Written question WQ92376

In November 2022 we published the Neurological Conditions Quality Statement which sets out our vision for good quality services for people of all ages living with neurological conditions in Wales, including migraine. It includes the outcomes and standards we expect NHS organisations to achieve in delivering services for people with these conditions. The statement was co-produced with the Neurological Conditions Implementation Group (NCIG) and the 20-plus third sector partners represented in the NCIG by the Wales Neurological Alliance, including representatives from the Migraine Trust.

I expect all NHS organisations in Wales to use the Quality Statement as the basis for planning how services for people with neurological conditions are developed and delivered, ensuring services are co-produced with people with lived experience, including those experiencing headache disorders such as migraine.

Headache disorders are debilitating. Timely access to advice and diagnosis has been an issue for people experiencing them. The All-Wales Headache Toolkit, which was launched in 2023 provides a quick reference guide for a range of healthcare professionals. The toolkit is fully aligned to National Institute for Health and Clinical Excellence (NICE) clinical guidelines and supports:

· The implementation of an All-Wales approach to improve headache diagnosis and the differentiation between different headache disorders (migraine, cluster headache, tension headache) and their management.

· Improving awareness and education of clinicians to manage people living with headache disorders.

· Clinicians to empower patients and improve their ability to self-manage their headaches, and understand the goals of available treatments, which in relation to migraine, might not be to eliminate them completely.

The toolkit is intended to provide a reassuring, structured approach to assessing, diagnosing, and managing headache disorders in the community, and increase confidence to make a referral where indicated.

Pharmacists can help people identify factors which may trigger migraines and support them to make lifestyle changes which may help reduce the frequency with which migraines occur.

Community pharmacists are able to discuss symptoms and offer a range of over-the-counter treatments for migraine, including medicines which were previously only available with a prescription.

Approximately one in four community pharmacies in Wales are now participating in our national pharmacist prescribing service, and from April this year, changes to the service will allow pharmacist prescribers working in those pharmacies to prescribe medication for people presenting with migraine if it is within their scope of practice. In accordance with NICE guidelines, pharmacists will refer people experiencing symptoms for the first time to their GP for follow up within eight weeks.