Critical factors for pharmacy to survive reforms and funding cuts

Recent headlines have all been about the funding cuts for community pharmacy, which I have commented on previously (
The Pharmaceutical Journal 2016;296:39), but the planned reforms go much deeper. The intention is to look at access with potential changes in the number and distribution of pharmacies; further integration into the NHS, with an initial focus on the more specialist clinical role of pharmacists in GP practices; and the increased use of technology, hub-and-spoke models, digitalisation and click-and-collect options for the supply of patients’ medicines. Much of these are the NHS’s aspirations and, it would appear, has limited evidence or a robust strategic plan to underpin it. But the reforms are driven by a desperate need to deliver the demands of the Treasury to balance the books and the NHS ‘Five year forward view’, which seeks to address demand, quality and funding gaps.

However, it is not just the community sector that is having to adopt new ways of working. Hospital pharmacy has been facing significant year-on-year reductions in funding and has had to closely examine skill mix, lean working and the use of technology to achieve this. Following the Carter review, it was announced that there would be a further £1bn savings required from reduced medicines waste in hospital pharmacy over the life of the current parliament.

We must face and indeed embrace change if we are to adapt to an evolving landscape where payers and patients’ expectations are constantly shifting. This is something that community and hospital pharmacists and their teams have been fairly good at doing over the past decade but the pace is accelerating and new skills and knowledge, both professional and business, are now required.

My critical success factors for the profession are that: we must have a greater degree of collaborative leadership and support, not only between the national pharmacy organisations but also at a local and practice level, and with other care professionals; we must have a compelling and relevant offer for patients and the care systems that is sustainable; we must have a funding system that recognises and incentivises the provision of pharmaceutical care and the prevention of ill health, not just medicines procurement and supply management; and, most of all, we must choose to change and create our own future.

Michael Holden

Election candidate

English Pharmacy Board

Royal Pharmaceutical Society