Position statement on pharmacy and the healthy food environment

The Welsh Pharmaceutical Committee supports regulatory action to restrict volume price promotions of High Fat, Salt and Sugar (HFSS) products, and restricting the placement of HFSS food and drink products at key selling locations including areas such as store entrances, checkouts and aisle ends.

The committee recommends these restrictions should apply to all pharmacies and where a pharmacy forms only a part of a larger retail premises, for example within a supermarket, the restriction should apply to the entirety of the footprint of the registered pharmacy and the areas immediately adjacent to the pharmacy.

The restriction should apply to all pharmacies regardless of physical size or number of employees.

It is estimated there are approximately 1.6m adults who are overweight and 0.6m adults who are obese in Wales, as noted on the Senedd's research website. More than one in four of our children are overweight or obese when they start primary school. The prevalence of tooth decay is improving at a population level but still affects one third of all five-year-old children in Wales as noted by Public Health Wales.

As a society we consume too much sugar, saturated fat and salt and too many calories. Being overweight or obese results in long term health problems such as cardiovascular disease, type 2 diabetes, and osteoarthritis. Excessive ingestion of sugar increases the risk of tooth decay at all stages of the life course.

Pharmacy professionals in all sectors play important roles in supporting people who are overweight to lose weight, supporting healthier food choices, taking more exercise, optimising medication regimens to minimise side effects from medicines which may cause weight gain, and prescribing and dispensing weight loss medication. Community pharmacy teams frequently provide advice about maintaining good, and the management of symptoms of poor oral health such as dental pain or gum disease.

In addition to helping people to take greater personal responsibility, the Welsh Pharmaceutical Committee agrees more can be done to ensure the environment supports people to make healthier choices. The committee recognises that as healthcare providers whose premises often include a retail component, community pharmacies are part of the wider food environment which influences people’s lifestyle choices.

This position aligns with the strategic goals for pharmacy in Wales specifically the goal to “increase our focus on health, wellbeing and prevention with all community pharmacies becoming health and wellbeing hubs” described in Pharmacy Delivering a Healthier Wales on the Royal Pharmaceutical website.

Community pharmacies play a pivotal role in shaping and contributing to public health. There are nearly 700 community pharmacies in Wales, located on high streets, shopping parades, in supermarkets and GP practices in villages, towns and city centres across Wales. As covered in the Journal of Public Health, they are more likely to be located in the most disadvantaged areas of Wales which the Senedd's research website notes are where health needs are greater and obesity rates are highest.

Community pharmacies are generally patients’ first and often their most frequent point of contact with a healthcare professional. Pharmacists are highly trusted sources of advice on health issues and on how to best protect the health of the public as noted by the Edelman Trust Barometer. In this context the role community pharmacies as retailers play in promoting a healthy food environment cannot be understated.

The committee consider it is plausible the availability or promotion HFSS products at pharmacy premises could incorrectly imply their overconsumption does not constitute an unhealthy lifestyle choice. The availability of HFSS products at pharmacy premises is in conflict with the professional responsibilities of pharmacists and pharmacy technicians and poses an unacceptable risk to the health of the public.

The committee believe the overwhelming majority of pharmacy owners already adhere to restrictions on the availability of HFSS products at their pharmacy premises but consider further action including, if necessary, regulatory action, is warranted to ensure community pharmacy demonstrates leadership in this area.