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Pharmacists risk missing out

Pharmacists risk missing out
10 December 2014



Pharmacists are at risk of missing out on having a front-line role within the NHS says a new report from the Nuffield Trust.

The report, Now or Never: Why Pharmacy needs to react, commissioned by the Royal Pharmacutaical Society (RPS) examines their role in the healthcare sector and how this has progressed in the last year.

It found that although there have been improvements in some areas of acute care – this isn’t the case in primary care where input from pharmacists could have a dramatic impact upon the quality of patient care.

Pharmacists are at risk of missing out on having a front-line role within the NHS says a new report from the Nuffield Trust.

The report, Now or Never: Why Pharmacy needs to react, commissioned by the Royal Pharmacutaical Society (RPS) examines their role in the healthcare sector and how this has progressed in the last year.

It found that although there have been improvements in some areas of acute care – this isn’t the case in primary care where input from pharmacists could have a dramatic impact upon the quality of patient care.

The report also highlights that while there has been a shift towards involving pharmacists in patient care, this has not been done on a national scale and varies between localities.

Speaking to The Commissioning Review, Dr  David Branford, chair of the RPS, said : “Every GP service should have the same pharmacist services as a ward.

“There have been many attempts to do this, but there has been no universal acceptance as to how to move on from this phase.

A pilot scheme in Brighton involved local pharmacists taking responsibility for patients taking coagulation medication. Instead of going to the GP, patients went to the pharmacist to have their blood taken and get their results much more quickly avoiding them having to make a trip to the GP or hospital.

Despite the success of trials in individual communities, Dr David Branfordechoes the report’s findings that there are a number of barriers preventing pharmacists from engaging with community care. One of these is the structure of the pharmacy contracts.

He said: “Predominantly pharmacists are paid a volume payment on the items that they have dispensed which is one of the problems. If the basis of the contract were to change then it would be easier to be remunerated for a wider range of services.”

Instead of contracting pharmacy services in volume the reportcalls for NHS England and the Department of Health to align the funding of pharmacy services more closely with GP contracts in order to offer an incentive to integrate services.

There are also calls for pharmacists to take a more active role and push towards promoting their field. While the dispensing of medications is often their main source of income the report highlights how pharmacists should be bidding for other healthcare contracts under the ‘any qualified provider’ policy which allows them to make offers to local health care commissioners.

Dr Judith Smith, lead author and Director of Policy at the Nuffield Trust said: “The leaders of the profession are still not speaking with one voice.

“Even when they hear what pharmacists have to say, NHS leaders are still not putting words into action through changes to contracts or alternative forms of funding.”

In 2013 a previous report, Now or Never: Shaping Pharmacy for the future, suggested that a lack of incentives leads to a perceived competition between GPs and pharmacists. This year’s report highlights that very little has changed creating a sense of segregation across the two services.  A GP interviewed for the report claimed:

“GPs and pharmacists have had decades of working isolated from each other. That will take some effort to overcome. They need to step back and begin to establish relationships”.

David Branford  agrees: “The current NHS system doesn’t have pharmacy at its heart. We’re not involved in commissioning groups or with well-being boards. If you’re not at the heart of things then it can be difficult to break through to the decision makers.

“Perhaps the NHS doesn’t always see pharmacy as part of them and pharmacists don’t see themselves as part of the NHS.”

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