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Review shows way forward for pharmacy services


Review shows way forward for pharmacy services

An independent review commissioned by NHS England has called for renewed efforts to make the most of community pharmacy clinical services.

The Community Pharmacy Clinical Services Review, carried out by Richard Murray, director of policy at the King's Fund, explains how community pharmacy teams can manage long-term conditions and embed medicines optimisation within care pathways. This may require national action through the Community Pharmacy Contractual Framework, as well as local progress on integrating pharmacies into evolving models of care, according to the report published today.

The report's recommendations include:

  • Incentivising the use of electronic repeat dispensing so that it becomes the default for repeat prescribing
  • A redesign of MURs to develop them into full clinical reviews including ongoing monitoring and follow-up of patients, consideration of prescription duration, and utilising independent prescribing as part of the care pathway
  • Including smoking cessation services in the national contractual framework
  • Using Vanguard programmes to develop the evidence base for community pharmacists, including integrating community pharmacists into long-term condition management pathways, involving them in case-finding programmes, and using new ways of contracting that mitigate any perceived conflicts of interest
  • Support from NHS England and national partners to help STP leads to integrate community pharmacy into their plans and local commissioners to contract for services
  • Joint work by PSNC, the Royal Pharmaceutical Society and national GP representatives to explore what practical steps can be taken to unravel professional boundary issues and ensure closer working between community pharmacists and GPs.

The report also calls for NHS England to set out how it intends to deliver on its commitment to ensure that minor ailments services are commissioned across England by April 2018. It also said that pharmacy technicians should be able to work under patient group directions. It recommends that a formal group, including community pharmacy representatives, should be established to have oversight of progress and recommend further action where needed.

Pharmacy Voice chief executive Rob Darracott said: “I am pleased to see so many elements of the Community Pharmacy Forward View reflected in Richard’s recommendations, although there are areas where we would have liked these to go further to match the sector’s own ambitions. Some of the recommendations will need further reflection, to understand how NHS England would look to implement them on a practical basis, and how potential unintended consequences would be avoided.

“The positive tone in this document is in stark contrast to the retrograde steps taken by the Department when it chose to reduce the NHS funding for community pharmacy services without a clear plan on how the network would adapt. I trust the publication of this report can mark the beginning of a new relationship between government and the sector as we both focus our efforts on delivering the best possible outcomes for patients."

Sandra Gidley, chair of the RPS English Board, said: “We welcome the reaffirmation of focus on pharmacists’ read and write access to patient records and other key clinical systems. For community pharmacy lack of access to critical clinical information remains a practical barrier to greater integration into NHS services that needs to be removed with urgency.

“It is not credible for anyone who works on the front line not to view this report without reference to the reduction in funding for community pharmacy. We are not alone in being concerned in how the circle can be squared; a reduction in resources does not help pharmacists do more to improve patient care.

“For the profession to have confidence in delivery of the recommendations set out in this document, the promised £300m integration fund needs to be translated into a workable implementation plan. The profession needs to hear how and when this fund will be deployed to ensure clinical medication reviews and independent prescribing move from being aspirations to reality."

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