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Multiples ask government to commission national pharmacy EHC service

AIMp and CCA: EHC provision currently varies by locality
AIMp and CCA: EHC provision currently varies by locality

Representatives of the large multiples and smaller chains have called on the government to commission a national emergency hormonal contraception (EHC) service in pharmacies.

Pharmacists with prescribing qualifications should be able to prescribe oral contraceptives and pharmacies should be commissioned to monitor these patients, the Company Chemists’ Association (CCA) and the Association of Independent Multiple Pharmacies (AIMp) said in response to a Department of Health and Social Care (DH) consultation on prevention yesterday (October 14).

Patients would also benefit from a national smoking cessation service commissioned through community pharmacies, the associations added.

No postcode lottery

Some community pharmacies currently provide these services, but they “vary across different localities”, they said in a joint response to the DH’s green paper ‘Advancing our health: prevention in the 2020s’.

EHC is commissioned by over 90% of local authorities, but “a number of these services are being closed due to funding restrictions”, resulting in different age restrictions and postcode requirements that can cause “unwarranted uncertainty for patients”.

Delivering a nationally commissioned EHC service through community pharmacies could bring a total net value of £24.9m to the NHS in the short-term, the associations said, referencing a 2016 PricewaterhouseCoopers report on the value of community pharmacy.

There would be “considerable benefits” to commissioning pharmacies to routinely monitor patients on oral contraception as part of repeat dispensing, “such as checking their weight and blood pressure”.

Smoking cessation services should also be nationally commissioned through community pharmacy, as a single national service specification would “ensure that patients across the country can access equitable care”, the CCA and AIMp said.

Improving the NHS Health Checks programme

NHS Health Checks, which are mostly provided by GP surgeries, should be commissioned from all community pharmacies, CCA and AIMp said.

This “could build capacity for GPs to focus on patients with more complex needs and will also give patients more choice and potentially be more convenient, given the accessibility of community pharmacies and the fact that many are open longer hours and at weekends”, the associations said.

Expand community pharmacies’ contribution

Pharmacies have the potential to “operate as neighbourhood health and wellbeing centres”, becoming the “go-to location for support, advice and resources for staying well”, the CCA and AIMp said.

Community pharmacies in England delivered more than 1.4 million vaccinations through the NHS Flu Vaccination Service during the 2018-19 flu season, and they “could be further commissioned to deliver other immunisations, such as hepatitis or the human papillomavirus (HPV) vaccination”, the associations suggested.

“There is still more that the community pharmacy sector can do, and its ability to deliver prevention services will require the skills of the whole pharmacy team. With the right funding, pharmacies can play a greater role in improving health outcomes through preventative interventions,” AIMp CEO Leyla Hannbeck said. 

Read the organisations’ full response.

5 Comments
Question: 
Do you think community pharmacies should offer more services?

Joan Richardson, Locum pharmacist

A national scheme would be a good idea.  Having worked in the West Midlands on the border of 4 different CCG's I can confirm that the current situation is a nightmare.  Each CCG organises its own training which has to be completed prior to being authorised to supply.  Then there is the variation in groups who qualify under the scheme according to where you happen to be working!  One CCG insisted on registration per pharmacy so a sudden booking at a new pharmacy left you having to phone them for permission to supply where you were on that particular day.

A national scheme would solve all of the above problems as well as making EHC more readily available.

Sunil Patel, Pharmacy owner/ Proprietor

Yep, a national scheme would be the answer 

Benie I, Locum pharmacist

In my experience contractors will generally only attend training for a service that will bring on money for them. With almost all income previously being derived from dispensing there wasn’t much incentive. 

N Ow  With the new contract funding moving away from dispensing and more ‘clinical’ service activity we are seeing a glut of pharmacies  coming on to the sales market. Those that are left will have no choice regarding training.

Bob Dunkley, Locum pharmacist

I would think that every pharmacy would want to provide these services if only to make up the shortfall in the new contract . However is there training linked in with these? Whilst GPs all have the training, pharmacists are not in the same boat. Quite a lot of pharmacists seem to treat training as an optional extra as evidenced by attendance at the various training events I go to. Before pharmacists can be considered as a viable force for putting these services into practice, then they must be trained and not just the few I see at training events but every pharmacists. 

Hackney Drug Dealer, Community pharmacist

Agreed:

we provide this service and therefore have the followings completed

1. CPPE EHC

2. CPPE Safeguarding + Gillick competency training. 

3. CPPE Consultation skills

4. Local area Training: Ulipristal,  + annual updates + DoC

These are MANDATORY to provide the service. Not a problem. Staff are also trained in-house regarding confidntiality & safegarding (signs to look for/alert the pharmacist). Staff are also trained for the condom supply service for clients 13+. Overall a very much appeciated service for clients and by clients. 

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