Community pharmacy was handed its biggest opportunity yet to shape its own future in December when NHS England published ‘Improving health and patient care through Community Pharmacy – a Call to Action’. This consultation provides a rare opportunity for pharmacy staff to make their voices heard at the highest level, and comes at a crucial time in the profession’s development.
This is an essential piece of work for the pharmacy profession, says Claire Ward, chief executive of the Independent Pharmacy Federation. ‘Pharmacy can’t remain at a crossroads forever. This is pharmacy’s moment to consistently add value to patients beyond the supply function. It is also the time to be fully embraced by the NHS and recognised as a core part of health care delivery. We need to get patients and professionals engaged in this debate to create a real understanding of what community pharmacy can deliver.’
Sue Sharpe, PSNC chief executive, describes the Call to Action as ‘an important milestone for the sector in the reformed NHS’. Community pharmacy cannot afford to miss this chance to secure its future, she says. ‘The whole sector must be engaged if we are to ensure that our national commissioner hears the case for the role pharmacies can and must play in the health service and acts upon that.’
The whole sector must be engaged if we are to ensure that our national commissioner hears the case for the role pharmacies can and must play
The main purpose of the document is to ‘stimulate debate in local communities, to shape local strategies for community pharmacy and to inform NHS England’s strategic framework for commissioning community pharmacy.’ NHSE plans to use the results to ‘develop a contractual framework that better supports these aims and secures the most efficient possible use of NHS and taxpayer resources.’ Its aims for community pharmacy are to:
The Pharmacy Call to Action, which forms part of the wider Call to Action that NHS England launched last July, asks four key questions, to be discussed locally, around:
NHS England area teams are currently hosting local discussion events. These are open to everyone who works in community pharmacy, CCGs, commissioning support units (CSUs), health and wellbeing boards, local authorities, patients and carers, local education and training boards (LETBs) and academic health science networks (AHSNs). And pharmacy bodies are now bringing interested parties together to ensure their proposals include contributions from a wide range of pharmacists, patients, healthcare professionals and other stakeholders. PSNC held a series of engagement events for LPCs around the country during January. It also has detailed guidance and resources on its website to help LPCs participate.
Pharmacists are being urged to engage in this important consultation. Mimi Lau, Numark’s director of pharmacy services, describes it as ‘our biggest opportunity to shape what we want for our profession in the years ahead’. It is therefore ‘imperative’ that every person who works in community pharmacy, including support staff and employers, engage with it, she says.
This consultation is significant because it is the first overarching review of community pharmacy by NHS England and it is part of a series that also takes in GP services and others in primary care, says Mike Holden, chief executive of the National Pharmacy Association. ‘Independent pharmacists have a unique perspective to give – it’s important that their voice is heard,’ he says.
Pharmacists and their staff can download the documents and respond online via the NHSE website. Ms Lau suggests responding to the consultation individually by sharing examples of local success and any barriers to change. Examples could be within the four domains of pharmacy services, namely: Optimising the use of medicines, supporting people to live healthier lives, supporting people to self-care and supporting people to live independently.
Pharmacists should discuss the consultation with staff, pharmacists, other primary care colleagues and stakeholders, and attend meetings being held by LPCs and local area teams. Mr Holden suggests that independents take along a copy of the NPA’s ‘From Survive to Thrive’ document (which is referenced in the Call to Action) to help articulate their needs. Pharmacists should share best practice at these meetings. ‘Tell the NHS what is good about community pharmacy, not just the problems.’ These meetings are also a good chance to make commissioners aware of services needed locally and of ways to improve the local population’s health, he says.
The timing of this Call to Action seems ideal for the profession, which has just conducted its own review of service development via the 'Now or Never’ report of the Commission on future models of care. ‘That report has shaped our thinking about the role of pharmacists and the need for the whole profession to change to focusing to providing better care primarily through improved medicines optimisation across the whole medicines pathway,’ says RPS English Pharmacy Board chair Dave Branford. The Society has outlined five clear priorities as a result (see box).
Pharmacy Voice believes that there is more than one answer to the question of how to improve community pharmacy services. ‘We need to create a variety of solutions and innovations, but we will only be able to do this by acting together, as it is essential that we all hold the same shared values, and have the same desire to improve the lives of the people we serve and the people we employ,’ says Rob Darracott, chief executive, Pharmacy Voice.
Patients want personalised, high-quality, seamless care that is focused on their needs, says Mr Darracott. In order to achieve this, health and social care services must transform to meet rising demand and public expectation. ‘We are part of the “how” that will make change happen. There has been enough thinking, and it is now time for some action. It is essential that we start doing things better in community pharmacy, as well as doing better things.’
Organisations outside of the profession are preparing to express their own views, and some, such as NHS Alliance, are particularly pro- pharmacy. Mark Robinson, pharmacy, medicines and medicines optimisation advisor to the NHS Alliance, believes that there are many excellent examples of innovative community pharmacy-based services around the country. ‘Our issue is both integrating these more effectively within the total community-based primary care service and spreading them across the country to provide a consistency that patients can recognise and rely on. Small improvements in the use of technology, accelerating the access to Summary Care Records, direct access to GP appointments and teleconsultation can make a significant difference.’