In Demand & On Demand: Community pharmacy at heart of 21st Century NHS

By Tracey Robertson, Product Director

The NHS in England has vowed to put community pharmacy at the heart of a new model of joined up care. The Long Term Plan is an ambitious framework that finally gives community pharmacists a seat at the top table of NHS care. The vision is for ‘fully integrated community-based healthcare’ where pharmacists play a prominent role in multidisciplinary teams aligned with new primary care networks.
However, with opportunity comes challenge. Somehow, a profession that has for so long operated at the edges of primary care must be properly integrated into the wider ecosystem to provide added value for patients. Getting there will require a system-wide shift in culture and connective technologies to fuel collaboration. The former may take time. The latter is readily available.

Changing Community Pharmacy Role

Many of the goals of the Long Term Plan have been accelerated as a result of COVID-19. Certainly the Long Term Plan’s promise to ‘make greater use of community pharmacists’ skills and engagement with patients’ has been key over the past year.

Pharmacists have been on the front line, supporting urgent care, promoting self-care and providing an accessible alternative to A&E for patients that don’t need hospital. In addition, retail pharmacy is rapidly transitioning to a ‘wellness destination’ where consumers can go for health checks for a range of high-risk conditions or education on the correct use of medicines.

The evolution towards the NHS’ five-year target to give every patient the right to ‘digital’ GP consultations also accelerated. As part of the next stage of the evolution, pharmacists could also feature in the online interaction, providing virtual services as trusted professionals at the centre of connected care pathways. Healthcare in England is poised to move into the 21st Century, with community pharmacy finally being given some much-deserved skin in the game.

On Demand and Accessible

The concept that pharmacy can play a greater role in primary care is built on irrefutable logic. As patients struggle to secure GP appointments and hospitals buckle beneath the weight of COVID-19 and A&E demand, pharmacists remain the health service’s most accessible HCPs.

In the Netflix era where consumers are accustomed to accessing services wherever and whenever they want them, community pharmacy are the closest thing we’ve got to Healthcare On Demand. They’re there when we need them. The value of skilled, accessible community pharmacies embedded within the local community is now recognised.

The Long Term Plan earmarks £4.5 billion of new investment to fund expanded community teams. This includes a ‘shared savings’ scheme for primary care networks so that they can benefit from their efforts to ‘reduce A&E attendances, streamline patient pathways and reduce over-medication through pharmacist review’.

Improving Collaboration

The plan also signals a political will to establish a culture of collaboration. Historically, GPs have appeared reluctant to build close relationships with community pharmacists, despite serving the same patient populations. This approach has led to poor – and in many cases non-existent – data-sharing between GPs and retail pharmacy. If community pharmacists are to deliver enhanced patient services that relieve the pressure on general practice, they must have access to GP records to help deliver timely, efficient care.

There was a step forward last year when pharmacists gained faster access to patient information through the new Summary Care Record (SCR) 1-click function, as well as Real-Time Exemption Checking – making it far quicker to find patient information. But problems are surfacing – the PSNC recently reported its concerns that some general practice teams are referring patients to pharmacies “informally” rather than via the Community Pharmacist Consultation Service.

The negotiator says it has received reports from contractors who have had patients referred directly from general practice for minor illness or an urgent medicine supply, bypassing the formal NHS 111 referral route. Where this happens, pharmacies cannot claim their £14 fee for completing a CPCS consultation, and the provision of advice or medicine is not recorded on NHS systems.

Conclusion

The Long Term Plan underlines the importance of data sharing as part of digitally-enabled integrated care. Alongside it, the steady increase in digital native GPs will likely stimulate a mindset shift where collaboration becomes the default expectation.

The technological barriers to integration do not exist. In the age of interoperability and cloud technologies, data from familiar, well-established systems can simply (and securely) be connected to empower HCPs with real-time information at the point of clinical care. These integrated solutions can power pharmacy-led services that help ease the burden on both general practice and acute care. Moreover, in the fullness of time, these platforms can be enhanced with new functionality that fuels On Demand models of virtual consultation.

COVID-19 has accelerated cultural change – and proved the value of Community Pharmacy in meeting patients’ on demand needs. The capability and the technology is out there. It’s time to join up the dots. See how we have been adapting to change: