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What is community pharmacy’s place in integrated care systems?

Primary care as a whole, not just community pharmacy, can influence ICSs’ strategy and clinical priorities, NHS England and NHS Improvement (NHSE&I) has said.

The Health and Care Bill – which the government presented to parliament earlier this week (July 6) – is set to change the way the NHS in England works “permanently”, director for primary care strategy and NHS contracts Ed Waller said at the virtual National Pharmacy Association (NPA) conference yesterday (July 9).

“It will establish integrated care systems (ICSs) formally as part of the NHS system and community pharmacy, as [well as] the wider pharmacy workforces, will be affected by that,” Mr Waller said.

So how should community pharmacies prepare for the “formal” introduction of ICSs?

Work with primary care networks

Mr Waller said NHSE&I wants to see community pharmacy as a “more integrated part of every primary care network (PCN)”.

“I know that is working better in some places than others but I’ve heard some really encouraging examples of how community pharmacy and general practice have worked together on COVID-19 vaccination, on flu vaccination, and on the management of various conditions,” he added.

It is important that ICSs get their clinical leadership “right”, Mr Waller added. Working closely with PCNs, community pharmacies can flag their clinical priorities and use the PCN “as a conduit for the perspectives of primary care to be to be taken account of in ICSs”, he said.

Asked by NPA CEO Mark Lyonette how he will ensure community pharmacy is not forgotten within an ICS and that it is appropriately represented, Mr Waller said it is “important is we don’t think about this necessarily as about representation”.

“We’re thinking about the clinical perspectives and service-level perspectives.

“I think primary care as a whole has the best influence when it can agree between all the providers in primary care, not just community pharmacy, but general practice and others, what it wants to see happen in a system and what it thinks the priorities are – there will be community pharmacy-specific issues,” Mr Waller added.

Develop clinical leadership and interoperability

In a slide presented during the webinar, Mr Waller wrote that it is “imperative that pharmacies organise in a way that provides strong, coordinated, influential and professional leadership across these new systems at all levels”.

Each ICS will appoint a single professional lead for pharmacy and medicines, who will lead on the development of a local medicines strategy.

The new bill also plans for the commissioning of community pharmacy services to be delegated to ICSs, which means that – although there will still be a national contract for pharmacies – there will be “some huge opportunities in a greater degree of local commissioning inputs to make community pharmacy a more integrated part of the NHS”, Mr Waller added.

During the pandemic, community pharmacy was seen as an “integrated part of the NHS in perhaps a way that it wasn't in the past, in a way that I'd like it to be more thought of in the future”, Mr Waller continued.

To help primary care service work in an integrated way, he added that NHSE&I is working on optimising access to care record “that support clinical service delivery across primary care… and the interoperability of systems to make data transfer efficient”.

How integrated is your pharmacy within your PCN?

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