Community pharmacists could help to relieve pressure in many areas

Time to wake up

Both the British Medical Association and the Royal College of Nursing are holding their annual conference as I write. Speakers in both conferences have highlighted the pressures on the NHS.

The RCN revealed that beds were in such short supply that frail elderly people were being moved in the middle of the night and that, in order to move patients out of A&E departments, some were left on trolleys in corridors or received treatment in storerooms. The BMA said that the National Health Service was “bursting at the seams”.

The BBC asked a very pertinent question: “Has failure in the NHS become the new norm?” Four of the five worst months for reaching waiting time targets in A&E departments were January to April this year; March 2016 is the worst-ever month on record, and the target has been met only once in the past 18 months.

Yet, in England, the Department of Health seems oblivious. A spokesperson said the NHS was performing well, despite the pressures and that patient safety was the priority: “We are determined to make the NHS the safest and most transparent healthcare system in the world." It beggars belief. If patient safety is such a priority, why is it then that, recently, at the site of a motorway crash, a tent had to be erected because ambulances were stuck outside the local hospital unable to unload patients as the A&E department couldn't cope?

I’m not knocking the NHS. The organisation and its staff, including pharmacists, are doing brilliant work, but the pressure is inexorable. There are some encouraging initiatives. The Vanguard programme in nursing homes is designed to prevent hospital admissions. Among other things, it involves pharmacists doing much- needed medicines reviews.

And it’s working – ambulance calls have reduced dramatically, as has the number of falls. This is brilliant – though the Nuffield Trust says it’s more important to focus efforts on reducing length of stay. I’m not convinced. Let’s say the average length of stay for an elderly patient is 20 days. If that’s reduced by 25 per cent, five bed-days are saved. If the admission is prevented, 20 bed-days are saved. I’m just a simple pharmacist, but it’s pretty obvious to me where the effort ought to be.

Money is clearly at the root of the problem. As usual, the DH is in denial, pointing out that extra money is being made available following the NHS Five Year Forward View, with £3.8 bn being given this year. But that’s likely to be swallowed up to pay off last year’s deficits. It’s been pointed out that community pharmacists could help to relieve this pressure in many areas. And yet the government seems bent on ignoring this potential and decimating our numbers. It’s perverse. With money so tight, demand unrelenting, and targets not being met, it’s high time for the DH and ministers to wake up and smell the coffee.

Withering is the pen name of a practising independent community pharmacist. Withering’s views are not necessarily those of ICP