Dr Jagan John, the chair of Barking and Dagenham Clinical Commissioning Group, has warned community pharmacy to ensure it is involved in the government’s social prescribing programme and other new models of care because its business model “is not fit for purpose any more.”
Speaking at a North East London Local Pharmaceutical Committee (NEL LPC) event at the London Stadium in Stratford, Dr John said community pharmacies needed to heed plans recently laid out by the health secretary Matt Hancock which are designed to tackle loneliness and isolation in local communities without the need for medicine.
Under the government’s loneliness strategy, GPs working alongside other healthcare professionals including pharmacists can refer people suffering from isolation to social and art clubs and cooking classes, the rationale being that social prescription can reduce the over-prescription of drugs.
Hancock last week unveiled his plans to introduce social prescribing academies which would underpin the social prescription model following the government’s pledge to provide an extra £1.8 million for community projects by 2023.
“We will create a National Academy for Social Prescribing to be the champion of, build the research base, and set out the benefits of social prescribing across the board, from the arts to physical exercise, to nutritional advice and community classes,” he said.
“A resource which GPs and other frontline health workers can draw on for guidance and expertise. Where they can learn what works, and what’s available in their communities.”
Urging community pharmacists to get involved in the academies, Dr John said: “Social prescribing allows people to access services they may not be fully aware of.
“In 2023 the government will support all local health and care systems to get social prescribing connected to schemes across the country. We’ve seen the contractual levers coming through and we’ve seen the monies attached to it.
“It’s a big thing that Theresa May and Matt Hancock have signed up to and say ‘we want to get to use the local assets.’ What is the local versus national formula?
“It should be available in GP practices? What Matt Hancock is saying is actually, it should be wider than GP practices. It should be wherever we think it should be in the community.
“There’s a loneliness minister. You’ll see that this (is part) of this whole strategic approach. How are (community pharmacists) going to deal with this older age population and how are you going to deal with frailty?
“Frailty is a big topic at the moment. In Barking and Dagenham where I reside as a GP, frailty can be a 30-year-old or a 20-year-old. It depends on the condition rather than the age.
“Of course, there is evidence about the physical and mental health and wellbeing of these patients. They are taking about a national academy for social prescribing. Are (community pharmacists) the future members of that academy?
“I hope you are. I hope north east London (LPC) will put in an attempt to say ‘we’ll actually be part of this.’”
Dr John said one view was that “the only way” community pharmacies could survive would be to become “private businesses” but insisted the sector had “a bigger role in terms of integration.”
“We are supported by a huge strategic landscape. The Mayor of London, it’s part of his inequality strategy and actually put money forward for this, the London health boards and executives are leading on (this), all of London’s STPs are signed up for the social prescribing,” he said.
“You are part of that STP (sustainability and transformation partnership). Where is pharmacy? Let me challenge you. I’ve already got meetings with Hemant (Patel, the secretary of NEL LPC) going forward but still, this is national policy. There is a wider system of leadership.
“You don’t actually need to look at our local STP. Some of our pharmacy colleagues are actually not pharmacies. They are centres for health and social care, really impressive stuff I’ve seen.
“If you look at some of these pharmacies you wouldn’t think you were in a pharmacy. There is a pharmacist who is the conductor but the services that he offers and the how well he is a part of the community is a very different model to what we have in the UK.
“The assets (pharmacy has), and not just buildings, but you as a workforce are an incredible resource that we really haven’t really explored. How do we keep you as part of that placed-based care (model), how do we involve you with this system integration going forward for any new design model of care?
“Where do you sit in the model? Do you want to got for the piecemeal stuff? I would argue the case that modern pharmacy and the business model you have is not fit for purpose any more.
“The only way you’re going to survive is by becoming private industries and that’s where your capital will come from but actually, pharmacy has a lot more to give, not just about medicines and doing bits and pieces on AF (atrial fibrillation) and mobility equipment (but) it has a bigger role in terms of integration, in terms of getting those communities going forward.
“How together do we, as clinicians and colleagues, push this agenda of the reactive to a proactive NHS or proactive community?”
Dr John said his CCG was “looking at wider opportunities” and insisted they wanted community pharmacy “to get involved hence why I’m here (at the NEL LPC event).”
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