How has 2019 shaped community pharmacies?

People made of tablets: face of community pharmacy

Deborah Evans, Managing Director of Pharmacy Complete, reflects on how 2019 has shaped the face of community pharmacy.

2019 has been an eventful year for pharmacy, most notably with the launch of the NHS Long Term Plan1 and new GP contract2, which together firmly embed the role of clinical pharmacists in primary care, specifically within the new primary care networks (PCNs).

Additionally, the NHS has committed to delivering an expanded role of community pharmacy in prevention of diseases and to become the first port of call for urgent minor illness. Furthermore, a consultation on the reimbursement of medicines is likely to change the way pharmacies are paid for the drugs they supply3 with the Government clear that it wants to improve transparency and equity whilst reducing costs associated with dispensing.

In July, the Government set out a new community pharmacy contractual framework4 that redefines the integral role community pharmacies play in delivering healthcare over the next five years. Pharmacy teams will be trained to provide a wider range of health advice and support, including the potential to identify and refer patients with unidentified health conditions, such as heart disease. Contingent on successful testbed programmes, more services will be commissioned from community pharmacies, all of which must be Healthy Living Pharmacies.5

“Structured medication reviews by pharmacists are expected to reduce avoidable A&E attendances, hospital admissions, avoidable outpatient visits and over-medication”

Working with GPs

Integration of pharmacy as a full partner in local PCNs will be key, and alignment of the pharmacy and GP contracts are a good first step to enable better use of workforce. To facilitate this, the GP Contract Network Directed Enhanced Service6 will require GP practices to engage and include community pharmacy from April 2020.

Pharmacists are expected to play a key role in supporting delivery of the Directed Enhanced Service6 specifications within the new networks including tackling over-medication of patients, inappropriate prescribing of antibiotics and the deprescribing of medicines no longer deemed necessary. Structured medication reviews by PCN pharmacists are expected to reduce avoidable A&E attendances, hospital admissions, avoidable outpatient visits and over-medication.

Community pharmacy will play a major role in relieving urgent care pressures, specifically with the launch in October 2019 of the new Community Pharmacist Consultation Service. Following an assessment by an NHS 111 call adviser, patients are transferred for a consultation for a minor illness or urgent medicine supply with a community pharmacist instead of being booked elsewhere in the system. Additional pilot phases are underway whereby patients can be referred into the service by general practice reception teams working with care navigators. This could change the way patients access the NHS.

The future

This past year has ended a period of uncertainty for community pharmacy, providing a vision of how pharmacists and their teams can contribute to urgent care and prevention of disease. However, turning this into reality requires significant cultural and operational change and this is at a time when workplace pressure is high, and funding has been reduced.

Fewer pharmacies are the likely result of a shift in funding from a traditional dispensing model, reduced margins on supply and patients opting for online provision.

However, there are significant opportunities for those who commit to a future which is more clinical, involves much closer working with others and responds to the changing needs of their local population.

Ever the optimist, the future for pharmacy is (and must be) positive.

Go to www.pharmacycomplete.org

1https://www.longtermplan.nhs.uk/ | 2 https://www.england.nhs.uk/wp-content/uploads/2019/01/gp-contract-2019.pdf | 3 https://www.gov.uk/government/consultations/community-pharmacy-drug-reimbursement-reform | 4https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/819601/cpcf-2019-to-2024.pdf | 5 Advancing our health: prevention in the 2020s – consultation document July 2019 | 6 https://www.england.nhs.uk/wp-content/uploads/2019/03/network-contract-des-specification-2019-20-v1.pdf