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RPS lays out the future of pharmacy in new policy document

The Royal Pharmaceutical Society’s vision for the future of pharmacy calls for access to virtual consultation tools and support for patient-facing pharmacists to become independent prescribers.

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Source: Royal Pharmaceutical Society

The Royal Pharmaceutical Society policy document aims to ensure that positive changes that have arisen during the COVID-19 pandemic are carried forward

All patient-facing pharmacists must be supported to become independent prescribers, and pharmacists across all settings should have access to virtual consultation tools and equipment, said the Royal Pharmaceutical Society (RPS) in its latest policy document on the future of pharmacy.

The future of pharmacy in a sustainable NHS’, which is comprised of 3 key priorities and 19 principles, draws on the experience of RPS members, patient groups and the wider pharmacy profession during the COVID-19 pandemic to highlight the enhanced contribution the pharmacy profession can make to patients and the NHS going forward.

It maps out key recommendations under three main priorities: supporting and valuing the pharmacy workforce; supporting an integrated NHS; and innovation. The aim of the document is to ensure that the positive changes and opportunities that have arisen for pharmacists during the COVID-19 pandemic are carried forward. 

“We’re clear that losing any key benefits to patient care and pharmacy practice that resulted from the COVID-19 pandemic is not an option,” said Sandra Gidley, president of the RPS.

“Much of the pandemic was extremely challenging but many positives have also emerged.”

Gidley highlighted examples such as flexible opening hours, which have given pharmacy teams the opportunity for professional development and time to focus on complex queries, and the growth of virtual consultations which has transformed access to care across the NHS.

“We want to see this implemented in pharmacies across the country to complement face-to-face advice,” she said.

“We also want to ensure the NHS and employers provide the opportunity for all patient-facing pharmacists to become independent prescribers. This will make the most of the profession’s unique skills and knowledge, increase capacity in the system and provide better outcomes for patients.”

Gidley said the RPS would work with governments, the NHS, employers and others to ensure the recommendations became the ‘new normal’ across all areas of practice.

“Pharmacy is at an important crossroads and the decisions and actions taken now will be critical in crafting the future we want for pharmacy and our patients,” she added.

Citation: The Pharmaceutical Journal DOI: 10.1211/PJ.2020.20208204

Readers' comments (1)

  • Dear Sandra Gidley
    I'm with you all the way I copy below a blog I recently wrote for Primary Care Commissioning that was published last week. Can the Community Pharmacy become the gateway to integrated care in the NHS?
    The NHS is a continually evolving innovative demand led public service the role of the Community Pharmacist is becoming the public face on a journey to the more responsible public engagement in the personal care of individuals and their family. There are currently over 11000 Pharmacies many are single or small chain service providers, while multiples occupy the urban shopping centres and more densely populated conurbations, the value of the rural High Street can’t be understated.
    COVID 19 and “Lock down” is driving change to on line shopping and remote prescription dispensing. Use of IT and remote prescribing and dispensing for an ageing population and the development of more “out of town housing” is putting pressure on GP services at a time when new entrant numbers are falling and failing to match retirements, many rely on locums. Surely this and the drive for more “Self Care and personal responsibility” though OTC medications gives the Pharmacist an opportunity to use their skills and competencies to best advantage, yet weekly I see announcements about the closure of pharmacies or staff reductions due to loss of viability as a business.
    Online shopping, working from home and other changing routines are heralding the demise of the of the High Street, the domino effect of closure of a Public House, Post Office, Library or Pharmacy can only reduce “Footfall” more rapidly leading to greater levels of isolation and exclusion particularly for the elderly and the infirm, in turn putting more pressure on the NHS. In the same way the other historic trade of the pharmacy is being denuded. This all adds up to question the continued viability of the Community Pharmacy.
    Added to the foregoing the development of centralised robotic dispensing and vending style collection machines will reduce staff costs, free up storage and other space within the footprint of the pharmacy business. Empty space does not earn.
    For over 25 years I have been involved in many facets of “Patient Representation” Community Health Council through to HealthWatch, besides provision of a new Acute Hospital, Ambulance Trust Public Governor, Fit to Practice Review I have for 10 years been the Lay Member of the PHE HLP Task Group. I have also been active in the development of a Rural Local Plan Review (Localism ACT). The next big leap in health provision will almost certainly be a National Standard Minor Ailment Service. Where will such a service operate from?
    The final paragraph of the 1948 NHS leaflet indicates that Health Centres will be opened in the future instead of GP practicing in their surgeries. Many are a long time coming, and practices are still run from former domestic premises or are in a conservation area, the later applies to many pharmacies as well expansion and relocation in the same site has already taken place or is impossible. New sites often have to be out of the centre of the community
    I put together a kaleidoscope of experiences, as they say in no particular order:-
    Proposed Minor Ailments Service
    Lack of development space
    To many inappropriate visits to A&E
    Ageing population
    Overcrowding of outpatient clinics
    Lack of further development space on hospital sites
    Merger of CCG’s
    Introduction of GP Networks
    Digital Health in Primary Care, Video Consultations
    Hyperacute Cardiovascular Stroke Centres
    Pacing clinic COPD and Diabetes management of stabilised patients
    ECG, INR, Retinopathy, Dermatology and Audiology
    Public Access Defibrillators
    Availability of SCR’s on line
    Carbon footprint
    Decline in public Transport services
    Greater emphasis on Self Care and taking greater responsibility for personal health
    No one knows what the long term demands of COVID 19 will be
    Identifying mental health issues
    Recruitment and retention
    Career structure

