Youth-led ‘Think Outside the Block’ toolkit rolled out to secondary schools across Pembrokeshire

A wNEW mental health and wellbeing resource designed by young people for young people has been launched in Pembrokeshire to mark Children’s Mental Health Week.

The county’s Children and Young People’s Rights Office (CYPRO) has unveiled Think Outside the Block – an interactive booklet and game aimed at helping pupils better understand emotional health and feel more confident talking about it.

The resource, launched this week (Feb 9–15), encourages open discussion, challenges common misconceptions and builds awareness around issues including anxiety, self-esteem, neurodiversity and general wellbeing.

Importantly, the project has been created by members of the Pembrokeshire Youth Assembly, working alongside CYPRO and the Primary Mental Health and School In-Reach teams.

The idea grew out of the county-wide “What Matters to You?” consultation, where young people identified mental health and emotional wellbeing as one of their top concerns. Participants said terms linked to mental health and neurodiversity are often used without clear understanding, which can create confusion and stigma.

Think Outside the Block aims to tackle that by using accessible language and interactive activities to help children explore key topics and develop the vocabulary they need to speak openly about how they feel.

Over the coming days, CYPRO will distribute the resource to secondary schools across the county. Staff will be able to use it in classrooms, youth settings and dedicated wellbeing sessions.

A spokesperson for CYPRO said: “This project has been led by young people, for young people. Their voices and experiences have shaped every part of this resource.

“We are delighted to share it with schools across the county and support meaningful conversations about mental health, emotional health and wellbeing.”

The Youth Assembly continues to play a central role in representing the views of young people locally, with this latest initiative described as a strong example of co-production in action..

Picture: Members of the Youth Assembly launch the Think Outside the Block resource (Pic: Supplied).

COMMUNITY pharmacies across Wales are being forced to sell some medicines at a loss because of an outdated NHS funding system that no longer reflects real-world costs, owners have warned.

Under current rules, pharmacists must dispense prescriptions at prices set nationally, even when those prices are lower than what they paid wholesalers — leaving them out of pocket on everyday items such as aspirin.

The situation has led to mounting debts, emergency loans and, in some cases, owners remortgaging their homes simply to keep their doors open.

Figures from the National Pharmacy Association suggest four in ten Welsh pharmacies were not profitable last year, with many described as “clinging on by their fingertips”.

Selling at a loss

Unlike normal retailers, pharmacies cannot set their own prices or refuse to stock products.

They are contracted to the NHS through the Welsh Government’s Community Pharmacy Contractual Framework, which fixes reimbursement rates for prescription medicines.

But wholesalers’ prices have risen sharply due to inflation, supply shortages and higher manufacturing costs.

That means the maths often no longer adds up.

In one example shared by pharmacists, a packet of 75mg aspirin costs £3.75 to buy but is reimbursed at just £3.05 — a loss of 70p each time it is dispensed.

Multiply that across hundreds of packs a month and dozens of other medicines, and small losses quickly turn into thousands of pounds.

One west Wales pharmacy owner told The Herald: “You wouldn’t run a corner shop selling bread for less than you paid for it. But that’s effectively what we’re told to do every day.”

‘Averaging out’ no longer works

The government’s model assumes that losses on some drugs will be balanced by profits on others.

But pharmacists say that system — once workable — has broken down.

Generic medicines that previously provided modest margins are now also rising in price, while reimbursement rates lag weeks or months behind market costs.

At the same time, running costs have surged.

Energy bills, staff wages, National Insurance contributions, fuel for deliveries and regulatory costs have all increased, while core NHS funding has remained largely flat in real terms for nearly a decade.

Owners say they are now busier than ever too, as GP surgeries redirect patients to pharmacies for minor ailments, vaccinations and clinical advice — work that takes time and staff but often brings little additional income.

Debt and closures

The result is growing financial pressure.

Some pharmacists report taking out short-term loans just to cover monthly payroll, while others have dipped into pensions or personal savings.

Across the UK, hundreds of community pharmacies have closed in recent years, with rural and small-town chemists particularly vulnerable.

Health campaigners warn that if closures continue, patients could lose easy access to prescriptions, advice and walk-in care — pushing more pressure back onto already stretched GP practices and hospitals.

