Core Belief: There Is a Clear Choice of Future

23 Aug 2017

‘There are two paths the sector can go down. One involves mass automation, centralised dispensing and pharmacists working predominantly from GP practices or remotely. The other sees community pharmacies better integrated with other services, operating efficiently as neighbourhood health and wellbeing centres and being a front door to the NHS. This second path is the only path built on solid foundations.’

As we reach the end of our blogs on the NPA’s core beliefs, it’s important that we look to the future of the community pharmacy sector. I believe that there are two paths ahead; and the choice that must be made by the Department of Health and the sector is a binary one.  We go one way or another.  There can be no standing still.

We already know the direction of travel that some elements within government want to follow – there has already been discussion of warehouse dispensing, centralised at depots; of Amazon-style deliveries; a direction in which the potential of locally based pharmacies all over the country is overlooked and undermined.

This particular path has obvious and significant flaws.  In the last twelve months, a quick search on Google reveals that no less than six warehouses have caught fire with devastating consequences for their supply chains; a similar fire last year put a major part of Amazon’s Christmas deliveries in serious doubt.

This path – the choice of bean counters in the Treasury – fails to consider the patients; those who are in pain or suffering from debilitating and long-term conditions. What happens to them in the event of an ‘interruption of supply’, or a postal strike preventing medicines from coming through? What happens to the diabetic whose insulin doesn’t arrive?

We know what happens; they go to A&E. They go to their GP, who prescribes them some more insulin.

And what of the much-touted scheme to put pharmacists in GPs surgeries, to be accessed by appointments? While they may have a role to play in the surgery, this move does not relieve pressure from the NHS, in comparison to a pharmacist in the pharmacy whose advice is currently available without an appointment simply by walking in off the street. This move towards surgery pharmacists can never substitute or replace the clear advantages of an accessible convenient network founded over centuries; the network of community pharmacies on our high streets. Research done by the British Medical Association shows that the number of GP consultations has gone up by 70 million in the last five years – pharmacists must be used in the pharmacy to relieve pressure on GP workloads.  I welcome the principle of healthcare professionals working together closely to provide seamless care.  But the real solution to GP access pressures can only lie in liberating the clinical potential of all pharmacists, especially those available without appointment, in community pharmacies right across the country.

I do not think it is an exaggeration to say that community pharmacy can be the solution to the NHS access crisis.  With consistent support from Government, we will make sure people get the primary healthcare they need, when and where they need it.

There is already strong evidence that a pharmacy first mentality works; in Scotland, a Pharmacy First pilot scheme has proven that patients using their local pharmacies to deal with minor illnesses are saving Scotland’s GPs an estimated 240,000 working hours per year – equivalent to the work of around 115 full-time doctors!  Making greater use of pharmacies to treat problems like coughs & sore throats can save the NHS  £1.1bn a year costs the NHS an extra £1.1billion a year by reducing unnecessary appointments at A&E or general practice.

Pharmacies can do much more to take pressure off GPs and hospitals, make access to NHS care more convenient, help people with long term conditions, tackle medicines waste and save the NHS money.  But it means making the active policy decision to build on the strengths of the community pharmacy network, rather than risk dismantling it.

So there is a clear choice of future; one with the pharmacist removed from the frontline of healthcare, denying patients access to free health advice on the high street.  The other route saves billions of pounds a year for the underfunded NHS. Down one path, mass automation, centralised dispensing and medicines advice e by appointment only. Down another, an NHS that works for patients, with pharmacy as its front door.

By Ian Strachan, NPA Chairman and Board Member, North East