The National Pharmacy Association (NPA) is calling for the rollout of a model of care that could release millions of GP appointments nationwide after a Sheffield pharmacy freed up appointments in a nearby GP practice by conducting medication reviews in the pharmacy and providing other dedicated support to the practice.
A new report on the scheme shows that if every pharmacy in England were to provide one day a week of such support it could free up 18 million GP appointments a year. The report is on the work between Basegreen Pharmacy and Jaunty Springs Medical Practice in Sheffield and supports the NPA’s long-held view that pharmacy should be the main point of medicines care for patients with long-term conditions, not the surgery.
The report stated the following;
“Through IT integration and a formal Partnership Agreement between the Community Pharmacy and the General Practice, the Community Pharmacist was able to undertake appropriate consultations within the Community Pharmacy setting. Read/write access to the full GP Clinical Record enabled real-time information sharing and allowed the community pharmacist to make full use of their training and knowledge as the NHS medicines expert. Patients were proactively directed towards the pharmacy as a source of care, reducing demand on the practice, and improvements in the patient experience as they were able to be seen more quickly as the community pharmacist was more readily available. The vast majority (67%) of pharmacist time was spent providing face to face direct consultation with patients, with the remaining 33% of time spent reviewing and updating patient care plans and pathways through the GP clinical system. The pharmacy team was also working to enhance the ongoing safety and efficiency of Community Pharmacy services. Our evidence suggests that the activity undertaken in the Community Pharmacy setting reduces pressure and redirects demand away from the GP surgery.”
NPA Chair, Nitin Sodha, said:
“On average there is one GP based pharmacist for 30,000 patients, which is nowhere near the scale required to meet current and future demand. In comparison, in Sheffield, the ratio was one community pharmacist for a practice population of 3500, plus the added resource of the pharmacy support staff. Since NHS England has invested heavily in the General Practice Pharmacist Scheme, there is surely a strong justification for investment in pharmacy-based schemes which deliver similar benefits but can cater for many more patients, conveniently and probably at lower cost. It is time for NHS England to review this alternative model in more detail and ensure funding is allocated from the Pharmacy Integration Programme to support the fuller deployment of the community pharmacy network.”
Pharmacist Garry Myers, who is the owner of the pharmacy and an executive partner in the surgery, said without support from the pharmacy the surgery could have closed.
“The experience of working in this way was beneficial for Basegreen Pharmacy and Jaunty Springs Medical Practice, which may not have survived without this partnership, as it was being overwhelmed by the needs of the local population. But above all, it’s been great for patients in the area, who have benefited from the improved access to medicines support. We have adopted the successful principle that any patient that could be well managed by the community pharmacist should be referred there to reduce practice workload, improve the patient experience and encourage positive patient attitudes towards self-care.”
When questioned on potential concerns of basing extrapolations on the findings in one study involving one GP practice and one community pharmacy Stephen Fishwick responded by saying;
“Prompted by the publication of this report, the NPA is repeating our call for “full deployment” of the community pharmacy network which – given the right level of investment – is capable of releasing more capacity in general practice and elsewhere in the healthcare system.
“The report is indeed based on the experience of Basegreen Pharmacy and the Jaunty Springs Medical Centre – but our call for investment to release the potential of the sector also rests on many other examples and evidence from across the UK and indeed internationally. We believe the experience of Garry Myers and his team in Sheffield adds to the already substantial evidence base for the benefits of a fully deployed community pharmacy network.”
The NPA Board will now examine the specific policy recommendations made in the report, including the idea of developing template Partnership Agreements to underpin shared care between GPs and community pharmacists.
You can read the full report here.
The compilation of the report was supported by a research grant provided by the NPA. It was co-authored by Garry Myers and James Roach.