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Expand Pharmacy First to include free OTCs for low incomes, urges HSCC

The health and social care committee (HSCC) has called for a “long-term vision” for clinical services in community pharmacies including a raft of service expansions.

Community pharmacies should provide free over-the-counter (OTC) medicines to people on low incomes, the health and social care committee (HSCC) recommended in its pharmacy inquiry report published today (May 29).

The committee said that patients in the midst of a cost-of-living crisis are often reluctant to pay for medication at their pharmacy, preferring to use GP services for minor ailments.

But it said that offering people on lower incomes free OTCs as part of the Pharmacy First service could push people to choose pharmacies over booking GP appointments.

Read more: 'Get a grip': HSCC calls for rapid change to drug substitution rules

The committee also recommended the introduction of an “establishment payment” to build consultation rooms, targeted at community pharmacies that are “most reliant” on income from NHS work.

It proposed that such a payment could depend on pharmacies providing “an agreed level of NHS service”.


Expanded services


The committee was bullish about expanding the range of services offered by the sector, recommending that NHS England (NHSE) and the government publish “a long-term vision for the further development of clinical services in community pharmacy settings” within a year.

It specifically noted the potential of pharmacists to manage long-term conditions, to carry out medication reviews and to support “medicine adherence”.

Read more: ‘Thriving market’: Minister upbeat about community pharmacy despite closures

In addition to its enthusiasm for Pharmacy First expansion, the HSCC also recommended that NHSE should commission the sector to provide “all routine and seasonal immunisations for adults and children” and the HIV prevention medication PrEP.

But the committee stressed that “any service expansion must be properly funded” and that commissioners should be “conscious of the capacity of pharmacists to deliver both existing services and any planned expansions”.


Workforce plan


The HSCC heard that the clinical development of pharmacy depended on pharmacists becoming prescribers but it noted that there are not enough training places available “to meet that ambition” for the sector.

It said that the government’s ambition to grow the pharmacy workforce needed to be met with a “specific” and funded workforce plan that addresses “access to supervision, training and protected learning time”.

Read more: CCA urges NHSE to publish full list of DPPs amid ‘risk’ to trainee placements

And it recommended that pharmacists and pharmacy technicians should be added to the list of healthcare professionals entitled to access the benefits of the Learning Support Fund.

The report also urged the government to review “the criteria connected to additional roles reimbursement scheme (ARRS) funding…within three months to understand whether any additional flexibility could reduce the drain of community pharmacists into primary care networks”.


Pharmacy inquiry latest


The idea of an establishment payment for refurbishing pharmacies was floated by HSCC member James Morris when the committee heard evidence in March from pharmacy minister Dame Andrea Leadsom and others.

But Dame Andrea said at the time that pharmacies are private businesses that offer “other services to members of the public” and that she didn’t think it was right that “the taxpayer should take on the burden of updating or upgrading those premises”.

Read more: GPhC reports 'growing caseload' over pharmacist prescribing

And at the January sitting of the pharmacy inquiry, Pharmacists’ Defence Association (PDA) chair Mark Koziol suggested to the committee that legislation could be changed to allow pharmacists to better focus on “medicines management issues”.

At the same session, General Pharmaceutical Council (GPhC) chief executive Duncan Rudkin told members of the committee that the regulator was seeing a “growing caseload around clinical issues”.

Meanwhile, today’s report also demanded drastic changes to sector funding and pharmacist substitution powers.

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