There are strong suspicions of a significant overhaul ahead regarding new services for community pharmacy. They began with reports that members of the Pharmaceutical Services Negotiating Committee (PSNC) had urged the organisation to give them plenty of notice about any changes that result from negotiations for the 2019-20 pharmacy contract, and were bolstered by pharmacy minister Seema Kennedy’s recent comments regarding an "expanded role" for the sector.
I’ve always thought that community pharmacists are underutilised and that, given the right services to deliver, they could positively impact on workload in general practice, mine included. This is especially true with the onset of the new GP contract and its emphasis on medicines safety.
Here are a few community pharmacy services that I think would benefit general practice:
- A medication safety service that not only empowers community pharmacists to recommend changes to patients’ medication to improve safe prescribing, but also enables them to see those changes through. One example, and there are many I could think of, would be to be able to add in a gastroprotective agent to a patient being prescribed a non-steroidal anti-inflammatory drug, in line with current guidance.
- A polypharmacy service that places the community pharmacist as integral in addressing deprescribing. Community pharmacists are not only perfectly placed to support patients in the decision-making process, but also to follow up and monitor them after medications have been stopped.
- And last, but by no means least, a comprehensive minor ailments service. If this was well-thought out and implemented with due consideration, it is the service that would have the most positive impact on GP surgeries; not only reducing workload, but also footfall into the premises, thus freeing up space for other consultations.
There is a huge ‘but’ here though. As Seema Kennedy touched on at the National Pharmacy Association’s conference in June, confidence in the sector is crucial. Not just from patients, but also from other healthcare professionals. That confidence comes from belief in the skills of the workforce, and the subsequent responsibility for their actions.
The new community pharmacy contract must empower pharmacists to ‘own’ the decisions they make about patients; not just ‘make recommendations’ that then have to be processed at the surgery and result in even more work. As well as sufficient funding and improved systems for full record sharing, this requires comprehensive training and upskilling.
We are entering a brave new world of primary care networks (PCNs) in which we are told community pharmacy will become fully integrated, and the dividing lines will increasingly blur. Surely it is time for all ‘primary care pharmacists’ to be classed as one – and have access to the same training.
Community pharmacists should be able to enrol on the same 18-month ‘clinical’ pharmacist training pathway that is being put in place for the GP pharmacists being funded in the new GP contract, as well as supported to gain their independent prescribing qualification.
This would truly show commitment from NHS England for its long-term plan and the desire to have community pharmacists as an integral part of PCNs.
The GP Pharmacist is a former community pharmacist working in a general practice