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Pharmacy must 'punch its weight', warns NHS policy expert

Practise Ahead of publication of an RPS report about pharmacy's future, its co-author Judith Smith of the Nuffield Trust said the profession needed to raise its profile in the NHS or risk losing out to rival providers

Pharmacy must "punch its weight" within the NHS or risk being shut out, Nuffield Trust policy director Judith Smith has warned.

Stronger national leadership and local collaboration were vital to securing a wider role for pharmacists as "care givers", argued Dr Smith ahead of the launch of the Royal Pharmaceutical Society (RPS) report on the future of pharmacy today (November 5).

"If community pharmacy doesn't start to get together and work in networks, it may find others have got in there first," said Nuffield Trust policy director Judith Smith

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The supply vs service debate

Dr Smith, co-author of the RPS-commissioned report Now or Never: Shaping Pharmacy for the Future, warned that pharmacy had to raise its profile in the NHS rather than holding internal debates on its future. "There's actually been more than enough analysis of pharmacy, but the overriding conclusion is very much realised in the title of the report – it's now or never," she told a briefing yesterday (November 4).

The RPS commissioned healthcare think tank the Nuffield Trust in April to chair the report into the future role of pharmacy. The report, to be presented to parliament today, set out recommendations for pharmacists, leadership bodies, the government and commissioners, to help pharmacists assume a wider role in patient care.

Dr Smith said she was struck "quite forcibly" by how marginalised pharmacists were in the NHS during her research. "At the moment, I don't think pharmacy punches its weight at a local or national level," Dr Smith stressed.

Dr Smith called for more united national leadership to tackle the poor understanding of pharmacy in the health service and among the public. At a local level, pharmacists should gather into networks to bid for services and collaborate with other professions, she said.

If pharmacy failed to make its voice heard, the door would be open for rival providers to take on services, Dr Smith warned. "Don't forget there are different players on the pitch," she told yesterday's briefing. "If community pharmacy doesn't start to get together and work in networks, it may find others have got in there first – for example, in providing services to care homes."

Dr Smith stressed that pharmacy was vital to managing medicines effectively – adding that it could play a "significant role" in anticoagulation monitoring and management of asthma, COPD and minor ailments.

How the report was compiled

The RPS English Pharmacy Board commissioned a report on the future direction for pharmacy in April. It appointed a commission to carry out the work, chaired by the Nuffield Trust's director of policy Judith Smith, to obtain a "fresh and external" critique of the sector.

The commission obtained views from patients and professionals on pharmacy's role by holding a launch event, online consultation, workshops, interviews and meetings. Its work focused on how pharmacy could help meet the current and projected needs of patients.

Based on the feedback, the commission set out key recommendations for pharmacists, leadership bodies, the government and commissioners. These included strengthening pharmacy leadership, changing the national contract and using technology and staff to boost pharmacists' capacity for services. The report will be presented to parliament today (November 5).

The report urged NHS England to put funding behind medicines optimisation and patient care in pharmacy – potentially moving towards separate contracts for supply and services. It also called on the government to support pharmacy by including the sector in plans for future out-of-hours and urgent care, public health and management of long-term conditions.

England's chief pharmaceutical officer Keith Ridge welcomed the report and reiterated the role of pharmacists in medicines optimisation. "We do think this is key at the moment to improving quality of care, and it could lead to overall cost reductions such as preventing hospital admissions and improving outcomes for long-term conditions," he stressed.

The RPS was eager to provide leadership in this area, said Ash Soni, member of the English Pharmacy Board. "We're keen to take up the leadership challenge and see it as a key element of what we're trying to do," he said.

The Independent Pharmacy Federation (IPF) agreed with the calls for stronger leadership. But the organisation's chair Fin McCaul said pharmacists must also take note of the report's emphasis on building pharmacy's profile locally, and urged them "not to wait for national leadership".

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