Sector bodies have met with the pharmacy minister after a report highlighted barriers to accessing primary care in England.
At an All-Party Parliamentary Health Group roundtable on October 21, the chief executives of Community Pharmacy England (CPE), the Company Chemists’ Association (CCA) and the Independent Pharmacies Association (IPA), as well as minister Dame Diana Johnson, discussed findings from the “First Point of Care” report by think tank Policy Connect, published last month.
The inquiry was co-chaired by pharmacist MP and All-Party Parliamentary Group on Pharmacy chair Sadik Al-Hassan.
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It found that community pharmacy has one of the “weakest foundations” in primary care, noting that the sector delivers £5.06bn of services against £2.76bn of funding.
The report also reiterated the findings of an economic review into community pharmacy that last year found 99% of pharmacies in England are “paid less than the cost of what they provide”.
And it identified that clinicians are trained but “not commissioned to work”, adding that only “a third of pharmacists” hold an independent prescriber qualification, while “around a quarter of community pharmacist prescribers have never prescribed”.
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But Al-Hassan said pharmacist prescribers are qualifying “in growing numbers” and it is “encouraging” how much capacity “is already there”.
“The skills and the technology are in place, and what is missing is the route by which the NHS asks them to be used,” he said.
CCA chief executive Malcolm Harrison told C+D that with new pharmacist registrants qualifying as independent prescribers from this year, it is “imperative that the government invests in the access and additional capacity [they] can provide”.
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The inquiry also found that funding is distributed “in ways that do not follow need” and that external organisations to the NHS “are already reaching people primary care does not”.
It said the “same failures” appear across all four primary care sectors with “inequality underpinning each issue”.
And it called for a “fundamental shift in how NHS resources are allocated”, such as redeploying existing NHS spending and “away from acute hospital care” so that primary care is rebalanced to deliver care closer to home.
Recommendations
The report offered 13 recommendations to improve primary care access, with the majority able to be implemented either “within existing resources” or with a “redeployment of funds”.
It said the recommendations were all “rooted in one key principle” that “any solution must be a joint effort across all four sectors of primary care”.
One suggestion was to establish a primary care investment standard that requires a “year-on-year growth in the primary care share of NHS expenditure”.
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It said this would also require funding distribution mechanisms in community pharmacy being reformed, and the funding gaps in the sector being addressed when “additional funding becomes available”.
The report said the Department of Health and Social Care (DH) should “should pair the neighbourhood health implementation with a workforce plan and a matching capital plan for the premises that workforce will need”, including pharmacy premises.
And the DH should ensure that new commissioning routes in community pharmacy “complement rather than destabilise existing NHS primary care providers”, it added.
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Across all four primary care sectors, the report called for establishing a primary care access standard, mandating “open data standards” and expanding the NHS app and NHS website functionality “alongside a guaranteed non-digital access route” for those who are digitally excluded.
It also said the DH should create an “integrated commissioning framework” across the sectors to address unmet needs, and “train, employ and retain the primary care workforce”, including addressing the deployment of qualified independent prescriber workforce in community pharmacy.
The DH told C+D that community pharmacy is “at the heart of our plans to bring more healthcare closer to home” and that “pharmacies will play an even bigger role in neighbourhood healthcare” through Pharmacy First and the 10-year health plan.
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CPE chief executive Janet Morrison told C+D that turning the report’s “ambition into reality” will require “the right funding and support” and fully integrating community pharmacy “into plans to improve access to primary care”.
And IPA chief executive Leyla Hannbeck warned that not addressing the “declining” primary care budget will make the NHS 10-year plan “extremely difficult to deliver”.
“Pharmacies and GP practices should not be competing for limited resources when both are essential to delivering accessible healthcare,” she said.
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“If we genuinely want community pharmacies to become a first point of care and relieve pressure on the wider NHS, we must ensure that funding follows the shift towards community-based healthcare.”
Al-Hassan said he looked forward to “turning the recommendations “into action”.
It comes after a report commissioned by CPE found that community pharmacies in England generate £31.6bn of social value.
