, the number of independent pharmacies has decreased, offset by a broadly similarly sized increase in the number of multiple (chain) pharmacies.
Source: NHS Wales Shared Services Partnership (Primary Care Services)
Community pharmacies by LHB and year on StatsWales
On 31 March 2023 there were 708 pharmacies in Wales, 4 (or 0.6%) fewer than on 31 March 2022 and 6 (or 0.8%) fewer than on 31 March 2014.
Of these, 486 were multiple (chain) pharmacies, 0.2% more than on 31 March 2022 and 5.7% more than on 31 March 2014.
222 were independent pharmacies, 2.2% lower than on 31 March 2022 and 12.6% lower than on 31 March 2014.
Prescription items dispensed
The main source of primary care prescriptions data is the Primary care prescriptions statistical release, which complements this community pharmacy release. The release provides detailed analysis on items prescribed by all primary care contractors and dispensed in the community. It includes information prescribing by pharmacists working in community pharmacies and those working in general practices.
78.8 million prescriptions were dispensed in community pharmacies in 2022-23. This excludes items dispensed by dispensing doctors and personally administered items prescribed and administered by a member of the general practice.
Figure 2: Average number of prescriptions dispensed per community pharmacy, year ended 31 March, 2014 to 2023
Description of Figure 2: Line chart showing the number of items dispensed by community pharmacies has increased steadily over the last 10 years.
Source: NHS Wales Shared Services Partnership (Primary Care Services)
In 2022-23, the average (mean) number of prescription items dispensed by community pharmacies was 111,330. This is an increase of 2.3% from 2021-22 and an increase of 11.7% from 2013-14.
Discharge medicines reviews
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.
703 pharmacies were accredited to provide discharge medicines reviews on 31 March 2023, and 543 or 77% of pharmacies provided discharge medicines reviews during 2022-23. This compares to 80% of pharmacies providing it in 2021-22 and 54% of pharmacies providing it in 2013-14.
Figure 3: Number of discharge medicines reviews, per financial year, 2013-14 to 2022-23 [Note 1]
Description of Figure 3: Line chart showing the number of discharge medicines reviews has increased markedly over time, more than doubling between 2013-14 and 2022-23.
[Note 1] Based on the number of claims paid for completing discharge medicines reviews.
Source: NHS Wales Shared Services Partnership (Primary Care Services)
Discharge medicines reviews (DMRs) by local health board and year on StatsWales
In 2022-23, just more than 14,630 discharge medicines reviews took place in community pharmacies, based on claims paid. This is an increase of 5.4% from 2021-22 and an increase of 101.8% from 2013-14.
Clinical community pharmacy service (CCPS)
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, emergency contraception, emergency medicine supply and seasonal influenza vaccination.
All pharmacies can provide the CCPS subject to meeting specified standards in relation to premises and training. All four services must be provided, or pharmacies must opt out of the service altogether.
As of 31 March 2023, 704 community pharmacies were opted in to provide CCPS. During the financial year 2022-23, the number of pharmacies that made claims for specific CCPS services may be greater as some pharmacies may have closed during the year.
Figure 4: Number of consultations provided through the four priority services included in the clinical community pharmacy service (CCPS), 2013-14 to 2022-23 [Note 1] [Note 2]
Description of Figure 4: Line chart showing a large upward trend in the number of common ailment services consultations, seasonal flu vaccines administered and emergency medicines supply consultations, while the number of emergency contraceptives provided has decreased slightly over the time series.
[Note 1] Emergency contraception data only available from 2014-15 onwards; common ailments service and emergency medicine supply only available from 2017-18 onwards.
[Note 2] The Emergency Contraception Service was extended to include the provision of bridging or quickstart contraception and renamed the Contraception Service in December 2022. Data for this service will be available in next year's statistical release.
Source: NHS Wales Shared Services Partnership (Primary Care Services)
Analysis for each of the four priority services is provided in the following sections.
Common ailments service
Community pharmacies provide advice and support to people on the management of common minor ailments, including where appropriate, the supply of medicines for the treatment of that ailment, for those people who would have otherwise gone to their GP for advice or a prescription.
706 or 99.7% of community pharmacies provided consultations through the common ailments service in 2022-23, based on claims paid.
Nearly 240,000 consultations for common ailments occurred in 2022-23. This is an increase of 73.9% from 2021-22 and more than 4 times (or 453.9%) as many consultations as five years ago.
More than 190,000 different people used the service during 2022-23. The large majority (82.0%) had one consultation in the year, but 16.4% had two or three consultations and 1.6% had four or more consultations.
