Helping community pharmacy prepare for a service-led future
Sima Jassal explores the Pharmacy First model and the role of technology in improving community pharmacy
This year marks a pivotal year for community pharmacy. As final preparations are put in place to launch England’s landmark Pharmacy First scheme, Community Pharmacy England (CPE) unveiled its new strategy for a thriving profession with a much-expanded clinical role.
In September 2023, the Nuffield Trust and the King’s Fund published the “vision for community pharmacy” report, commissioned by CPE, which outlines an ambitious strategy for the sector that will place it at the heart of integrated healthcare for local communities.
The report went beyond the scope of Pharmacy First and the community pharmacist consultation service (CPCS); it called for additional essential services to be specified and priced. This included, in the longer-term, services around hypertension, atrial fibrillation case-finding, cancer detection and referrals.
All these developments are welcome news for a profession that desperately needs additional income and has so much to offer patients beyond its core dispensing role. But the question arises: how can pharmacy prepare for these new opportunities and the shift towards a more service-driven future?
I explore the lessons we can learn from the CPCS, and, of course, from technology, which will have an important role to play in supporting pharmacy to evolve.
Lessons from the CPCS
By looking at the data held on EMIS’s own systems about CPCS patient consultations, I think that it’s clear the scheme was most successful when pharmacists were trained to offer patients a wider range of treatment options via patient group directions (PGDs) instead of being restricted to over-the-counter (OTC) and pharmacy-only (P) medicines.
An example would be prescribing patients antibiotics to treat a urinary tract infection (UTI) . In my experience, and I am sure other pharmacists experience this too, one of the most common reasons for a failed CPCS referral occurs when a patient requires antibiotics, and the pharmacy is unable to prescribe these.
While the Pharmacy First service will enable the prescribing of antibiotics when it is clinically appropriate, it is still important for pharmacies to continue to train their staff to offer the widest possible range of treatment options.
This would increase the likelihood of a pharmacy being able to address a patient’s concern without a visit to the GP. It would also increase patient confidence in our profession, so that we are considered a source of frontline healthcare advice. Independent prescribing would also help.
CPE’s report underlines this point; it calls for a “national offer” of pharmacy services that is consistent and easily understood by patients.
The role of technology
We all know that pharmacy teams are already under immense pressure, so new clinical services and the required training to deliver them will increase the demand on professionals.
But I believe that technology could help solve this problem. Having good systems improves workflow, efficiency and can help streamline operations as community pharmacy’s role diversifies, so pharmacy professionals can deliver better communication with GP practices.
Technology can support in the following ways:
- Sending structured updates through to the GP record following a pharmacy intervention. This would create a holistic view of the patient’s treatment and it would integrate pharmacy with the wider healthcare team.
- Ensuring a coherent and reliable process for patient referrals from GP to pharmacy. Many GP systems now use an online triage template created to support the CPCS, which saves time by preventing inappropriate referrals.
- Creating a single booking calendar on the pharmacy system so that all patient appointments and referrals are in one place. This would save time and ensure a good patient and pharmacist experience.
- Increasing GP and pharmacy system interoperability. EMIS, along with other providers, is preparing to implement the NHS booking and referral standard (BaRS) in pharmacy, which enables booking and referral information to be sent to and from care providers quickly and safely, in a format that is useful to clinicians.
- Using GP systems to drive additional referrals to pharmacy. Including identifying patients who need a blood pressure check and referring them to the pharmacy.
The role of technology is not just important for new services, it is also important to support safe and efficient dispensing which remains a core part of pharmacy’s role.
Solutions such as hub-and-spoke dispensing can help free up a pharmacist’s time to deliver additional services - including clinical and accuracy checks within the patient medication record (PMR).
The imminent launch of Pharmacy First is an important moment for community pharmacy.
While the devil is in the detail, the direction of travel is clear, and I am looking forward to playing my part in helping pharmacy make the most out of this and out of other clinical service opportunities in the future.
Sima Jassal is the clinical director at EMIS Health.