Some would say that transformation in pharmacy will never happen, some that it is overdue; others would say its on the horizon, but most are witnessing that it is here and now! We are going to experience a radical and rapid evolution in what community pharmacy looks like and does in the next five years, those who adapt will continue to successfully operate as healthcare providers.
In 2009 we looked ahead at what was fairly predictable and being looked for by commissioners. That led to the development of the Healthy Living Pharmacy (HLP) initiative. Ten years later it will be embedded as an essential requirement in the contractual framework and we finally have prevention high on the agenda for the Government and the NHS. HLP was never just about brief advice and interventions on healthy lifestyles, although that is an important output. The HLP model was, and remains for those who fully embrace it, an organisational development framework to transform pharmacy in preparation for what was to come. One based on workforce and premises development plus effective engagement with the community, the population (the consumers of our services) and other providers of health and care. That was the first time that the need for unilateral leadership development was identified and implemented in pharmacy to lead the required change in culture and activity.
What we see now in the shift from a contractual framework almost totally reliant on procurement and supply of medicines to one which is more service-led and quality based, driven by financial, population health and consumer demand was inevitable. The need to get upstream of what creates much of ill-health, both physical and mental, – the prevention agenda – puts community pharmacy in a good place providing we have the capacity, will and skill to occupy that space.
Digital healthcare is now moving at such a pace that community pharmacy and other healthcare providers are struggling to keep up. Web-based information, consultations, algorithms and ‘health-bots’ are now common place. Distance selling pharmacies now provide around 3% of prescriptions and growing fast. Yes, Pharmacy2U grew 80% last year, admittedly at an operational loss due to investment write-offs. Echo (Lloyds) and Well are also increasingly significant players in the online market. Now enter the giant… Amazon Pharmacy is now trademarked in the UK in addition to the Far East, US and Australia. Their cost base will be much lower as they have the established infrastructure and distribution networks plus a massive consumer base. So transacting product is no longer a unique option nor a sustainable model for ‘bricks and mortar’ pharmacy.
We need to find a new model which can only be provided face-to-face. Turkish barbers and coffee shops are everywhere. Why? – because you cannot get a haircut or a cup of coffee online! So what is our unique face-to-face offer? You cannot have a vaccination given online; diagnosing effectively and supporting individuals to change their behaviours around safe medicine use or healthy lifestyles is difficult to deliver online. It is said that to change people’s hearts and minds you need to look them in the eyes – we listen with our eyes as well as ears, or at least we should do.
The fixed funding in the contractual framework is insufficient to support the existing community pharmacy estate. This means that new skills and skill-mix must be developed; operational efficiencies must be found; technology must be embraced; we must develop new services and products that people and commissioners want to buy; consistent high quality consumer experience must be delivered; community pharmacy must collaborate and be fully integrated into local health and care systems; and we must must must promote what we do effectively.
All this change needs to be actively led at all levels but predominantly at an individual pharmacy level, no-one is going to do it for you. This requires an enhanced level of leadership and business planning skills. Our recent experience of delivering our Effective Engagement and Communication workshops for PCN Pharmacy Leads has demonstrated a real hunger for these leadership skills and a passion to transform what we do. We have also developed a Transformation workshop to help create the time, capacity and capability to implement and deliver more services.
The future is bright, but only if we truly understand why we must change, how we do it and move fast.
People buy why you do things, not what you do (Simon Sinek).