Community pharmacy faces a real and urgent need to transform or be eliminated from the NHS equation.
The NHS is undergoing an unprecedented transformation to meet the future needs of very different populations. This has brought about seriously challenging developments in robotics and distribution methods, technologically empowered communities, multidisciplinary teams and virtual working, as well as artificial intelligence.
It has also prompted self-care and person, not patient-centred, care. But has the profession even considered the difference in provision of care with this small change in wording? I fear not, when we have people [at the local pharmaceutical committee (LPC) conference and other sector events] discussing how to tinker with the existing model.
Get to grips with new technology
The profession needs to get a firm grip on the NHS agenda, which is embracing powerful advances in technology. Cloud-based data management and devices which will make the 365-day-a-year, 24-hour-a-day personalisation of care possible – all while looking to improve care by significantly changing public engagement and personal responsibility for health and wellbeing.
Community pharmacists should be talking about how to make a contribution to multidisciplinary teams with integrated pharmacy care everywhere: in community pharmacies, GP surgeries, hospitals, care homes, and people’s homes, as a part of these teams.
New mindset needed
This requires a new mindset which recognises a need for collaboration between local pharmacists, and updated clinical and communications skills. It requires re-planning pharmacy layouts to ensure that space is allocated according to income – at present I estimate NHS services yield 90% of pharmacy income, yet they get 20% of space.
It will require community pharmacists to become experts in behaviour change to support lifestyle changes, to understand that simply giving information has limited impact, and to understand that to produce transformational care plans you also need to combine psychological support and clinical tools.
The sector will need to give pharmacy staff greater respect and responsibility from their employers, and a real stake in the system, to ensure that they feel part of it and are able and motivated to react to local changes. To make this happen, I would recommend that we look at creating associate status, to recognise the value of the knowledge, skills, relationships and time invested by our employee pharmacists.
Employers will need to act as local collaborators instead of competitors. In a world where Samsung makes phone screens and Microsoft writes software for [their competitor] Apple, it makes sense to review how we work with our competitors.
No place for division in sector
The creation of accountable care organisations as part of the sustainability and transformation partnerships will not permit a divided community pharmacy network, which attempts to work for divided owners instead of the public, the NHS, and increasingly value-for-money-minded commissioners.
The small thinking and lack of urgency demonstrated at recent conferences is not only depressing and mind-boggling, but indicative of a rudderless, engineless boat drifting towards dark and dangerous rocks.
Apart from lip service, I expect nothing from the Department of Health. So, what will save community pharmacy? Inward looking and short-sighted owners? Resentful and myopic employees? The pharmacy press, who are only interested in soundbites, rather than helpful policy analysis? Superman?
Whatever your view, the last remaining grains of sand in the hourglass will soon run out. We need a leader to turn the hourglass and restart the grain fall.
Hemant Patel is secretary of North-east London LPC
