Making the case for pharmacy
The current set of proposals will not deliver the outcomes that the government is demanding
Pharmacy Voice chair Claire Ward sums up the bodyâ€™s initial response to the governmentâ€™s proposals for the profession
Pharmacy Voice has grave concerns about the content of the consultation announced on December 17 in the â€˜Community pharmacy 2016 and beyondâ€™ document. It is concerned about the way the consultation has been conducted and the risks posed to patient care and population health. Its initial response to the consultation, published on February 15, sets out proposals for a more constructive and forward-looking approach to realising the full potential of community pharmacy.
Its position can be summarised as follows:
- Community pharmacy is a vital amenity for patients and the public. Pharmacy teams help people to stay healthy and well, and provide crucial clinical services when needed.
- Community pharmacy is an ambitious, entrepreneurial and innovative sector embedded in every city, town and village.
- Community pharmacy leaders recognise the unprecedented demands facing the health and care system and understand the need for continuous improvement in efficiency, quality, outcomes and value.
- We share the governmentâ€™s stated ambitions for the sector to play a greater role at the heart of the NHS, and want to work in partnership to achieve them.
- The current set of proposals will not deliver the outcomes that the government is demanding as they are ill-conceived and inconsistent.
- The effective, safe and sustainable route to a better future is through sector-led change, strategic investment and partnership working.
- Community pharmacy organisations are keen to play their part in delivering the Five Year Forward View for the NHS. We can help reduce demand on other providers, manage healthcare cost inflation and improve patient and population outcomes.
What pharmacy can deliver
- Universally high-quality public health and clinical services so people can confidently choose Pharmacy First for all support with medicines use, minor illnesses and healthy lifestyles advice.
- Urgent care services at pace and scale.
- Greater patient choice, convenience and personalisation.
- Management of all aspects of pharmaceutical care outside hospital: including medicines management across general practice, care homes and domiciliary settings and at points of transfer such as hospital discharge.
- Seamless patient journeys, enabling access to other services and professionals when required by signposting, making referrals, booking patients directly into other services and providing online access to specialist support and advice.
- Improved access to primary care services, making use of clinical expertise including prescribing skills to improve medicines use.
- Solutions to help address the crisis in GP access, by relieving the demand on general practice.
- Innovation, taking opportunities presented by devolution of health and care responsibilities and the development of new care models and working with local colleagues to find ways of removing barriers to integration, efficiency and effectiveness.
What we need
We call for the following commitments in return for the investment of resources, effort, expertise and time that the sector is willing to put into delivering the governmentâ€™s stated vision and our ambition for the sector:
- Stop the planned disinvestment in community pharmacy in 2016/17
- Agree a sustainable long-term settlement with the sector
- Invest in service transformation in the same way as for other parts of the NHS
- Put in place a joint, coordinated approach to planning investment and implementing change, in partnership with national community pharmacy bodies
- Deliver reforms required in other parts of the system, and in legislation, to enable community pharmacy to play its full role.
We need a planned, coordinated approach to:
- Make progress at pace and scale towards nation-wide delivery of:
- Minor ailments schemes
- Integration into NHS111
- E-repeat dispensing
- Development of a pharmacy care plan to support medicines optimisation.
- Initiate and manage a funded plan for integrating community pharmacy into urgent care networks and services (including enabling direct to community pharmacy referrals from NHS111; pharmacy teams accessing the Directory of Services; and refer and book from community pharmacy into other services), within the next six months.
- Ensure the Pharmacy Integration Fund supports community pharmacy development and integration. This includes investing in new models of pharmacy-based care to demonstrate value, evaluating new approaches, supporting research into what works, and disseminating evidence and experience to build scale.
We need commitment from NHS England and the Department of Health to:
- Take action to ensure local commissioning of community pharmacy services is managed effectively, and to address conflicts of interest within GP-led commissioning of primary care provision.
- Enable and enforce the use of EPS (including for CDs) and electronic repeat dispensing within general practice.
- Secure a firm commitment from Public Health England and local government to invest in the public health services offered by community pharmacy.
- Give community pharmacy professionals full read/write access to shared care records.
- Implement original pack dispensing.
- Change regulations to allow community pharmacy professionals to deliver advanced services outside the pharmacy.
- Allow generic substitution.
- Remove the bureaucratic burdens of administrating prescription charges.
- Stamp out prescription direction.