The NPA today (July 13) published its new “prospectus for the development of community pharmacy services”, which it called a “challenge to old ways of thinking and an opportunity to redefine the sector’s role in the NHS”.

 

It set out the ways that the sector can “develop much further as a clinical care and safe medicines supply service” during the remainder of the 2020s, if it is backed by “informed policy-making and sufficient public investment”.

 

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But the NPA said that while the document “[pushes] the boundaries of clinical service development”, it is “clear” that the “safe supply of medicines should continue to be a foundation stone upon which other pharmacy-based support is built”.

 

The document, which “follows months of dialogue with NPA members”, will be shared with the King’s Fund and Nuffield Trust who are currently working on a new vision for the sector’s future on behalf of Community Pharmacy England (CPE), it added.

 

 

“Scope for service development”

 

 

The document said that “medicines optimisation, prevention, same day urgent care and long-term conditions should all be in scope for service development over the coming years”.

“The community pharmacy of the future needs to be able to offer a broader service to deal with the urgent care and chronic care needs of the population whilst also delivering preventative services”, it added.

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It set out a range of ambitions, including:

 

• Improving the management of long-term conditions such as asthma, hypertension, heart failure and diabetes

• Expanding preventative interventions to help make the NHS a “wellness” and “health-inequality reversing” service, with a “public health service bundle” and an expansion of the Healthy Living Pharmacy offering

• Shifting focus from a dispensing role to an “end-to-end prescription management role”

• Becoming the “go-to professionals” for medicines optimisation, including upgraded Structured Medication Reviews (SMRs) based in community pharmacy and post-discharge reconciliation

• Offering prompt and accurate diagnosis, with risk stratification based upon genotype and the capacity for personalised treatments

• Increasing medicines safety 

• Building on “hospital touchpoints”, such as by preparing people going into hospital for elective care, give them a “soft landing” back into the community and reducing readmissions

• “Dramatically” improving access to primary care, including by expanding Pharmacy First and the Community Pharmacist Consultation Service (CPCS) via patient group directions (PGDs)

 

“National travel vaccination service”

The document said that the pharmacy network is also an “obvious place to start in developing a national travel vaccination service” thanks to its “track record in public health and the unparalleled access it provides”.

It added that community pharmacies should provide point-of-care testing and screening so that they can “regularly review and manage long term conditions, with the application of diagnostics and laboratory tests where appropriate”.

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And it said that community pharmacies can “act as the patient link to the NHS, supporting communities to get health-active online”.

It also proposed an “NMS+” service to build on the current New Medicines Service (NMS), with pharmacists “able to make the necessary alterations to medication that may be affecting patient adherence”. 

 

 

“Investment critical”

 

 

However, the NPA stressed that a “boost” to the workforce, a “supportive national contractual framework” and better digital connectivity would be needed to turn its ambitions “into a reality”.

It said that “substantial and sustained new investment by the government and NHS England (NHSE) is critical to success”, adding that “urgent action is needed to maintain current services and lay the ground for an improved service offer”.

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And it called for a requirement for local NHS managers to conduct an “impact assessment prior to any further recruitment” into GP or primary care network (PCN) sites under the Additional Roles Reimbursement Scheme (ARRS) programme.

“We also believe that community pharmacy should be able to access ARRS funding and deliver integrated services from community pharmacies”, it said.

It comes as Association of Independent Multiple Pharmacies (AIMp) chief executive Dr Leyla Hannbeck also told C+D this week that community pharmacies should be offered a workforce recruitment programme like the ARRS.

 

“Major opportunities”

 

 

NPA chair Nick Kaye said that there are some “major opportunities” for the sector within this decade, building on the “existing portfolio of services” in areas such as prevention, medicines optimisation, long-term medical conditions and urgent care.

 

The NPA is “seeking to challenge orthodoxies that have limited the sector’s scope for too long”, he said, adding that its ideas “are firmly planted in reality because our start-point is what our paymasters in the NHS want, not what we can dream up”.

 

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Mr Kaye said that some of the proposals are about “redrawing the borders of pharmacy practice” such as by applying pharmacogenomics to pharmacist prescribing, while others 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,” he added.

 

And he said that the NPA is “confident” that the “large majority” of its members “are open to the idea of ambitious, transformative change”.

 

Read more: The choice is ours: Look to the future or get lost in the slipstream of change

 

In a foreword to the document, chief executive of the Surrey Heartlands Integrated Care System (ICS) Dr Claire Fuller praised the NPA for backing a “can-do agenda” for the sector. 

 

“This is the kind of thinking – based in an understanding of what commissioners need - that makes people like me sit up and take notice”, she said.

 

It comes after MPs last month launched a new inquiry to examine the future role of pharmacy services.

 

And NHSE published its new primary care recovery plan in May, announcing a community pharmacy funding injection of “up to £645 million” over two years to “expand” services - which could be implemented from as soon as this month.