High up on the list of positive changes brought about after the pandemic was an increased public recognition of the value of community pharmacists and the vital role they could play in reducing pressure on primary care and hospital services and providing a faster resolution to minor health issues.
We have just witnessed the introduction of Pharmacy First, a significant initiative that we welcome and are pleased with the opportunity it gives for community pharmacy to start to work more closely with general practice, and indeed with other parts of the health and care system, moving forward their involvement in integrated neighbourhood teams.
We know community pharmacy colleagues have a wide range of under-utilised skills.
Pharmacy First is the initial step towards them being enabled to effectively deliver the prevention and long-term conditions services, which would support our belief in the need to move away from a purely biomedical model of delivery towards one of patient activation in which people are encouraged to take steps in improving their health and wellbeing.
There is no doubt that public perceptions of the value of community pharmacy have changed for good.
During the pandemic the front face of the NHS to a great extent, apart from hospital A&E departments, was community pharmacy, with people suddenly realising that it was a place they could go to get some advice, some help and some idea of whether they should be worrying about something and needed to see a doctor.
That recognition of the value of community pharmacy has been retained post-pandemic, but my fear is that the system will lose it by not retaining the opportunity to use community pharmacy more effectively as part of what happens within integrated care systems (ICSs).
In a recent National Association of Primary Care (NAPC) podcast I outlined a number of key ways in which the expertise of community pharmacists and their desire to put it to effective use could be harnessed by health care systems.
Better integration and a greater role for community pharmacy was mentioned in both Delivery plan for recovering access to Primary Care and NHS Long-Term Workforce Plan published by NHS England last year.
As far back as 2015, the Royal Pharmaceutical Society recommended that, with patient consent, all pharmacists directly involved in patient care should have full read and write access to the patient health record in the interests of high quality, safe and effective patient care.
But while pharmacists were granted read access to summary care records the following year, discussions about write access have become mired in legal considerations.
Our work could be so much more effective if, after talking to patients and working out what is needed, we could record this into the common patient record.
One of the perceived barriers to a perception of community pharmacists as patient-focused clinicians is their status as independent business people, whose premises are often owned by profit-motivated commercial conglomerates.
This is an issue I feel passionate about. I might work in a private pharmacy, whether it is my own or owned by a big company, but I am a pharmacist and I am there with my professional head on to provide the best care to individuals, regardless of anything else.
I am not going to turn round and say ‘I don’t care what’s wrong with you – I am going to sell you this because my company tells me I have got to’. That is not the way I operate – none of us do because we are professionals.
One of the positive things that came out of the pandemic was a changing perception of pharmacies from somewhere that sells me something, to someone that provides me with professional advice.
Within the health system we still hang on to some of the language and behaviours around pharmacy that the public themselves have started to move away from.
Integrated neighbourhood teams
A key distinction between community pharmacies and other healthcare settings, is this: you don’t walk into a doctor’s surgery and say: ‘I am well today, what are you going to do for me?’
Whereas you can walk into a pharmacy for something completely un-associated with health and end up having a conversation about your health.
You might be walking into what is considered a retail space, but you are going to see a clinician who can provide you with help and support and direct you to the most appropriate place to meet your health needs.
The ultimate goal is to have community pharmacies recognised as part of fully integrated teams that work together to serve the needs of a local population, delivering the best quality care and supporting their health and wellbeing.
The full discussion is available here https://napc.co.uk/the-future-of-community-pharmacy/
By Professor Ash Soni OBE, President of the National Association of Primary Care (NAPC) and a practising community pharmacist