The NHS Long Term Plan sets out its ambitions for transformation over the next decade to ensure the NHS is fit for purpose in the future.
The plan’s key aims are to:
- ensure everyone gets the best start in life;
- deliver world class care for major health problems; and
- support people to age well.
So where does Pharmacy fit into the plan? Key areas that will impact on pharmacy include:
- make greater use of community pharmacy’s accessibility and skills
- establishment of Primary Care Networks with £4.5 billion investment
- out-of-hospital and urgent care
- supporting self care and self management
- promoting good health
- prevention and treatment of cardiovascular disease, stroke, diabetes, cancer and respiratory conditions
- greater involvement in provision of Health Checks and their outcomes
- support to improve mental health and wellbeing
- involvement in social prescribing
- expansion of digital healthcare and use of technology including automation
- reducing waste and exploring alternative reimbursement and supply arrangements for medicines
Inevitably there are both risks and opportunities for community pharmacy so planning and executing the next steps are critical for a successful future.
PSNC’s negotiations with NHS England and DHSC on a new contractual framework have started. Within these conversations, understanding how community pharmacy can be part of the implementation and delivery of the plan’s ambitions is key to our future.
A new sustainable contractual framework must be developed quickly and support provided for its implementation and delivery against national and local NHS and public health needs. A remuneration model which is equitable, drives the right behaviours and delivers consistent, high quality outcomes. In addition, the reimbursement model must change to become fair and equitable.
Integrated Care Systems (ICS) are due to be in place everywhere by April 2021. As they are to be central to delivery of the plan, there is a major influencing and leadership role for Local Pharmaceutical Committees (LPCs) by working with ICSs and CCGs to ensure that community pharmacy is firmly embedded, supported and active within the Primary Care Networks (PCNs).
Over the coming years there will be additional roles employed in these PCNs including an increasing team of Pharmacists and Pharmacy Technicians as well as other healthcare professions such as Social Prescribing Link workers, Physiotherapists, Paramedics and Physician Associates. This multidisciplinary team will work across GP practices and with other health and social hare providers including, assuming we embrace the opportunity, community pharmacies.
Individual pharmacies must start to work together now and engage with their emerging local Primary Care Network to understand who the key stakeholders are and hence who to build effective relationships with, develop an understanding of priority needs and influence pharmacy’s opportunity to be embedded (and funded) in the solutions.
Ask not what the NHS can do for community pharmacy but what can community pharmacy do for the NHS. This is where any new money will flow through so critical for a sustainable future.
It is now ten years since the Healthy Living Pharmacy initiative was developed in anticipation that community pharmacy could play a bigger and better role in improving the health and wellbeing of the communities we serve and support. It was predictable then that a supply-based contract could not be sustainable in the long term and a shift to a quality-led, service-based contract including pharmaceutical care, supply and prevention would come. Hence the then, and continued focus on organisational development.
PCNs are called networks for a reason and they must also be inclusive of hospital and community trusts. From a pharmacy perspective this could look something like this:
The Chief Pharmaceutical Officer, Dr Keith Ridge, has now communicated his vision for pharmacy’s role in the new NHS. That includes opportunities for community pharmacies to support medicines optimisation and patient safety, acute and urgent care, and the prevention agenda. Let us not miss this opportunity to make it happen both for the future of pharmacy and the health of our local populations.