A shot in the arm from pharmacy

Community pharmacy as the natural home for primary care vaccinations? It’s a no-brainer, believes CCA chief executive Malcolm Harrison

They say prevention is better than cure, and over the past two years, this adage has never been more true.

Public awareness of vaccinations and the vital role they can play in keeping the nation healthy is at an all-time high. Government and the NHS are keen to maintain this awareness and the present momentum in uptake for vaccinations against common illnesses. Quite rightly, they see community pharmacy playing an important role in this space.

But with access to GPs still a burning issue, why beat around the bush? Community pharmacy should be the home for all routine NHS vaccinations in primary care. 

At the CCA, we recently published our prospectus A future for community pharmacy in England. As part of our offer for the health service, we call for all NHS-recommended vaccinations to be commissioned from community pharmacies. 

The sector already provides five million flu jabs a year and to date we’ve administered over 33 million covid vaccinations. We believe the sector can easily provide an extra 10 million routine vaccinations each year, including for diseases such as pneumonia, shingles, and meningitis.

There is no need for NHS England to carry out a pathfinder, pilot or trial – no need for evaluation or procrastination. Pharmacies have repeatedly shown they can deliver key national vaccination programmes. Patients want to get their vaccinations from their easily accessible and conveniently located local pharmacy.

The sector has a long history of offering private vaccinations and meeting patient needs. Increasing numbers of patients are turning to their pharmacy each year due to convenience and digital accessibility when it comes to booking appointments. When the NHS was concerned about the uptake in certain harder-to-reach socio- economic groups within the population, who did they turn to?

Changes needed 

At the CCA, we are not resting on our laurels. We are working to facilitate the transition of vaccination programmes into the sector. In summer 2020, a CCA-led roundtable presented the changes and steps needed to deliver flu vaccinations in a covid-afflicted world.

This work led to changes in law and in service specification, enabling off- site vaccine delivery, digital consent, and the use of pharmacy technicians as vaccinators. We also pushed for the sector to be able to access centrally produced stocks of flu vaccines.

Last year, my team worked with NHSE ahead of the winter 2022/23 vaccination programme. We put forward pragmatic proposals to simplify the designation processes and improve the service specification. More recently, my team engaged with influential think-tank Policy Exchange to develop the concept of a broad vaccination programme from community pharmacy. We were pleased that our recommendations were included in its subsequent report A Fresh Shot.

In a recent BBC interview, shadow health secretary Wes Streeting indicated his support, saying that pharmacy “has a big role to play”. Last month, health secretary Steve Barclay called for pharmacists to do “even more”.

It goes without saying that pharmacists are already overstretched. However, we know the sector can meet Mr Barclay’s challenge, if given the right tools and adequate funding. Covid-19 was a prime example of what can happen when you put faith and investment in pharmacy.

Capacity concerns

There is a danger, however, that the sector will reach its capacity limit. For more vaccinations to be delivered, it is necessary to release pharmacist time and expand capacity within the pharmacy team. This will require expanding the role of pharmacy technicians. This applies not only to vaccinations, but also to the increasing clinical direction of travel for the sector, as we examine what further clinical care pharmacies can provide.

During the covid vaccination programme, technicians showed a glimpse of their potential, providing real- world evidence that they can increase capacity. We need to go further to reap these benefits. Without delay, pharmacy technicians should be added to the list of professionals who can work under Patient Group Directions. This is something the CCA has campaigned for and will continue to do.

Community pharmacy as the natural home of vaccinations is a no-brainer. Access to primary care urgently needs to be increased, and if policymakers want pharmacies to help, they must ensure the financial viability of the sector.

Commissioning pharmacies to deliver more vaccinations will bring in much needed funding. Crucially, patients will be able to receive a vaccination closer to home, at a time that is convenient for them. This shot in the arm is in the best interests of patients and primary care.

Malcolm Harrison is the chief executive of the Company Chemists’ Association (CCA)