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Calling community pharmacy to action: where should the sector be heading?

The NHS “Call to action” for community pharmacy closes this month. Emma Page finds out what representatives from the profession hope the consultation will achieve

Pharmacy needs to speak with one voice in order to be heard, because messages from the profession can be confused or conflicting, according to the profession’s champion in Parliament Oliver Colvile, MP for Plymouth Sutton and Devonport, and vice-chairman of the All-Party Pharmacy Group.

For community pharmacy, there is hope that through NHS England’s “Call to action” consultation the profession can communicate to the NHS, commissioners and policy-makers what action should be taken to harness the sector’s potential. Time is running out though: the consultation closes on 18 March.

“NHS England’s call to action provides pharmacy with a real opportunity to define its own future,” says Kevin Barron, chairman of the APPG. “I’ve been in politics for over 30 years and I know that opportunities like this don’t come along every day — pharmacy must not miss the chance to make its voice heard.”

Where pharmacy should be heading

Many would like to see community pharmacy become the first port of call for patients with common ailments and for people seeking health and lifestyle advice. Rob Darracott, chief executive of Pharmacy Voice, argues that community pharmacy is not only a valuable health asset but also an important social care asset.

Peter Marks, chairman of Community Pharmacy Greater Manchester, believes that through the healthy living pharmacy model and providing minor ailments services pharmacy teams can divert patients away from GPs, freeing doctors’ time for more complex cases. “By increasing awareness and promoting the profession, we should be able to reduce the pressure on A&E and on the out-of-hours service,” he says.

Peter Bainbridge, director of pharmacy at Boots UK, believes that there is an “increasing level of innovation” coming through, highlighting the collaborative Community Pharmacy Future project (see News).

Clare Kerr, head of external affairs at Lloyds-pharmacy, summarises: “We are calling on NHS England to improve the ways in which services are commissioned from pharmacy, to bring about more consistency in specifications and accreditation which will undoubtedly improve public engagement, to introduce incentives which encourage greater collaboration among professionals, for example, shared outcome measures, access to healthcare measures and properly joined-up services with the patient at the heart.”

Wasim Baqir, research and development pharmacist at Northumbria Healthcare NHS Foundation Trust, agrees. “Community pharmacy needs to be seen to be a part of the NHS family and not an external business,” he says. He advocates a stronger relationship between community and hospital pharmacists, stating that sharing data and intelligence at the point of hospital admission and discharge will improve efficiency and safety, and reduce the risk of readmission.

Barriers that need to be overcome

Given the pressures on pharmacists’ time, how will these goals become reality? Independent contractor Mark Collins argues that, although it is important for community pharmacies to retain a supply function, the sector can take steps to change how it works.

“An example of this is to introduce dispensing robots, so pharmacists are less involved in the practicalities of dispensing and have more time with their patients,” says Mr Collins, who is also chairman of the Pharmaceutical Services Negotiating Committee’s local pharmaceutical committee and implementation support subcommittee.

Funding mechanisms must change, too. “Pharmacies will need to be given greater responsibilities for patient care,” says the PSNC’s head of NHS services Alastair Buxton, “and we believe that funding will need to be diverted away from secondary care and into preventive and primary care.”

Mark Burdon, North Eastern regional representative for the PSNC, wants to see a funding model that will allow local innovation. “But this should supplement a national pharmacy contract that delivers sufficient funding for us to continually invest in our businesses and improve the service we can offer our patients.”

Sandra Gidley, locum community pharmacist and member of the Royal Pharmaceutical Society’s English Pharmacy Board suggests that there should be a basic funding level for the core dispensing role, and then consideration could be given to how additional services are delivered and funded. This could be achieved by putting the contracts in the hands of individual pharmacists or, alternatively, the NHS could consider paying individual pharmacists to work across a range of pharmacies, she says.

How the public can best be served

It is also necessary for the public and other healthcare professionals to recognise pharmacists as medicines experts. “Medicines are the most frequent form of treatment for illness and maintenance of good health, yet the NHS Constitution fails to recognise this, or the important role pharmacists play in helping people use their medicines effectively. If the NHS Constitution is going to be important as a mechanism for signalling to the public what they can expect from the NHS, then this needs to be remedied,” argues Mr Darracott.

Another enabler for effective integrated services is pharmacy access to patient records. In its response to the NHS call to action consultation, Devon LPC argues the case: “It is a bizarre situation that a community pharmacist today is tasked with the legal responsibility to ensure that a medicine is appropriate for a patient, but has no access to the patient’s notes to confirm the disease that the drug is being used for.”

Individual pharmacists and the organisations that represent them need to take the opportunity offered by the call to action to demonstrate that the profession has a clear idea of where it wants to be and how this can be achieved.

Robbie Turner, chief executive of Community Pharmacy West Yorkshire, goes further: “We need to find out, through the call to action, what patients will need from us in the future, set a strategy with NHS England and then properly plan how best to deliver it. This is not the time for tinkering around the edges. This is the time to be bold.”

Citation: The Pharmaceutical Journal DOI: 10.1211/PJ.2014.11135457

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