Health services are changing. There is unprecedented demand as people live longer and suffer more complicated health issues, but our options to detect, treat, refer, or support self-care are benefitting from the rapid introduction of new technologies. Our vision for the future of community pharmacy is very different too, as the focus shifts in particular from supply to prevention and the first port of call for minor ailments and injuries.
This change in focus and activity will shift the development needs of the pharmacy workforce, and LPCs up and down the country are working out, often in partnership with local NHS England and Health Education England bodies, and the Centre for Pharmacy Postgraduate Education, how best to meet the demand.
One of the more difficult things facing community pharmacy is the variation in specification and processes associated with locally-commissioned services, even in small geographies. With a mobile and flexible pharmacy workforce it can become very difficult for regularly rotating teams, relief staff and locums to keep themselves appraised and certified to deliver the range of potential services.
The work to enable development goes hand-in-hand with harmonising service specifications and accreditation requirements so they are consistent (or as consistent as possible) across Sustainability and Transformation Partnership (STP) areas, simplifying operations such as claims processing, and understanding the delivery mechanics through widespread use of PharmOutcomes.
For LPCs, the latest NHS initiative to deal with is working within clusters of local health partners called primary care networks (PCNs). In the longer term, CCGs will strategically commission PCNs to deliver outcomes, so a lot of the tactical commissioning of health services may come via the PCN rather than the traditional CCG or local authority routes. Preparing the workforce to be ready for when these organisations are looking for help with their issues will sometimes be at odds with the traditional method of learning to deliver a service in response to a commission, or clearly stated commissioning intention.
Like many LPC colleagues in the country, I have work to do in clearly articulating to contractors why engagement with PCNs and investment in their workforce now will enable them to offer sustainable and profitable services in the future.
The timing and co-ordination of this activity is crucial, not least with newer branches of our profession such as GP practice pharmacists, medicines optimisation pharmacists and care home pharmacists. Some cross-discipline collaboration will be vital to ensure we all understand what each brings to the PCN team.
I’m ambitious for a future where collaboration between the pharmacy elements of a mature PCN makes the treatment outcomes for patients better and more accessible, with the right care being delivered efficiently at the right place by the right person. We have seen the initial positives of this in Cheshire with the chief operating officer of a GP federation attending our briefing on the new GP Digital Minor Illness Referral Service pilot, where practices will be referring patients directly to community pharmacies within his PCN. His attendance was to ensure that they could cascade to their whole team the scope of the work we could do and to make best use of the service for their patients. This was great. Multidisciplinary teams working in a collaborative, not competitive, manner for mutual benefit and the best outcomes for patients. Just what was envisaged and really encouraging.
We have an exciting time ahead. All this work must sit alongside that underway to develop the pharmacy workforce syllabus and standards, which is being undertaken by Health Education England, NHS England and the Royal Pharmaceutical Society on a national footprint. Ultimately all of this should lead us to a point where wider pharmacy teams can operate together to best deliver care to patients in a more sustainable manner. Sustainable for the system, for GP practices, and making community pharmacies an important, embedded, and part of primary care locally.