The National Pharmacy Association (NPA) today (October 2) published a report calling for “an expansion of pharmacy services” to “help patients use their medicines effectively”.
Carried out by the York Health Economics Consortium and commissioned by the NPA, the report found that expanding community pharmacy’s medicines optimisation role - such as in the NMS and the DMS - could save the NHS “billions of pounds”.
It also argued that moving some structured medication reviews (SMRs) and prescribing reviews “for people taking 10 or more medicines” from general practice to community pharmacy could save GP practice time and reduce NHS costs and hospital admissions.
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Overall, the report claimed that the NHS could save a “potential £1.2 billion” by implementing its proposals.
For the NMS, it found that an estimated £66 million in cost savings could be made if participating community pharmacies in England increased their activity “by 10%”.
And if those participating “all met their [NMS] cap”, the report estimated that the NHS could save “an additional £372m” – with pharmacies “currently reaching around 52.5% to 54%” of the cap on average.
“Under-utilised” services
Turning to the DMS, the report noted that the service is also “under-utilised” with only 43% of community pharmacies in England “claiming for a DMS in the first year” after a patient received medication changes in hospital.
It estimated that “having all areas across England delivering [the DMS] to the same potential as the highest delivering area in the UK could result in an additional annual cost saving of £26m” for the NHS.
The report argued that savings could also be made by “investing in new interventions” in community pharmacy and implementing them “on a national scale”.
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These included:
- “Moving SMRs to community pharmacy” – this has the potential to “save a large amount of primary care staff time” and is “estimated to be cost saving compared with primary care clinical pharmacists and GPs”
- Polypharmacy clinics providing “reviews for people with 10 or more medicines” delivered by pharmacists – this could result in “net savings of nearly £620m from reduced medicine costs and a reduction in hospital admissions”
- Pharmacists providing “personalised asthma action plans (PAAPs) and educational advice for asthma” – this could increase the uptake of PAAPs and “generate additional cost savings of over £70m”
- “Education and advice” from community pharmacists for people with chronic obstructive pulmonary disease (COPD) – this would include guidance on “inhaler technique” and “general lifestyle advice” such as smoking cessation
- An “error-checking intervention called PINCER” – a pharmacist-led “IT intervention” aimed at improving prescribing safety
“Medicines reset”
The study concluded that general practice “does not have the capacity to provide these services to the entire population that would benefit”.
With legislation changes and “a rapid increase in pharmacist independent prescribers (IPs), there is an opportunity to use the clinical skills of community pharmacy professionals to meet this demand”, it argued.
But it noted that for this to happen, “future funding of community pharmacy overheads may need consideration”, adding that the “integration of pharmacies into the rest of the health system” must also be improved.
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NPA chief executive Henry Gregg said that the report shows “how better patient outcomes could be achieved for a reduced overall cost, given investment in medicines services provided by local pharmacies”.
He described the findings “as a kind of ‘medicines reset’ for a population that isn’t currently getting best use from their prescribed medicines”.
In April 2021, the community pharmacy medicines use review (MUR) service was decommissioned and replaced with SMRs completed by GP or PCN pharmacists – but concerns were last year raised that they were being “missed or de-prioritised”.
