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A visionary alternative

We have to challenge the assertion put forward by Simon Stevens that it costs £2.8bn to deliver £9bn

of medicines

Chair of Pharmacy Voice Claire Ward explains why the Community Pharmacy Forward View is such an important document

It is difficult to know what the final outcome will be of the government’s plans for pharmacy. I assume that the worst case scenario is that the full £170m cut originally proposed would be implemented from December. And the best case consists of whatever the Department of Health can be persuaded to do as a result of further negotiations and campaigning.

There is no doubt that the strength of representations, including over two million signatures on a petition, has not passed unnoticed by politicians and government officials. The test is whether they allow it to shift their plans for pharmacy.

However, the government does have an alternative if it is prepared to think more strategically and longer term. We know that NHS England and the government need a solution to the problems they face: an ageing population, insatiable appetite for better medical treatment, shortage of medical staff and rising costs.

The Five Year Forward View set out the problems and some of the initial thoughts on how to solve them. Above all, it recognises that solutions would come from across all parts of the health service.

The pharmacy solution

We have recognised that if we are to operate more effectively we need to be integral to the NHS. We have to showcase and explain how pharmacy can be part of the solution, not a costly problem. We also need to show, as evidenced by the recent PwC report, the true value that community pharmacy contributes.

It is not simply about medicines supply. Indeed, we have to challenge the assertion put forward by Simon Stevens that it costs £2.8bn to deliver £9bn of medicines. On the contrary, he needs to understand that if he did not have the pharmacy network with all the extras it brings to patients and the public, that £2.8 billion would be a drop in the ocean compared to the real costs.

The Community Pharmacy Forward View has been a joint production of Pharmacy Voice and PSNC. Together, and with the support of the RPS, we have focused on how to create a sustainable role for community pharmacy that integrates it into everyday healthcare needs. Most of what is contained in the document is not unusual or even untested. There are numerous pharmacies across the country operating in close cooperation with their local GP, undertaking different services and utilising new diagnostic technology.

What is important about this document is that it is the first sector-wide vision for the future. It is the starting point for the conversation that pharmacy must have with the government and NHSE in order to solve the problems facing our society.

It has been developed by a group of pharmacists representing every part of the sector, because these are the people best placed to represent the vision of community pharmacy. It is not a finished piece – it does not end with the glossy publication. On the contrary, it is a starting point that needs even greater input from those working every day in community pharmacy.

Our vision is centred around three interdependent functions of the network:

  1. The facilitator of personalised care for people with long term conditions. An enhanced role for teams in supporting people with LTCs will be based around the principles of medicines optimisation and personalised care and support planning, and build on the clinical knowledge and procurement skills of community pharmacists to promote evidence-based and cost-effective use of medicines.
  2. The trusted, convenient first port of call for episodic healthcare advice and treatment. Our vision is that, in future, the habit of using ‘pharmacy first’ for non-emergency episodic care will be ingrained in patient, public and professional behaviours. To facilitate this, systems that enable triage to, and referral from, community pharmacy will be included in all local urgent care pathways and in the NHS 111 service. Pharmacy will have access to shared care records, too.
  3. The neighbourhood health and wellbeing hub. The local pharmacy will become the ‘go to’ place for advice and support on health and wellbeing. It will work closely with community leaders and local organisations to support and signpost patients to services that enable them to remain or become fit and well.

Much of what is described is already happening across all or part of the network, or could be if we had the right supporting systems, processes and incentives. We know that to implement the full vision we need better integration with the NHS and more collaboration across the health and care system. It will need new ways for pharmacy teams to work and of course a new way to fund these services.

It is ambitious but achievable. I hope you can contribute to this vision and ensure that the government understands that it can and should be its vision for pharmacy too.

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