The National Pharmacy Association (NPA) has released its 10-year vision for community pharmacy, setting out what the sector can do to meet NHS and patient needs over the next decade.
It said that clinical services should be developed that help to cut GP waiting times, improve access to urgent care, prevent poor health, provide integrated care for major conditions such as cardiovascular disease, diabetes, respiratory disease and mental health, and deliver value for money for the taxpayer and accessibility for patients.
Dr Claire Fuller, chief executive of the Surrey Heartlands Integrated Care System (ICS) commented that the plan is based on an understanding of what commissioners need, which she described as the kind of thinking ‘that makes people like me sit up and take notice’.
The NPA said that it would be sharing its vision for community pharmacy in England with the King’s Fund and the Nuffield Trust, which are developing a vision for the sector on behalf of Community Pharmacy England (CPE).
The NPA said that ‘by and large we are all agreed on the need for community pharmacy to take a clinically focused journey, building on the medicines supply function, integrated with the NHS and adequately resourced’.
But it added that: ‘National Pharmacy Association members by their nature – as natural innovators and agile, skilled health care professionals – are particularly open to the idea of ambitious, transformative change.’
In its prospectus, it suggested a range of ideas for new and expanded services that fit into a ‘strategic service development sweet-spot’, where the three driving forces of ‘community pharmacy aspirations, patient needs and services that commissioners value’ align.
This includes the proposal of a national travel vaccinations service through community pharmacy, commissioning of community pharmacy to support medicines adherence in care home settings and allowing pharmacist independent prescribers to adjust prescriptions as part of an expanded new medicines service.
But to support this, the NPA said that ‘urgent action’ on funding was needed ‘to maintain current services and lay the ground for an improved service offer’.
It said that the current Community Pharmacy Contractual Framework (CPCF) was failing NPA members, the wider sector, the NHS, government and patients, and was adversely affecting independent pharmacy contractors in particular.
It set out 10 principles which it said any new deal should take into account, including creating a ‘level playing field’ for independents that do not benefit from ‘averaging’; paying pharmacies ‘in a timely fashion’ rather than relying on backdated ‘clawbacks’; stopping ‘dispensing at a loss’ and paying pharmacies for services in addition to dispensing.
It also said that a multi-year deal should guarantee uplifts in line with inflation ‘as a minimum’ and that any excess margin should be re-invested into the development of pharmacy services, as it is in Wales.
And it called for independent financial regulation that mitigates the risks of a single purchaser [the government] ‘using its power to achieve short-term gain at the cost of sustainability’.
To address workforce shortages, the NPA said that more pharmacists were needed across the sector ‘to match increasing patient demand and the development of clinical services’.
And it proposed that community pharmacies be able to access Additional Roles Reimbursement Scheme (ARRS) funding to deliver services in the community, and that local NHS managers conduct an impact assessment prior to any further recruitment into GP or Primary Care Network sites under ARRS.
Community pharmacy should be better integrated at a local level, the NPA added, as service development and commissioning moves to local Integrated Care Boards (ICBS). And it said that ‘national leadership needs to be embedded into the 42 ICS ‘laboratories’ and recognise the scalable winners’.
In addition, the NPA also said that digital advances, such as artificial intelligence (AI) could be used to support face-to-face access to care.
And it said that private services delivered by community pharmacies should continue as they were key to developing innovative new services and benefiting patients.
NPA chair, Nick Kaye, said that ‘building out from the existing portfolio of services’, there were ‘some major opportunities within this decade, encompassing prevention, medicines optimisation, long term medical conditions and urgent care’.
He added: ‘We are seeking to challenge orthodoxies that have limited the sector’s scope for too long. At the same time, these ideas are firmly planted in reality because our start-point is what our paymasters in the NHS want, not what we can dream up.
‘Some of this is about redrawing the borders of pharmacy practice – for example applying pharmacogenomics to pharmacist prescribing.
‘Other aspects are about re-imagining what is our domain as a sector; we are rightly based firmly in the community but our impact ought to be felt and formalised across the entire system, including hospitals. We need to be “in the community but out of the box”.’
He added: ‘We are confident that the large majority of NPA members – by their nature innovators – are open to the idea of ambitious, transformative change.’
This story first appeared on our sister title, The Pharmacist.