The health secretary Wes Streeting made a pledge about 40,000 more primary care appointments. But did he mean nurses, paramedics, GP pharmacists, ponders Nick Kaye...

I am writing this after a fundamental shift in the leadership of our country occurred. For the first time in 14 years, there a Labour government is in power and in Cornwall where I’m based, there are no conversative MPs at all. I cannot remember the last time that was the case.

It has made me reflect on what this change of leadership will mean for community pharmacy. It will mean that locally for community pharmacies, and nationally for Community Pharmacy England and all the pharmacy trade associations, relationships that were built up over the last 14 years whilst the Tories were in power will now need to shift.

I think this could be a particular challenge at local level given the complete change in political landscape. However, with a changing landscape there are often new opportunities.

One of my first reflections was I was amazed that a secretary of state would say that “the NHS is broken,” as health secretary Wes Streeting did in his first statement in office.

Maybe you can only say that when you are newly elected, and with a big majority to boot, but I thought it was an unbelievable statement to make. Why would he say that? Well, maybe to allow him to make large and sweeping changes.

Streeting has already announced a review “to fix the NHS” which, we’re told, will be an “independent, full and frank assessment of the NHS’ performance.” The review will be carried out by Lord Darzi, an honorary consultant surgeon at Imperial College Hospital NHS Trust.

As a previous health minister, he led a review of the NHS to mark its 70^th birthday in 2018 which focused on the quality care for all and an outcomes-based framework.

This new review is being hailed as the first steps on the road to recovery for the NHS. I think this could be an opportunity for community pharmacy. I have heard senior leaders in the NHS and Department of Health and Social Care say that “Pharmacy First may not be perfect but when we have invested in you, (‘you’ being community pharmacy) you have delivered and we have seen a return on our investment.’” This has to be a good thing.

Wes Streeting has stated that Labour wants to “reverse the shocking trend of closures and reduced opening hours in pharmacies,” which he rightly said are “at the forefront of our health service.” As the National Pharmacy Association chair, you would expect me to say that I believe our Day of Action, which has been supported by so many NPA members and much wider, had a part to play in Streeting’s statement.

I have also seen the way in which Streeting has been promoting a reduction in red tape and an outcomes-based approach. This could set community pharmacy up in a good place. We have seen Streeting make a pledge about 40,000 more primary care appointments, although that did not specifically say GP appointments. Does that mean nurses, paramedics, pharmacists who that work in a general practice?

Or could it mean Pharmacy First-style appointments which link with Labour’s pledge about supporting an independent prescribing pharmacist service. Community pharmacy has to look at this as an opportunity.

If we are looking at system-wide, outcomes-based commissioning, what about medicines optimisation? Why couldn’t a community pharmacist implement an integrated care board prescribing strategy and get the same benefit and incentives to do that work, as other parts of primary care to do now.

There is currently an issue with patients getting access to Leqvio, so why couldn’t a community pharmacist prescribe and administer this product. But if there’s an outcomes-based framework, could that mean dispensing is delivered in a different way and is that a risk?

I also believe that the key will be to deliver things differently. We won’t get new money to do the same things and that will apply to all aspects of healthcare, not just community pharmacy.

What is certainly true is it will be critical for every one of us in leadership roles to continue making the case for more investment in community pharmacy. But this must also come with the realism that the sector has been under-funded for a decade. Transforming and resetting our contract, when and if we get there, comes with the realism of what life is really like if you are on the frontline owning a community pharmacy right now.

We must make that case for investment loud and clear to create a sustainable sector.

Nick Kaye is a community pharmacist based in Newquay and chair of the National Pharmacy Association. These are his personal views.