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Create closer GP ties for NMS success, sector says

It would be 'madness' not to recommission the service after the evaluation's positive findings, says Robbie Turner, Community Pharmacy West Yorkshire chief executive

The positive findings of Nottingham University's evaluation of the new medicines service proves the scheme's value, pharmacists have said. CPWY chief executive Robbie Turner said it would be “madness” not to permanently commission the scheme, but some contractors expressed concerns about the pressures of providing the service.

Pharmacists have welcomed the positive findings of an evaluation on the new medicine service (NMS) and called for closer collaboration with GPs to ensure its success.

The report by Nottingham University, which showed that the service "significantly" improved medicines adherence and saved the NHS money, proved that the service should be permanently commissioned, industry leaders said.

But some contractors expressed concerns about the pressure the service placed on under-staffed pharmacies and the difficulties of signing up patients.

Pharmacy Voice chief executive Rob Darracott told C+D that the evaluation was "something to be celebrated" and the service deserved investment.

Mr Darracott highlighted the report's findings that greater integration between pharmacy and the rest of primary care was needed to improve the service further. "GPs should understand what the service is - you need the right kind of dialogue between different groups," he said.  

Numark director of pharmacy services Mimi Lau said she was "relieved" that the long-awaited evaluation had finally been published and agreed it was important to get GPs engaged with the service.

"We have to be clear that the service complements the GPs' service, they shouldn't be seen as competing. The Department of Health needs to communicate to GPs that this is the role of pharmacy," she told C+D.

Proven value

David Branford, chair of the Royal Pharmaceutical Society's English Pharmacy Board, said the "rigorous" evaluation left him in "no doubt" that the service benefited patients.

He called for the NMS to be expanded to include patients with depression and dementia, but said access to patient records and effective IT systems were vital to make this a success.

Robbie Turner, chief executive of Community Pharmacy West Yorkshire, told C+D he was "not surprised" by the positive findings of the evaluation and said it would be "madness" not to re-commission the service.

"For this to work and get the best possible patient outcome it needs validation from all players in the NHS, especially GPs. We're seeing that in pockets [of the region] at the moment," he said.

Practical difficulties

However, some pharmacists did not agree with the evaluation's positive appraisal of the NMS and cited practical difficulties with delivering the service.

Amanda Smith, manager of Heath Pharmacy in Halifax, told C+D that the lack of communication with GPs had made it hard to sign up patients.

"I think GPs feel they should follow up with patients, but it would free-up appointments if [patients] used NMS. People would trust the service more if it was referred from the GPs," Ms Smith said.

'Burden' to pharmacists

Community pharmacist Clive Hodgson told C+D that NMS targets could be a "burden" for staff in under-resourced pharmacies.

"There are only so many hours in the working day and like many pharmacists I gave up on the NMS some time ago. I personally think there are many more important things to prioritise before allocating time to the NMS," Mr Hodgson posted on the C+D website.

Community pharmacist Stephen Eggleston said he had a "foot in both camps". It was "discouraging" when some patients turned down the NMS in favour of their GP, but even these conversations helped build relationships with patients, he posted on the C+D website.

Read the Twitter response to the NMS evaluation here.

How has the NMS evaluation affected your opinion of the service?

We want to hear your views, but please express them in the spirit of a constructive, professional debate. For more information about what this means, please click here to see our community principles and information

Z ZZzzzz, Information Technology

My understanding at the time of launch of NMS was that GP representatives did not want to get involved because they were not going to get paid anything for pointing out the initial referal. So asking us to now cosy-up to them is a bit of a slap in the face. I reckon all these so called "great and good" people making comments found in the article must think pharmacists have short memories. We don't!

I think NMS is a good idea which yet again PSNC completely messed up. Remenber the flawed initial payment system that was based on ridiculous fantacy figures. They should have insisted the patient was refered by the GP right from the start. Most of my time is wasted trying to sign-up patients that may be new to the pharmacy but have been on the med for months or years. In busy pharmacies I can find myself approaching about a dozen possible candidates daily before finding one patient the service is valid for.

So in this case I advocate that the respective represetative bodies from both pharmacy and general practice get together again and sort the referal pathway out, rather than the piecemeal way advocated by some, that should know better, in the article.

Cod Fillet, Community pharmacist

NMS services are definitely overlaping (surgery nurses with community pharmacists)

Gerry Diamond, Primary care pharmacist

Well one thing is true about NMS it is not clear cut as Robbie Turner makes out. Always keen for others to deliver services but no long term experience as a front line community pharmacist more a technocrat telling us what is good for us...lolx

Meera Sharma, Community pharmacist

Like most of the other readers, am happy that this service has been shown to be valuable. However, there are challenges in delivering it as it's intended - especially for employee pharmacists. Most will be familiar with the concept of "tick-box" exercise and completing it simply to keep the bosses happy. The real challenge is recognising that pharmacists do make a difference at store level and allowing them the scope to do their work effectively. As opposed to conveyor-belt style service provision - conterproductive for both pharmacist & patient!

N C, Community pharmacist

I love how the solution to everything is always 'cosy up with gps'. Rather than this 'helpful' rallying of the troops does anyone actually want to tell us how to do this. In my experience, it's easier said than done.

Graham Phillips, Superintendent Pharmacist

Hello N C. Well why don't you start by sharing what have you done thus far? Maybe others will join in with their own experiences (hopefully some positives here) and let's see what might be possible?

Kevin Western, Community pharmacist

"closer collaboration with GPs" how about "from gps" instead.

London Locum, Locum pharmacist

More arse kissing of GPs ! Wonderful I can't wait.

Clive Hodgson, Community pharmacist

If I may elaborate to earlier comments I have made.

I would say the number one priority is the essential medicine supply service. This after all accounts for the vast bulk of income for any Pharmacy and is our primary role.

Every Pharmacy is having to devote extra resources to obtain the ever increasing number of both branded and generic medicines that suddenly become unavailable for whatever reason. Most of us are having to adapt to EPSr2 and this is bringing its own problems and increased workload. And then there is the ever increasing bureaucracy inflicted on Pharmacy that was mentioned in an excellent blog in C&D last week.

After all this, if there is capacity, then the NMS is a great service to offer although I think some would some argue that MURs may be more worthwhile and should be considered first.

I think it is great that the value of the NMS has been formally established and that it is probable that funding will be made permanent. It does however only represent a relatively small income stream for Pharmacy and does have to know its place in the hierarchy.

Clive Hodgson, Community pharmacist

Just to add to my above comment. With all this new found enthusiasm for a service like the NMS just spare a thought for many employee Pharmacists. Not only will have to carry out the essential medicine provision with the the extra work I have mentioned but also have to meet the compulsory targets for services like the NMS. I am not sure how enthiastic they will be.

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