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Fund to integrate pharmacy into NHS 'won't offset cuts'

Bruce Warner: The fund is not exclusively for community pharmacists

A government fund to help integrate pharmacy into wider care settings was never intended to “offset the cuts", NHS England’s deputy chief pharmaceutical officer has insisted.

Bruce Warner said he would be “very concerned” if the 'Pharmacy Integration Fund' – a £42 million fund to support pharmacy to “develop new clinical pharmacy services, working practices and digital platforms” – is seen as a tool to lessen the impact of the funding cuts scheduled for December.

Instead, the money is an “enabler” to help the NHS and pharmacy “do things differently”, he said.

“It is intended to integrate pharmacy services into the wider and broader NHS,” Mr Warner told C+D in an exclusive interview last week (October 21).

“It is there to make that progress to a more clinical and digital future, in terms of the platforms we are using,” he added.

England's chief pharmaceutical officer Keith Ridge – who also spoke to C+D – said the fund is “designed to do what it says on the tin”. 

Dr Ridge gave the example of granting pharmacists access to better IT and NHS email systems, as areas which the funding could be used for.

"Glass half full, or empty"

Mr Warner stressed that the integration fund “absolutely includes community pharmacists” and whether the sector uses it depends on whether you are a “glass half full or empty person”. 

"It doesn’t mean the fund is there exclusively for community pharmacy. I wouldn’t want anyone to get the impression they are excluded from it," he said. 

According to the Department of Health, the integration fund will be used to deploy more pharmacists into primary care settings, such as general practices. 

It follows NHS England's announcement earlier this year, that an additional £112m fund had been allocated to quadruple its existing scheme to recruit pharmacists to work in GP surgeries.

When asked by C+D how pharmacists can get involved in the deployment into other care settings, and whether the process will be “similar” to the practice pharmacist scheme, Dr Ridge said "we're in the process of planning that now.”

How would you like to see the integration fund spent?

Mike Hewitson, Superintendent Pharmacist

The policy process has been like a Carry On film. 

"One of the proposals that we shall announce shortly is a proposal for an integration fund of £300 million, which will be used entirely to provide services and pay for pharmacies to provide them"

David Mowat MP, speaking to the House of Commons on 20th October. Yet the tail is wagging the dog, the CPO released his own 7 point plan, which doesn't seem to have much in common with his boss'. 

1. Two work streams aimed at integrating community pharmacy into the NHS’ national urgent care system, to run in parallel from December 2016 to April 2018: the urgent medicines supply service and the urgent minor illness care work with NHS 111.

2. Health Education England has been commissioned to produce a workforce plan for pharmacy professionals in primary care to be able inform the workforce development needs for pharmacy across the health care system linking with the work they have already done in secondary care. We expect this to be ready by Spring 2017

3. From April 2017: deployment of pharmacy professionals in care homes and funding workforce development for pharmacists who work in care homes including a prescribing qualification.

4. From April 2017: there will be funding for pharmacists working in urgent care clinical hubs, such as NHS 111, integrated urgent care clinical hubs or GP out of hours services, and again this will include a prescribing qualification.

5. There will be educational grants for community pharmacists to access postgraduate clinical pharmacy education and training courses up to diploma level from April 2017.

6. Also from April 2017, a programme of pharmacy technician clinical leadership development.

7. An agreed priority will be to evaluate the impact of digital technologies on the health care system to improve efficiencies and modernize.

Apparently if you have legitimate concerns about the operation of the Fund (no practicing pharmacists including on the Oversight Group), you are denigrated as being a 'half glass empty man'. No sorry Bruce, but I see this as little more than a massive vanity exercise. 

Take the first point on the CPOs list. The PURMS service & the Minor Ailments non-announcement. The PURMS service has a budget of £2m set against it, which sounds like a lot of money, but in reality this is one referral per pharmacy per month. This is not going to change the world Bruce. The Minor Ailments thing is an absolute non-announcement, it isn't a national minor ailments service 

"minor ailments scheme, which will be commissioned right across the country so that, by April 2018"

- David Mowat MP 17/10/16

"That will be commissioned separately from the other things we are talking about today, and paid for separately from the integration fund"

- David Mowat MP 20/10/16

C&D established there was no money to fund a minor ailments service.

What they are talking about are referrals from NHS111 to buy their own medicines. Which as we all know is going to lead to more pressure on pharmacies, explaining to patients that they have to pay for their medicine when they have received an NHS referral. 

The Integration Fund is £18m down on where they promised it would be earlier this year, there are no guarantees beyond March 2018, even though the theoretical carrot of £300m over 5 years has been dangled. Nothing much on that list to get excited about, even the promise of educational grants to support postgraduate education is hollow, employers will almost certainly be asked to put their hands in their pockets to fund backfill and other costs, which is not going to land well. Besides that, thousands of pharmacists already have Masters degrees, and don't want or need extra 'clinical' education because we already have it! 

That's me off the Christmas card list, but it's still not going to stop us holding you lot to account for this mess. 

Dodo pharmacist, Community pharmacist

Ridge and Warner are like a comedy double act, except they are not remotely funny. Their only interest is destroying community pharmacy. Infact Ridge is to community pharmacy what Dr Beeching was to the railways in the 1960's.

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