Figure 5: Common ailments service (CAS) consultations by ailment, 2022-23
Description of Figure 5: Bar chart showing the number of consultations for each of the 26 conditions included in the common ailments service ranged from just over 40,000 for conjunctivitis to 17 for colic, in 2022-23.
Source: NHS Wales Shared Services Partnership (Primary Care Services)
Over half (54.0%) of all consultations were for four conditions (conjunctivitis (16.8%), hay fever (14.3%), sore throat and tonsilitis (12.6%), and dry skin/dermatitis (10.3%).
The number of consultations was greater in 2022-23 than in 2021-22 for all conditions. The largest percentage increase was for sore throat/tonsilitis which saw over a seven fold increase (725.0%), followed by chicken pox for under 14-year-old children (230.1%) and ingrowing toenail (116.1%).
Figure 6: Number of common ailments service (CAS) consultations by month, 2022-23
Description of Figure 6: Bar chart showing the number of CAS consultations varied by month, ranging from just fewer than 26,000 consultations in March to just more than 15,000 in September.
Source: NHS Wales Shared Services Partnership (Primary Care Services)
The demand for common ailment service consultations varied with the seasonality of the most common conditions and potentially the growing awareness of the service.
The number of consultations peaked in the last month of the financial year (March 2023), where over 7,300 conjunctivitis consultations and over 2,500 dry skin/dermatitis consultations occurred, more than in any other month, in addition to over 3,800 sore throat/tonsilitis consultations, the second most of any month.
The second highest number of consultations was in December 2022, where there were over 10,000 consultations for sore/throat tonsilitis, equivalent to a third (33.4%) of all consultations for this condition.
Similarly, the third highest number of consultations was in June 2022, where there were over 10,800 consultations for hay fever, equivalent to nearly a third (31.6%) of all consultations for this condition.
Figure 7: Distribution of common ailments service (CAS) consultations by age and sex, 2022-23
Description of Figure 7: Population pyramid chart showing a high concentration of consultations were for children, with further peaks for adults aged around 35 years old and 55 years old. The majority of consultations for adults were for females, while the number of consultations was more evenly distributed between male and female children.
Source: NHS Wales Shared Services Partnership (Primary Care Services)
In 2022-23, there was a high concentration of consultations for both male and female children, with close to one in four (27.3%) consultations relating to children under age 16.
Overall, a larger number of consultations related to female patients than male, with close to two thirds (62.2%) of all consultations relating to females.
There was slight variation in the age distribution of consultations for adult males; however, there was much greater variation in the age distribution for adult females with peaks between the ages of 30 and 40, and between ages 50 and 60.
Seasonal flu vaccine (SFV)
Community pharmacies can provide the NHS vaccination against seasonal influenza. The statistics in this release only includes 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.
673 or 95.1% of community pharmacies provided seasonal flu vaccines during 2022-23, based on claims paid.
Just over 160,000 seasonal flu vaccines were given to people eligible for NHS-funding. This was a 3.6% decrease from the previous year, but nearly 3 times as many (196.4% higher) than five years ago.
More than 25,000 people received the vaccine for the first time.
Of those people who had also received a seasonal vaccine in the previous year, a third (33.8%) had it provided through their GP practice in the previous year.
Figure 8: Number of seasonal flu vaccination (SFV) by sex of recipient, 2014-15 to 2022-23
Description of Figure 8: Line chart showing a large upwards trend in the number of vaccines given to both males and females between 2014-15 and 2021-22, followed by a slight decline for both groups in 2022-23.
Source: NHS Wales Shared Services Partnership (Primary Care Services)
In 2022-23, where the recipient’s sex was specified, 57.8% of seasonal flu vaccines were given to females and 42.2% to males. These percentages have remained consistent since 2014-15, the first year data was collected.
Figure 9: Number of seasonal flu vaccinations (SFV) by eligibility reason, 2022-23 [Note 1]
Description of Figure 9: Bar chart showing the large majority of vaccines were provided because the patient met the age criteria for NHS funded vaccines, in 2022-23.
[Note 1]: Includes all reasons for eligibility, not the number of people who were eligible. If a single person met more than one criterion, all reasons are counted in this chart.
Source: NHS Wales Shared Services Partnership (Primary Care Services)
In 2022-23, more than 15,000 people who received the vaccine in community pharmacies met the eligibility criteria for more than one category.
45.2% of recipients were eligible for NHS-funded vaccination because they were aged 65 or older; 41.3% because they were aged between 50 and 64; and 7.3% because they had a chronic respiratory disease.
Emergency medicine supply
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.
