Members of the public need to understand what we’re able to provide and how we can play a vital role in the health of their community

Mukesh Lad, chairman of the LIPCO federated group, reflects on how far the profession has come over the past 25 years. And how far it still needs to go

The year-end always gives me the urge to look back, and I’ve recently been reflecting on my 25-year-plus journey as a pharmacist. Without doubt there have been significant moments.

How many readers remember the Nuffield Report saying: “The pharmacy profession has a distinctive and indispensable contribution to make to healthcare that is capable of still further development”? Ever since 1986, we’ve been encouraged to step out of our dispensary and engage with patients to allow our education and training to equip us to “play a unique and vital role in provision of healthcare in the community”.

It took almost 20 years to apply the sentiments of that report to the negotiation of the new pharmacy contract of 2005. At last, a contractual framework to deliver pharmaceutical services to patients …

In addition to our essential services allowing us to provide a core supply function, we witnessed the introduction of advanced and enhanced categories of service. This fundamental development encouraged us to put into practice the knowledge we gained as a graduate.

Back to the future

Fast forward another 10 years and two more significant developments in 2015. Firstly, a £15m investment by NHS England into practice-based pharmacists to stimulate GPs into allowing them to play a critical role in the delivery of collaborative primary care. If implemented with careful planning, this initiative could banish the traditional silo mentality and lead to improved inter-professional communication and collaboration.

The second and most clinically significant development has been the introduction of the national pharmacy flu vaccination service. Despite the late arrival of the green light for the 2015 flu season, it’s nevertheless set a precedent for community pharmacy and its capability to deliver invasive procedures to patients – first of its kind for the NHS since its inception.

On reflection, throughout my career so far, there have been moments of major significance. Nobody said anything would happen quickly. If I were to have said to a pharmacist 25 years ago that one day I would be working in a GP surgery or that I would be injecting a patient with flu vaccine, I would have been called a fool.

Today, though, brings us a new reality. NHS change, including the Five Year Forward View and the introduction of innovations like the Primary Care Home proposal, will undoubtedly impact on community pharmacy. I don’t think anyone can argue that the speed of change over the past 25 years has been slow. The next 25 years will be different. Change will be gathering momentum at an incredible pace. This is not because of NHS restructuring or our ability to deliver new clinical services. In fact, the future inertia is almost out of our own hands because our industry will be driven by technological development.

Embracing technology

Who would have thought 10, let alone 25 years ago, that we would now be able to buy a mobile phone that’s also a television? If you’d have told me I would be able to change my home heating thermostat without even leaving my workplace, I’d have called you mad! But the moment pharmacy embraces the capabilities of this level of technology, our profession should become unstoppable in what it can achieve.

However, let’s get back to the reality of our situation in the here and now. As independent pharmacists, most of us are eager to embrace the smart, shiny and new. But what about our customers?

The shocking truth is that most of them still don’t realise what we can do for them. Only last week, to support the Ask Your Pharmacist campaign, I was on a BBC Radio phone-in show fielding listener questions. Not one person asked about services available from a community pharmacy. Instead, I almost lost count of the number of people asking about the effects of statins. The majority of patients still just see us as a place to pick up their pills and, if we’re fortunate, as experts in medicine; hence the NPA’s theme for the week – ‘A package of care, not just a packet of pills’.

A long way to go

Our profession still has a long way to go before we can immerse ourselves in the exciting world of technology. First we need to concentrate on communication, communication, communication. Members of the public need to understand what we’re able to provide and how we can play a vital role in the health of their community.

It’s taken a long time for us to reach the point we’re at today. Independent pharmacies especially have to now accept the broader scope of being able to deliver clinical services. Most important of all, though, each and every pharmacy team needs to sell its value in the heart of local communities. You have to seize every opportunity to make the public aware of what you can do for them, other than provide packets of pills of course.

We can’t be complacent. As in every year that draws to a close, the Grim Reaper is always lurking in the shadows. This year, he’s already roaming the darkened portals of government, where latest suggestions are hinting at a reduction in pharmacy numbers to cut NHS costs.

For us to guard against such threats, independents need to integrate into local health and social care models. We need to adapt and makes ourselves indispensable to the local NHS provision agenda. Of course, there’ll be no point at all in doing that unless we remember to communicate, communicate and communicate, with the public at large, who, ultimately, are our end users.