Open more hours - the prime minister's challenge

Will the goverment's Challenge Fund mean longer opening hours for pharmacies? P3 asks

The Prime Minister’s £50m Challenge Fund will enable more than 1,000 GP surgeries to open evenings and at weekends. The initiative aims to relieve pressure on emergency services and is expected to benefit more than seven million patients in England, says David Cameron. But will pharmacies be expected to follow suit?

Mimi Lau, Numark’s director of pharmacy services, says that the issue is something that pharmacies will certainly need to consider. ‘Pharmacies that are affected by this first wave of 20 pilots will need to assess the implications of extending their hours or not, balancing their decision on commercial and professional grounds,’ she says.

Would patients be happy to wait until the next day or Monday to visit their usual pharmacy having received a prescription from a GP surgery with extended hours, or will pharmacies find themselves competing for more evening and weekend business over an above current hours?

"Pharmacies will need to assess the implications of extending their hours or not, balancing their decision on commercial and professional grounds"

‘This may not be an easy decision to make given that pharmacy margins are already challenged. There appears to be no golden ticket from David Cameron to fund pharmacy for this initiative. Once again, is pharmacy a loser in this next round of new government ideas to save the NHS?’ asks Ms Lau.

United front?

 

 

Royal Pharmaceutical Society director Howard Duff is more positive about the potential implications, and opportunities that the new initiative opens up for community pharmacies. ‘If demand for such services is there then pharmacies should be open longer to meet these needs. We would expect suitable compensation,’ he says.

It’s another opportunity to present a united front with general practice and run pharmacy services alongside those of general practice, he suggests.

‘For us [the RPS], this is more about the kinds of services offered rather than the opening hours. Pharmacists need to be integral to the healthcare service, integrated with doctors and nurses. We welcome such initiatives that utilise the skills of pharmacists.

‘This is an ideal opportunity to put to good use pharmacy’s unique public access in a way that will make us part of the primary care team,’ he stresses.

Improving access for patients

In December the Prime Minister, David Cameron, invited GP surgeries to apply for part of a £50m ‘Challenge Fund’ to pilot improvements in access to appointments for up to half a million patients. In April 20 pilots were announced that offer a range of different innovative schemes.

The pilots will explore a number of ways to extend access to GP services to better meet local patient needs, including:

  • Longer opening hours, such as extended weekday opening (eg 8am to 8pm) and opening on Saturdays and Sundays
  • Greater use of technology to provide alternatives to face-to-face consultations, eg via phone, email, webcam and instant messaging
  • Greater use of patient online services, including online systems of patient registration
  • Greater use of telecare and health living apps to help people manage their health without having to visit their GP surgery as often
  • Flexible access through emails, Skype and phone consultations
  • Easier online registration and choice of practice.

The pilot is part of a wider ambition to secure fully integrated seven-day services covering primary, community and social care, as well as hospitals.

Missed opportunity

Pharmacy Voice spokesman Rob Darracott says he feels that pharmacies already offer a very accessible service within wide opening hours. ‘Community pharmacies are generally open for longer than

GP surgeries, available without appointment throughout the week, in the evenings and at weekends. This makes pharmacists the most accessible health professionals.’

Not enough thought has been given in the new plans to consider how the wider system, including that of pharmacy, will work for patients. An already stretched pharmacy community may suffer as a result of this worrying oversight, he warns.

‘Given the current focus on increasing self- care, this announcement by the Prime Minister is yet another opportunity missed to join the system up better by investing in all the options for people when accessing the care they consider urgent. Putting more money into GP surgeries without context may paradoxically bring more pressure on the GP system.’

Why has pharmacy been left out of the plans, he asks? ‘Professor Sir Bruce Keogh’s initial report on urgent and emergency care put community pharmacies at the forefront of promoting more appropriate access. It’s a pity the PM has decided to apply a sticking plaster to general practice for a quick headline instead of taking this opportunity to invest in the community pharmacy front line, where access and convenience ‘after hours’ and at weekends is largely already a given‘With up to four per cent of out-of-hours calls relating to patients running out of their usual medicines, and up to one in five GP and A&E consultations for conditions pharmacists are perfectly capable of handling, Mr Cameron has missed a trick yet again by putting all his eggs in the same old basket,’ says Mr Darracott.

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