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This is how GPs could be 'hubs' and pharmacies the 'spokes'

"Pharmacy and the high street clinic model could offer a radical solution for the NHS"

The sector’s High Court battle against the funding cuts paralysed all development in community pharmacy, says Hemant Patel. Now it is time to re-engage

Having seriously and very deeply considered the fate of community pharmacy and realising the urgent need to reinvigorate the sector, I have a few thoughts on pharmacy’s future, which I submitted as part of the NHS’s ‘Developing the long-term plan’ consultation – which closed at the end of last month.

Now is the time to rethink and re-engage with commissioners and the government after the High Court funding cuts case paralysed all development in community pharmacy – just like Brexit has paralysed our country. The prospects of a national contract are not good, as the NHS prepares contracts for new integrated care providers, where populations of 30-50,000 people would be locally managed within a single coordinated system.

I believe pharmacy – and a high street clinic model – could offer a radical solution for the NHS, instead of the ‘tinkering’ approach we have seen in the past.

Essentially, I am saying:

  1. We need to stop coming up with ideas to improve pharmacy services bit by bit. We must think big and transform community pharmacy into high street clinics.
  2. A new vision should be created and community pharmacists should be consulted to ensure that they have a stake in the new integrated care systems.

With over 10,000 GP and over 35,000 nurse vacancies and more GP practice closures and mergers on the horizon, there is a clinical under-capacity in the NHS. Community pharmacy can help relieve this.

One solution is an integrated, clinical hub-and-spoke system, where reduced GP surgeries form the hubs and community pharmacies form the spokes in communities. All repeat prescribing for stable long-term conditions can be transferred to independent prescribers in community pharmacy, where teams can also check for potential adverse conditions and monitor patients’ ongoing health.

This will make local healthcare systems more accessible, cost-effective and patient-friendly.

Read a summary of Mr Patel’s submission to the NHS consultation here.

Hemant Patel is secretary of North-east London local pharmaceutical committee, and a member of both the National Pharmacy Association and Royal Pharmaceutical Society’s English pharmacy boards. Read a summary of Mr Patel’s submission to the NHS consultation. 

Mr Patel will be hosting three sessions at the Pharmacy Show in Birmingham this coming Sunday (October 7). C+D is also exhibiting at the show – come meet the team at stand PC27.

6 Comments

How High?, Community pharmacist

We've been at a crossroads for how many years?

This great thinking, a proper heads up of what we could do.

But

We need to stop coming up with ideas to improve pharmacy services bit by bit. We must think big and transform community pharmacy into high street clinics.

This is good, but we don't have the staff due to endless cutbacks by employers in response to decreased income. Half of the the advanced services are commissioned by different bodies, hence all the horrible little claims at the end of each month. Who's going to pay for it? How?

I also suspect that the GPs despite their lack of interest, mass retiring (yet somehow still working part time and raking it in as overpaid locums whilst enjoying a full NHS pension) will block it as we try to "steal more my income" as I was accused of this week when submitting flu vaccination advices to GPs

A new vision should be created and community pharmacists should be consulted to ensure that they have a stake in the new integrated care systems

Again, how? Owners pay the least they can get away with, employ the least number of staff they can (as the GPhC still won't man up and issue guidance) leaving a bunch of apprentices working with a guy/gal on £20 an hour. Then you want the highest standards, best service delivery and some professional "ownership"

We're stuck in a Cul-de-sac in front of a very big lorry with no reverse gear and limited steering.

Benie I, Locum pharmacist

You get what you pay for. And for the responsibility £20 is not worth the hassle and why retention is so poor in community pharmacy. You only have to look at all the pitiful jobs on offer on this site for embarrassing money!! Job of the week is manager in Liverpool for £40k for goodness sake. The only reason someone would stick their head in that noose is to clear their student loan.

Leon The Apothecary, Student

"One solution is an integrated, clinical hub-and-spoke system, where reduced GP surgeries form the hubs and community pharmacies form the spokes in communities. All repeat prescribing for stable long-term conditions can be transferred to independent prescribers in community pharmacy, where teams can also check for potential adverse conditions and monitor patients’ ongoing health. "

I would say this is basically the spirit of Repeat Dispensing. To remove a lot of the unnecessary aspects of prescribing for patients with long-term conditions. It also highlights how ineffective the industry is at implementing change. 

C A, Community pharmacist

I thought a lot of the problems with repeat dispensing was how "hard" it was for GPs/surgeries to implement... as well as they weren't getting paid "extra" to do it.

Leon The Apothecary, Student

To be honest, I can relate to that pain - trying to explain issues with Repeat Dispensing to a clerk is rather painful.

Barry Pharmacist, Community pharmacist

I love it Hemant. Makes a lot of sense.

Unfortunately submissions regarding developing a long term plan for pharmacy now have to be sent to the Paris office of the DHSC.

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