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My manifesto for pharmacy


My manifesto for pharmacy

After the interminable elections of the last 18 months, Mukesh Lad sets out his own manifesto to ensure a strong and stable future for community pharmacy

Our sector needs a resolute and responsible leader to make decisions that will improve our quality of service and ensure greater access to pharmaceutical care for the nation. Respect and recognition is long overdue for our invaluable healthcare contribution and the way in which we support health improvement across the UK. Pharmacy must become an integral part of all patient pathway design. Few NHS decision makers realise pharmacy is a part of primary care and that our role should be considered at the outset of all clinical considerations.

Single body
In order to achieve this rational objective, we first need to create a single representative body: a British Pharmaceutical Association in the same way that General Practice has the British Medical Association. A legal entity such as this would consist of pharmacy representatives from all the sectors of our industry with a clear mandate to promote and negotiate the interests of our profession. We need just one representative voice to be listened to and respected by healthcare decision makers. We then need to control the number of pharmacy degree student applications.

A strong profession needs good succession planning, and control, into its market each year. This not only gives strength and negotiating power but also respect for the profession. Currently, we risk falling into the world of Fiverr with pharmacists available for a dime a dozen. I would then set a national minimum rate for pharmacy pay.

Of course, the supply and demand effect will always influence the rate at which pharmacists are remunerated. However, we need to align the profession to a national minimum wage. Not only is this equitable and fair in accordance with all other areas of business and industry, but it also recognises the personal investment of achieving a pharmacy masters degree. However, not all the onus is on us to up-skill and deliver.

The Government has to invest in our IT infrastructure in order to provide secure, efficient and effective connectivity between all pharmacy networks as well as integration with the full complement of NHS providers. We need current technology, high-speed connectivity, standardised data and the latest system providers.

Investment in robotics
Automation is another fundamental area of technology that needs to come to the forefront of pharmacy practice. By investing in robotics and system software, we can achieve vastly improved efficiency in the supply of medicines, as well as huge cost savings. These savings should then be ringfenced for re-investment into the development of additional pharmacy services with medicines optimisation programmes to improve the health of the nation.

It’s incredible to think we even need to propose investment in medicines optimisation programmes. What are pharmacists if not the drugs experts? Few decision makers know we have the professional skills to assist patients in understanding their medicines and the additional ability to support them in getting the maximum benefit out of the treatment prescribed.

The Government needs to urgently capitalise on this opportunity and introduce medicines optimisation programmes at all levels of care. The newly introduced Quality Payments Scheme is an ideal vehicle for setting standards and goals to be achieved such as discharge medicines services to support the transition of care from secondary through primary care and into the community.

Framework fail
Public Health England and its outcomes framework sets out objectives. There’s no shortage of requirements for measuring progress. What it lacks is clarity over who’s going to deliver the services to help local authorities tackle their public health priorities. The word ‘pharmacy’ isn’t mentioned even once in the 360 pages of the outcomes framework document.

Greater focus needs to be placed on programmes such as Healthy Living Pharmacy that allow pharmacies to deliver key public health initiatives, including smoking cessation, alcohol harm reduction and emergency hormonal contraception. These services are devolved to local authority commissioning, with little equitable provision across areas of differing geographic and demographic profiles. The implementation of centrally-funded direct enhanced services models through community pharmacy would deliver far greater outcomes. Public health awareness campaigns should be integrated into the relevant pathways in order to achieve the greatest possible impact amongst service users of all ages.

Finally, the General Practice Forward View has already committed over £100m of investment to support clinical pharmacists to work in general practice. These pharmacists are working as part of practice teams to resolve day-to-day medicines issues and consult with, and treat, patients directly. The role is considered pivotal to improving the quality of care and ensuring patient safety.

In closing my manifesto, I would like to see a conversion programme to give new clinical pharmacists and pharmacy graduates the opportunity to become general practitioners. Crucially, the role of the pharmacist in practice allows GPs to focus their skills where they are most needed and helps demand-management of GPs’ time. The next few years are going to be challenging. We need to secure our place in the broader healthcare economy and establish on-going economic security and the future prosperity of all those working in community pharmacy.

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