    No doubt the reader will add more!

    I said above I had been the Patient Representative member of the HLP Task Group, Level 1 has been achieved “HLPs will be embedded in the Community Pharmacy Contractual Framework, as of April 2020.” Level 2 is being defined.

    Community Pharmacies are recognised (Pharmacy First) as the first port of call (After 999/111 for trauma and non-life threatening emergencies). The use of “Freed up space” could provide new services in the community. Many of the planning time and constraints of new build would not apply as pharmacies are established health service delivery premises.

    So where is this leading?
    I would like to see rapid advancement to an additional level that I name HLP Level 4.
    I note SHPN 36 part 3 – Health Facilities Scotland, but go further.

    I advocate the commissioning of this Level 4 service, premises remuneration being set through the District Valuer according to local costs and a form of capitation according to services provided. An initial one off payment for fitting out and staff training.

    The premises enhancement would consist of:-
    An accessible discreet waiting area 2/3 chairs, display screen for health promotion controlled from a central source (No commercial advertising) unisex toilet with specimen pass through. Waiting patients should be visible from the pharmacy work area. An accessible interview room; table and 3 chairs, EMIS (or other system IT), Wi-Fi for both patient and clinician access.
    A consulting room equipped for purpose depending on selection of services offered.
    Hand wash PPE and infection control, clean and dirty facilities, lighting and ventilation, assistance alarm, ligature proof and an alternative exit as appropriate throughout. If there is not already a Public Access Defibrillator available 24/7 in the locality one should be included in the development.

    A nationally controlled computer system with printer able to print standard ailment guidance information as required including large print if required (including the leaflet in every medication package) this should also be available in GP Surgeries, A&E and other appropriate places. Selected information should be down loadable to the Patients phone or Laptop etc. This would also remove the need of many posters and leaflets while insuring everything is up to date.

    There needs to be a system of alerts when medications with contra indications are on the same script including precautions such as “avoid sunlight” “depletes vitamin......”

    I see the development of a career structure, Nurses, Paramedics and Social Care workers becoming part of the Pharmacy team. The creation of a new role of “Pharmacy Support Worker” these would work across the Network. Their function being to set up specialist equipment, clean, maintain and storage after use, BP and BMI, chaperone, ensure the patient has the right information and understands the medications purpose. Home visits to encourage lifestyle changes, observe medication/appliances storage and advise on consumption/use.

    Appointment booking centralised across the Net-Work, GP’s able to book urgent appointments between routine consultant reviews. Community and Social Services work allocation should also be controlled from this function. Hospital outpatient consultants and support when necessary could then be attached to one or more Networks according to work load. This would then create free space on the hospital sites. Reduce parking requirements at hospitals and reduce risk of cross infection

    While the principle of “walk in” must be maintained the majority of use should be by appointment set up by need of a consultant review, GP & 111 referral. With IT advances diabetic retinopathy services, and audiology maintenance services could be brought in instead of being in a transit van with two plastic chairs in the car park, no doubt there are other services this applies to. A larger more diverse community team will enable more home visits, better medication management.

    I contend that this will:-
    Improve the integration of Pharmacy into a holistic community care system.
    Be a “Greener” more efficient and less stressful experience for the patient.
    Enable GP’s to make better referral choices for newly diagnosed patients.
    Provide a space for live video consultations with remote consultants with additional skills.
    Ensure the continued viability of the Community Pharmacy
    Expand and make better use of NHS Estate without incurring excessive development and new build costs.

    Of course this is only a start. Is this a gate that needs pushing open?

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