Core Belief: Community Pharmacy Works

25 Jul 2017

‘We have unique strengths and deliver immensely valuable benefits to patients, communities and the NHS. The network of local pharmacies must remain the beating heart of pharmaceutical care in the community.’

Ade Williams is the Superintendent pharmacist at Bedminster Pharmacy in Bristol. Bedminster is a multi-award winning pharmacy, including 4 titles at this years C+D Awards 2017 where Ade himself was crowned as both Community Pharmacist of the Year and Manager of the Year.

As a new parent, I have found myself many times observing how the newborn’s journey parallels the story of community pharmacy presently. (Health warning: excessive coffee ingestion and sleep deprivation does play a part in this).

Baby plays with his toys, then after a short time pays no attention anymore to the lights, sounds and props all expertly affixed to withstand the falls, strains and pulls that he dishes out to it. He simply moves on. This is apparently very common behaviour, his mum read up on it. Rather than chase him about with the toy looking distressed (my ploy), mum takes it away and reintroduces it to him after a few days. The skill and expertise that put the toy together, is once again tested, as joyful playtime and relief (mine) sets in.

The question I ask is why do we take things of value for granted?

I do feel community pharmacy remains the underestimated, undervalued resource at the bottom of the NHS pile, that gets called upon reluctantly and yet consistently delivers for the NHS, time and again beyond expectation. Thankfully, our patients don’t have this recollective failure. A focus on our dispensing role – its efficiency, value for money and safety – continually finds that we are not just good but more importantly outstanding contributors to patient health and NHS financial value.

Just look at the key health phrases trending presently such as deprescribing, social isolation, loneliness, wellness, polypharmacy. No other part of the NHS family has the patient trust and experience at tackling these things like we do.

We have a professional obligation to ensure appropriate, safe and effective use of medicines. We are community health and wellbeing hubs, the interface between primary, secondary and social care. We understand and manage the crises that occur daily. Our safeguarding and patient care role make it our prerogative to help our patients to attain and maintain wellness not limited to just their health challenges.

All pharmacies refer into, work with and in some instances even set up projects of their own to offer social prescribing solutions to their communities. Add these to the wide range of screening and health promotional services, advanced services like vaccinations, usage reviews, new medicines support, commissioned lifestyle support and coaching services, you not only see that community pharmacy works but gasp and ask how do they do it?

Communities across the country signed a petition saying in effect, “my community pharmacy works for me in a way nothing else does, please do not take it away” – they should know. We work with other health practitioners, voluntary and charitable groups to deliver and champion the best care locally. Our skills are ever-evolving. Over one million flu vaccinations in community pharmacy last flu season is a testament to how we up skill, engage and deliver for our patients.

My continual patient interactions make my role fulfilling. This is facilitated because I work in the context of a supply model which makes my skill and expertise readily available alongside providing their prescribed medications. Mr Smith may only come in for aspirin tablets, but he knows I will make time to look at the rash on his back in the consultation room. He is caring for his wife who has cancer so, with the pressures of being a time constrained carer and increasing difficulty getting a GP appointment, he may well rather trouble no one and do nothing.

He knows that the pharmacist is accessible and knowledgeable. The surgery knows that too. A call to request that Mr Smith sees the GP as an emergency is prioritised.

We are their triage resource; clinicians on the high street. Self-care advocates with the knowledge and expertise readily used to help them manage their torrent of anxious patients, increasingly discontented with long appointment waits due to the national GP shortage.

Mr Smith has shingles and he is in great discomfort. He would just have soldiered on, putting his wife who is undergoing chemotherapy treatment at great risk. It’s not a just a prescription supply that we provide next; the medicine delivery service is part of the wrap-around care involving managing his repeat medicines and liaising with the district nursing team.

We understand social factors, patient behaviour, and clinical and medicinal information. Ironically, the things we are most likely to take for granted are what we should value the most. Community Pharmacy is in my opinion greatly undervalued and underappreciated.

If the strain on our health system is trying to manage access to health professionals whilst promoting better lifestyle choices and self-care, why would we close the doors of a single community pharmacy?

We are a resilient, proven cost-effective NHS resource, trusted and valued in our communities. Just, imagine what would happen if the government truly allowed us to fulfil our potential.

By Ade Williams