Are perceptions starting to shift?
With the pressures on primary care unrelenting, are local commissioners starting to appreciate what community pharmacies could deliver? Nick Kaye would like to think so…
The pressure on primary care is unprecedented. In a world of Covid catch-up and the onset of winter, the pressure on the NHS is on everyone’s mind. I listen to GP colleagues who tell me that being a family doctor has never been so tough and that the system is ready to break, if it is not already broken.
There has never been a greater need for health care that serves its community well, and it is absolutely true that this pressure is also felt by those of us practising on the front line in community pharmacy.
The number of calls for advice and reassurance has never been higher, but in all this noise there are also signs that ‘the system’ is beginning to look at community pharmacy differently at a local level. As winter pressure funding is released community pharmacy is beginning asked how that money should be distributed for patients to have a better experience in health care.
My worry is whether we are ready and if we have capacity. There is talk of a walk-in consultation service and an expanded minor ailments scheme. This could absolutely help to shift patient behaviour away from accessing GPs to visiting community pharmacies.
It could be a great thing as community pharmacies are not hampered in delivering services, in that we are not reliant on other parts of the system (such as GPs or hospitals) before we can deliver care to our patients.
In Cornwall we still have a locally commissioned walk-in emergency supply service. This saves 750 to 1,600 patient contacts a month. This was ‘turned on’, in and out-of-hours, for the G7 summit and has never been switched off since due to system pressures. Can you imagine if we applied this to a walk-in service? The activity we could move away from other parts of the health system could be massive, but are we ready and able?
We are facing unprecedented difficulties in recruiting pharmacists, and pharmacists that are working talk of a massive amount of workload pressure. However in my experience pharmacy owners will adapt and survive in ways that allow us to grow our businesses.
Pharmacies will be more resilient if we embrace opportunities to deliver more services. We see that in the flu and Covid vaccination programs where pharmacies are seeing it as ‘business as usual’ activity. Pharmacy owners are now employing nurses and paramedics, and even GPs, to deliver outstanding care. This shows community pharmacy in a different multi-disciplinary light and I believe is changing the way in which commissioners locally, and hopefully nationally, view them as a value centre and not a cost centre.
A senior leader in the Cornwall primary care system said to me some weeks ago that community pharmacies are one of the best value places he commissions from. If this is the case, we are all wondering why more services are not commissioned from pharmacies.
Now it the time for our commissioners to have faith in us and release our potential as front-line clinicians. This will allow us to invest in our businesses and enable us to deliver great healthcare to patients where they want it - closer to home and face-to-face if needed - without being beholden to another part of the system.
I hope that these great conversations we are having in the far South West are being replicated up and down the country, and in Scotland, Wales and Northern Ireland too. It would be fantastic if these potential changes could be delivered across the four nations. The impact and benefit to the population could be huge, giving people the healthcare they want within their community.
Community pharmacy … the clue really is the title.
Nick Kaye is a community pharmacist in Newquay and vice-chair of the National Pharmacy Association. These are his personal views.