David Thomas, Welsh Board member for the National Pharmacy Association said: “These shocking findings should sound major alarm bells to the Welsh government and will understandably cause concern to patients who depend on their local pharmacy.

“It is simply unsustainable and unfair to expect individual pharmacy owners to remortgage their house and dip into their pension pot to subsidise the cost of prescriptions and to keep their doors open for their patients.

“Pharmacies are hanging on by their fingertips and something has to change. Without urgent action, the government risks pharmacies closing for good and their New Prescription Service going up in smoke.

“To prevent this from happening, the government should step in and offer pharmacies a stabilisation payment, similar to recently offered to GP colleagues.

“Only through stabilisation and long term investment can pharmacies deliver the expansion in services for patients and take pressure away from others in the NHS.”

Russell Goodway, Chief Executive at Community Pharmacy Wales, the organisation representing all community pharmacy owners in Wales, said:
“The findings of this poll closely mirror our own evidence and reinforce the very real financial pressures currently facing community pharmacies across Wales, regardless of size or ownership model.

“Community Pharmacy Wales has been in ongoing dialogue with the Welsh Government Cabinet Secretary for Health and Social Care since before Christmas, seeking to secure a recurring stabilisation payment. Such support is essential to prevent further deterioration and to safeguard the sustainability of the sector. We will continue to make a strong and evidence-based case for the additional resources that are urgently needed.”

Government response

The Welsh Government says it recognises pharmacies are an essential part of primary care and points to increased investment, including additional stability payments and grants for premises improvements.

A spokesperson said reimbursement prices are set using supplier data and that “while some medicines may be reimbursed below cost on occasions, this is offset by the profits pharmacies make on most of the medicines they dispense”.

But pharmacists argue that assumption no longer reflects reality.

A simple question

At the heart of the row is a basic principle.

If the NHS commissions a service, pharmacists say, it should at least cover the cost of providing it.

As one owner put it: “No business can survive by selling stock at a loss and hoping it balances out. Eventually the numbers catch up with you.”

Unless the funding formula changes, many fear more local chemists could disappear from Welsh high streets — and with them one of the most accessible parts of the health service.

Photo caption: Community pharmacies say fixed NHS prices are forcing them to dispense some medicines below cost (Pic: stock).

DECISIONS on the future of nine frontline hospital services across west Wales will be made later this month when Hywel Dda University Health Board holds a special two-day Board meeting.

The Extraordinary Board will meet on Wednesday (Feb 18) and Thursday (Feb 19) to determine the next steps for critical care, dermatology, emergency general surgery, endoscopy, ophthalmology, orthopaedics, stroke, radiology and urology services.

Health chiefs say the proposed changes are aimed at tackling staffing shortages, improving clinical standards and cutting waiting times for diagnosis and treatment.

More than 4,000 people responded to a public consultation on the plans. Feedback was gathered through questionnaires, public meetings, staff sessions and discussions with stakeholder groups.

An independent consultation report compiled by Opinion Research Services will form part of the evidence considered by Board members. It will sit alongside updated data on workforce pressures, estate condition, clinical standards and how services link together across hospitals.

All documents to be considered by the Board have now been published online ahead of the meeting.

Alternative ideas assessed

During the consultation, communities also submitted 190 alternative proposals.

Each idea was tested against “hurdle criteria” to check whether it was safe, practical and capable of delivery before being taken forward.

Of those, 22 met the criteria and have been developed into full options. These will be considered alongside the Health Board’s original proposals.

Board members will assess whether each option is clinically sustainable, deliverable, accessible to patients, aligned with the Health Board’s long-term strategy and financially viable. They will also decide whether further engagement or evidence is needed before any final changes are introduced.

Some changes, if approved, could be phased in over time.

Dr Neil Wooding, Chair of the Health Board, said: “At our meeting next week, the Board will carefully consider the consultation feedback alongside the latest clinical evidence, workforce insights, updated impact assessments and the alternative options that were put forward during the consultation.

“Our responsibility is to consider the full range of evidence and ensure we make decisions that ensure that our services are sustainable for the future. No decisions have been made ahead of the Board. We are committed to a thorough and transparent process, ensuring each option and alternative options are considered in the round, and focused on improving services for the people who rely on them.”