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Community pharmacy

Primary care networks should 'harness' benefits of community pharmacy, says clinical senate

The clinical senate for the South West of England has backed the idea that pharmacists should have full access to the patient record, and said there should not be a cap on the number of medicines use reviews they can do.

Pharmacists should have full read/write access to patient records, the current cap on medicines use reviews (MURs) should be scrapped, and primary care networks (PCNs), should be used to integrate the potential of community pharmacies into wider community services, the clinical senate for the South West of England has said.

The senate, which is one of 12 across England, also said it hopes that its local recommendations will be adopted nationally by the NHS England pharmacy commissioning team, NHS Digital, and Public Health England.

Clinical senates provide advice to commissioners to improve healthcare decisions for local communities. In the South West of England, the senate met with national pharmacy leaders, local pharmaceutical committees and commissioners, as well as hospital pharmacists, to consider how pharmacists can support community integration and deliver the aspirations of the ‘NHS Long-Term Plan’, which was published in January 2019.

The resulting recommendations say that all sustainability and transformation partnerships (STPs), integrated care systems, and PCNs should clarify their strategies to harness the benefits of community pharmacies, and, in doing so, consider how existing pharmacy pilots, such as the NHS Urgent Medicine Supply Advanced Service, could be implemented locally and regionally.

The senate also said that community pharmacists should have read/write access to primary care clinical information systems to facilitate cross-messaging between clinical professionals and add value to patient records.

Another recommendation was for NHS England to remove the quota cap on community pharmacies which contractually limits them to 400 MURs per year. This, it said, would facilitate the provision of postdischarge reviews in the community, and consequently, reduce hospital bed days.

An interim funding arrangement for community pharmacy in 2019/2020 limited pharmacies to a maximum of 200 MURs in the first six months of next financial year. The Pharmaceutical Services Negotiating Committee said that this was because the future use of MURs would be part of soon-to-start negotiations on the community pharmacy contract.

Michael Lennox, chief executive of Community Pharmacy Somerset, said the senate’s report ”recognises the profound opportunity that exists in integrating community pharmacy within the emerging primary care networks and wider health ecosystems.

“I hope it will support system focus on delivering the key enablers required to optimise the care role of community pharmacy and positively influence both local and national development plans for the profession.”

In its report, the senate said that in discussions it had been told that pharmacists were “a highly skilled and significantly trained clinical workforce that has the capacity to deliver the aspiration of the ‘[NHS] Long-Term Plan’ or pharmacy, but which is currently an underutilised professional resource”.

And it had been highlighted that patients had not been told effectively of the additional services offered by pharmacists, in particular around long-term conditions.

It was agreed that a “culture shift” was required to ensure there was a shared vision for pharmacy services as part of a “wider community integration” to help build public confidence and acceptance of the “pivotal” role pharmacists can play.

The senate said that two of the STPs in the South West were already developing community pharmacy commissioning strategies.

Citation: The Pharmaceutical Journal DOI: 10.1211/PJ.2019.20206272

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