701 or 99.0% of community pharmacies provided items through the emergency medicines supply in 2022-23, based on claims paid.
More than 81,500 consultations for emergency medicines occurred during 2022-23. This is an increase of 54.6% from the previous year and more than 4.5 times (or 357.6%) higher than five years ago.
Figure 10: Reasons for requesting an emergency medicine supply, 2022-23
Description of Figure 10: Bar chart showing the number of requests for emergency medicine supply ranged from nearly 37,000 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: NHS Wales Shared Services Partnership (Primary Care Services)
A little fewer than half of requests (or 44.8%) for emergency medicines were due to the patient not ordering items from their GP in time, while just over a quarter (28.7%) of requests were because the items were not available for collection at the general practice.
Almost 9,000 (11.0%) requests were made by people who went on holiday without their medication, and almost 8,000 (9.7%) were from patients who misplaced their medication. Nearly 5,000 (or 5.8% of) requests were because the patient was unable to collect the medication from their usual pharmacy.
Figure 11: What the patient would have done if the emergency medicine was not provided, 2022-23
Description of Figure 11: 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: NHS Wales Shared Services Partnership (Primary Care Services)
Had the emergency supply of medicine not been given, more than 44,000 patients (or 54.0%) would have gone without their medication, while almost 36,000 (or 43.9%) would have contacted their GP or out-of-hours service.
Just over 1,000 (or 1.2%) patients would have visited an emergency department.
Figure 12: Most frequently supplied items through emergency medicine supply, 2022-23 [Note 1]
Description of Figure 12: Bar chart showing the 10 most frequently supplied items through the emergency medicine supply ranged from just over 3,500 Amlodipine (5mg, 28 tablets) to just fewer than 1,900 Ramipril (2.5mg, 28 capsules) during 2022-23.
[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: NHS Wales Shared Services Partnership (Primary Care Services)
Just over 131,000 items were prescribed through the emergency medicines supply. Nearly half (45.5%) of consultations resulted in 1 item supplied; just over a quarter (26.8%) resulted in 2 or 3 items supplied; and just over a quarter (27.7%) resulted in 4 or more items supplied.
2.7% of all items prescribed 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 Ventolin (100microgram, 200 dose) which contains the active ingredient salbutamol and is generally used for the relief and prevention of asthma symptoms.
Other items most frequently supplied include medicines to treat and prevent stomach ulcers, to reduce cholesterol levels, and to treat depression.
Emergency contraception
Community pharmacies are able to provide emergency contraception and sexual health advice.
685 or 96.8% of community pharmacies provided emergency contraception in 2022-23, based on claims paid.
Emergency contraception was provided on a little more than 31,000 occasions in 2022-23. This was a decrease of 2.6% from the previous year and a decrease of 13.6% from five years ago.
Figure 13: Reason for requesting emergency contraception, 2022-23
Description of Figure 13: Pie chart showing the large majority of emergency contraceptives were given because no contraception was used. This was followed by failure in the contraceptive method used and from the recipient missing a dose of the daily contraceptive pill, during 2022-23.
Source: NHS Wales Shared Services Partnership (Primary Care Services)
In 2022-23, three out of five (60.5%) recipients of emergency contraception reported that they had not used contraception. This is broadly unchanged from the previous year.
A quarter (24.6%) reported their contraception method failed, 8.9 percentage points lower than in the previous year. One in eight (12.3%) reported they had missed a dose of the daily contraceptive pill, an increase of 5.5 percentage points from the previous year.
Quality and methodology information
The data is provided by NHS Wales Shared Services Partnership (Primary Care Services). Further information is available in the quality report.
National Statistics status
The United Kingdom Statistics Authority has designated these statistics as National Statistics, in accordance with the Statistics and Registration Service Act 2007 and signifying compliance with the Code of Practice for Statistics.
National Statistics 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 National Statistics status following an assessment by the UK Statistics Authority’s regulatory arm. The Authority considers whether the statistics meet the highest standards of Code compliance, including the value they add to public decisions and debate.
It is Welsh Government’s responsibility to maintain compliance with the standards expected of National Statistics. If we become concerned about whether these statistics are still meeting the appropriate standards, we will discuss any concerns with the Authority promptly. National Statistics status can be removed at any point when the highest standards are not maintained, and reinstated when standards are restored.
The continued designation of these statistics as National Statistics was confirmed in June 2012 following a compliance check by the Office for Statistics. These statistics are designated as National Statistics and last underwent a full review against the Code of Practice in 2012.
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:
- Published the statistical release in html format, with more open data published on our StatsWales website.
Updated the quality report and refreshed commentary in the release.
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.
