At the Association of Independent Pharmacy (AIM) dinner recently, Jeremy Meader, managing director of Numark, set out a five-point plan for community pharmacy. He asked if NHS England or the Department for Health & Social Care recognise and appreciate fully the contribution of community pharmacy. He went on to say.
“We all know the answer to that, but it is actually the wrong question: what we need to ask is how we change that dynamic, move forward and secure a future that is financially sustainable, improves outcomes for patients and demonstrably helps the NHS address the huge challenges it faces”.
He then went on to set out five areas where progress needs to be made.
“Firstly, we need to agree with the Department for Health & Social Care a vision for community pharmacy which delivers world-class healthcare services in partnership with other professionals be those GPs, hospital doctors or social care providers. In February of this year Professor Sir Chris Ham, CEO of the Kings Fund stated ”the promise of integrated care will only be delivered if doctors, nurses, allied health professionals, pharmacists and many others in clinical roles work much more with each other and with staff working in social care and the voluntary sector around the patients and populations they serve.
“There has been much talk about an integrated patient-centric healthcare service, but that cannot be achieved without community pharmacy as a core pillar.
“Without a vision, it is difficult to see how you can agree on a common-sense pharmacy contract which provides fair and sustainable funding over the medium to long-term. That then delivers the financial stability we need in order to invest in our branch networks: something the government has called for. So, government you do your part and you can trust us to deliver.
“Scotland has achieved this. It wasn’t easy by any means, but a shared vision formed a foundation between government and community pharmacy to build upon even if there were differences of opinion here and there about the specifics.
“Secondly, we need to get community pharmacy more involved in the service innovation pilots taking place across England to join up healthcare provision. There are a number of models being explored including Integrated Care Organisations, Integrated Care Partnerships and Integrated Care Systems. Community pharmacy needs to have a voice at a top level in those pilots. I am not sure we are achieving that at the moment. Is community pharmacy seen as a “must have” or a second thought ‘add-on extra’?
“We are enthusiastic about what we do and the difference it makes to the lives of people: we need to do more to engage policymakers and commissioners to ensure they too share that enthusiasm. That would benefit us. Benefit the NHS. And benefit patients.
“Thirdly, we need to continue to work towards presenting government and policy opinion formers with a clear, distinct and united voice. We may never have the kind of influence which the BMA has, but that should be our ambition.
“We must not lose the focus which the likes of AIM bring, but we also need to consider how the various representative pharmacy bodies work together to combine forces in order to maximise influence.
“The Health Secretary has stated he will spend as much as possible of the proposed £20 billion-a-year extra funding for the NHS in England on preventative care which includes community pharmacy: that is a challenge we must meet. The money is there and we have common purpose, so let’s ensure we maximise our voice.
“The harsh reality is that Pharmacy’s share of the extra £20 billion won’t be for dispensing, the Government is simply going to continue to squeeze dispensing costs whilst driving their agenda of a greater focus on service provision. Clearly, our challenge is to secure appropriate funding for service provision.
“Fourthly, in an internet age, I think we need to get better at explaining why a visit to bricks and mortar pharmacy is better for patients and the NHS than a delivery through a letterbox. We need more sustained personalised care for a population that is ageing and living with multiple chronic conditions. Much as I admire Royal Mail, a box of medication delivered through the letterbox every month is not the high-quality healthcare many patients need or deserve.
“That is not to say in any way that internet pharmacy does not have a part to play. We cannot be a King Canute sector. Rather it is to go back to a vision of health care in the UK which understands where the internet and medicines supply works well and where the physical interaction between patient and professional is required. We are not there yet and, frankly, it is confusing for patients.
“Finally, we need to embrace change and technological evolution. I recognise remote supervision and hub-and-spoke are controversial, but time and technology have moved on and we must recognise that: can you imagine going on a long car journey nowadays without your mobile phone and Sat Nav or indeed life without the internet? Too often, we can be perceived as the “why not” rather than the ones saying “what if”. Put bluntly, it is the latter, the what if’s who get government funding, not the former.
“Hub and spoke or remote assembly offers exciting opportunities for community pharmacies to deliver added-value services which the government will pay for providing we can demonstrate it reduces the strain on GP surgeries and A&Es and delivers better patient outcomes. That’s an exciting opportunity and yet are we shouting from the rooftop? Are we saying look at us and the investment we are making in delivering better patient care or are we a bit timid?
“In summary. I believe that despite the current issues we face, community pharmacy has an exciting future ahead of us. If you look at what the NHS needs, what patients need and what politicians want from our health care system then you invariably end up with community pharmacy as a solutions provider.”