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‘Pharmacy should be given a fighting chance in the current broken primary care system’

As the long-awaited Fuller stocktake is published, Leyla Hannbeck reflects on the missed opportunity to put pharmacy at the frontline of prevention and questions the real reasons the sector has once again been overlooked

The Fuller stocktake report aimed to decipher the next steps for integrating primary care. Published on May 26, it noted “there are real signs of genuine and growing discontent with primary care – both from the public who use it and the professionals who work within it”.

But the report by Dr Claire Fuller, while welcome, could have been more radical and substantive with respect to community pharmacy.

My members welcome the potential for future roles in urgent care and prevention, including early-stage cancers, but believe the capacity challenges and imperative for cost-effective healthcare could and should have recognised the enormous potential of community pharmacy in the drive for improving efficiencies.  

When we think of the end game of integrated pathways – namely: improving outcomes and population health; tackling inequalities; improving access, while enhancing productivity and value for money – then local pharmacies really do have the tried and trusted credentials to deliver within the communities they reside.

The report highlights the challenges of silo working, multidisciplinary integration and the need for change, which drives the cultures that have been barriers for decades. To add to that, there needs to be a fundamental review into IT systems, as the IT structures within primary care do not speak to each other, inevitably causing further barriers to integrated working.

With integrated care systems (ICSs) now less than six weeks from operational status, the Association of Independent Multiple pharmacies (AIMp) is asking for leadership to take a more courageous leap of faith into community pharmacies’ unique access, convenience, and infrastructure, to direct the clinical leadership to “pharmacy first”. 

Our sector’s strengths lie in its ability to offer highly effective, trusted, cost-effective care within communities. We accept the recognition that community pharmacy can play a more substantive role in urgent care and prevention, but feel there are still barriers to pharmacy’s acceptance.

Trust is a huge problem to integration at the best of times. Silo working is a problem across all strands of frontline, multidisciplinary working. The frustration is even more acute, because right now, pharmacy is not given even a fighting chance in the current system. Community pharmacy is substantively underfunded, unstable, and demoralised at all levels. 

The transformation of primary care networks to neighbourhood teams will only exacerbate that instability and uncertainty. It feels like we are embarking on a jigsaw only to find the pieces are not making the picture, so we hurriedly redesign to make the pieces fit.

The aspirations, we believe, are fine, but community pharmacy needs real commitment at integrated care board and integrated care partnership level to ensure we are not overshadowed once again. That will require intervention and strong leadership, which firmly believes in our sector’s credentials.

I recently heard an NHS chief say: “Integration can only move at the speed of trust”. That trust will only be achieved by a complete change in culture.


Leyla Hannbeck is CEO of AIMp

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