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Community pharmacists mentioned once in NHS five-year update

Simon Stevens: Rising pressure on A&E wards is partly caused by delayed transfers of care
Simon Stevens: Rising pressure on A&E wards is partly caused by delayed transfers of care

NHS England has specifically name-checked community pharmacists just once in a 75-page update on its five-year strategy.

For comparison, the commissioner’s Next Steps On the NHS Five Year Forward View document – published this morning (March 31) – contains 10 references to “clinical pharmacists” employed in GP surgeries.

In the document, NHS England said it expects GP surgeries to work together in primary care networks, which would “involve working more closely” with community pharmacists “to make fuller use of [their] contribution”.

It also referenced its own role in overseeing pharmacy, GP and dental contracts, as well as pledging to “work with vendors to seamlessly route electronic prescriptions from NHS 111 and out-of-hours GPs to pharmacies via the electronic prescription service”.  

Under the section on how NHS England plans to “get best value out of medicines and pharmacy”, the commissioner cites the co-funding of "clinical pharmacists" embedded in general practice to “support GP prescribing and optimise medicines usage”.

It also cites plans announced earlier this week (March 28) by NHS Clinical Commissioners, which has identified areas of prescribing it argues are of “low clinical value” and should be removed from prescriptions to “drive important savings”.

Increasing the number of practice pharmacists

The commissioner provided more details on its pledge to increase the number of pharmacists working in GP surgeries, from the current figure of 491 to over 1,300 by March 2019.

NHS England chief executive Simon Stevens said the report also sets out where progress has not been as quick, “with rising pressure on A&E and acute wards, partly caused by delayed transfers of care”.

In the document, NHS England added that as the demands on the NHS are higher than when the original Five Year Forward View was published in 2014, now is an “appropriate moment to take stock of what has worked, and what hasn’t”.

In 2014, NHS England told C+D its Five Year Forward View contained everything about its primary care strategy, despite only mentioning community pharmacy four times.

What else does the five-year update say?

On GPs:

  • NHS England is on track to deliver 3,250 GP recruits over the next two years
  • GP funding will rise by £2.4 billion by 2020-21
  • There are plans to roll out evening and weekend GP appointments, to 50% of the public by March 2018 and 100% by March 2019

On emergency care:

  • Every hospital must have "comprehensive front-door clinical streaming" by October, so that A&E departments are free to care for the sickest patients. £100m will be invested in this
  • The £1bn provided by the chancellor in the March budget for investment in adult social care must be used in part to reduce delayed transfers of care

On mental health:

  • NHS England will “substantially” increase investment to enable 60,000 more people to access psychological, or ‘talking’, therapies for common mental health conditions "over the coming year".
  • 24-hour mental health liaison teams will be placed in A&E departments and 1,500 therapists will be placed in primary care

On illness prevention:

  • NHS England will ensure NHS premises offer “appropriate” food and drink options. Public Health England (PHE) will publish specific targets in 2017-18 to reduce the sugar contents of nine food categories
  • By 2018-19, PHE will work with local authorities to offer an NHS health check to 2.8 million more people
  • PHE will expand childhood flu vaccinations to include children in school year four, from the upcoming flu season onwards.

Read the full document here

What do you make of the Five Year Forward Update?

Former Cist, Pharmaceutical Adviser

Luckily I reached retirement age just as the ex-profession of community pharmacy was sadly waking up to the inevitable realisation that there is no future for the current model. I really don't mean to offend but think it through. If your role was to help facilitate a quality, cost-effective, evidence based NHS, what can the current community pharmacy programme contribute. Sticking a label on the right box does not require a Masters degree. The "Ask your pharmacist" role has frankly disappeared. Home delivery by low paid part-timers has replaced the OTC professional interactions and the professional clinical pharmacy role has been captured by practice pharmacists. Add to this the irrepairable damage to the community pharmacy reputation of the over-ordering of repeats on behalf of patients (a cash cow which has become systematic fraud) and the supply issues caused by rampant (but very lucrative) exporting and I ask the question, what can community pharmacy deliver that could not be provided by a single contractor in a city centre backed up by an Amazon type pharmacy delivery service. The future for community pharmacists is in practices. They won't earn as much and the opportunities to mint it as a contractor with a chain will be gone, and the multiples with their tier of non-qualified supervisers will be upset (shame!), but your pharmaceutical knowledge will be trusted, valued and appreciated. Simple cost-saving measures are mocked in community pharmacy but believe me CCGs and the NHS value this very highly. Independent clinical advice, patient medication reviews, med queries and once you are a prescriber (and this is now a must) you will take on a face to face responsibility with patients also, all of which is recognised by practices, CCGs, NHS and the Government. This improves quality, saves money, is cost-effective, supports the GP service and frankly offers a future for the largely demotivated community pharmacy workforce. Wake up to the sad fact that the world of healthcare has changed or at least that part provided by the NHS. Offering  words of abuse and then burrying your head in the sand is not a constructive  response.


Soon-To-Be Ex-Pharmacist, Superintendent Pharmacist

Post it again, Ajaz. I'd like to know what half arsed comment you came up with this time.

ajaz akhtar, Student

Don't big up yaself too much ... sticking a label on a box...ACTs are the future/online pharmacies. Lost a couple of 100 items to local online pharmacy. Life goes on :) 

Soon-To-Be Ex-Pharmacist, Superintendent Pharmacist

Makes me wonder why someone with such a low opinion of community pharmacy would be posting on a community (mostly) pharmacy forum?

O J, Community pharmacist

He is a mussy fudge lol.

Soon-To-Be Ex-Pharmacist, Superintendent Pharmacist

This just goes to show what high regard we are held in by the government. The only time pharmacy ever seems to get a look in is when it's being mentioned as a way to 'take the pressure off......(add other service provider of your choice)' while the pressure we are under is never considered.

ajaz akhtar, Student

Nurse practitioners taking over Surgeries

ACTs taking over pharmacy

It's all about the money. Show me the money 

Grumpy Pharm, Community pharmacist

Just shows yet again that Mowat and the rest do not understand the difference between community and practice pharmacists and treats them interchangeably as Mowat did when speaking at the PSNC conference and westminster. Already seeing signs that NHSE sees Community money as fluid, in west yorks they plan to fund the easter rota from the pharmacy integration fund!!!

ajaz akhtar, Student

Surprised it was actually mentioned !!!!

Future is ACTs and online pharmacies,

Throw GPs out of general practice , train pharmacists, nurses to take over . GPs to perform minor operations instead. 

O J, Community pharmacist

Innit my mussy fudge. U killed it. King Julian !!

Soon-To-Be Ex-Pharmacist, Superintendent Pharmacist

No thanks. I don't want to be closeted up in a small room with nut-jobs and smelly people. Thats why I didn't do medicine.

ajaz akhtar, Student

*This comment has been deleted for breaching C+D's community principles*

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