Your local pharmacy – the future is clinical

By Dr Bruce Warner, Deputy Chief Pharmaceutical Officer for England

As pharmacy and medicines professionals we have so much to be proud of in the way we have responded to the COVID-19 pandemic – how we have supported patients, local NHS teams and our local communities.

We have played a key part in delivering the COVID vaccine to millions of people and consolidated our clinical role as part of NHS teams providing integrated clinical services to patients.

Since the Community Pharmacy Contractual Framework (CPCF) five-year deal was agreed in 2019, the expansion of clinical services in community pharmacy has included minor illness and urgent medicines referrals from general practice and NHS 111 into the NHS Community Pharmacist Consultation Service.

And community pharmacy teams are working clinically with their professional colleagues in hospitals and primary care networks to prevent harm to patients when they leave hospital with new medicines through the Discharge Medicines Service.

New clinical services being introduced as part of the Year 3 CPCF agreement include hypertension case finding and referral of patients from hospital to continue receiving support with stopping smoking.

Community pharmacies are also supporting referral to a new weight management scheme as part of the Pharmacy Quality Scheme (PQS).

In addition we have introduced a significant expansion of the New Medicine Service (NMS) into new therapeutic areas including epilepsy, Parkinson’s Disease, heart failure, stroke/transient ischemic attack and coronary heart disease, allowing many more to benefit from expert advice and support.

I see the expansion to the NMS, now covering sixteen therapeutic areas in total, as an important endorsement of the clinical skills of community pharmacists and the role you and your teams have to play in supporting patients to get the best from their medicines.

This takes the service into new, and potentially more clinically challenging areas which demonstrates the trust and confidence that commissioners, other healthcare professions and, critically, patients have in community pharmacists.

Community pharmacy has a vital role to play in supporting people with their mental health and wellbeing. Pilots starting in early 2022 to include people who are starting to take a new antidepressant, in NMS, is further evidence of this trust and confidence.

As we move into this potentially more challenging area, it is really important that we get it right.

Piloting potential areas for expansion through the Pharmacy Integration Programme is incredibly important in helping us think through any potential pitfalls, any training support that may be required and making sure the service is safe and effective, allowing us to test models before rolling them out at scale.

The size of the ‘prize’ is huge, particularly for patients. By having these initial and follow up conversations with a highly qualified health professional they trust, in a confidential setting, research has shown that more patients will take their medicines in the correct way and will benefit more in terms of their outcomes.

Imagine the difference it can make to somebody’s quality of life if we help them to take newly prescribed antiepileptic medication in a way that means they remain free from seizures.

Living with heart failure, and then suddenly being able to walk to the local shops again because somebody has understood your needs, and helped you make sure your newly prescribed medicine is taken in a way that works effectively.

Playing a part in restoring dignity can be incredibly rewarding.

Other parts of the CPCF can also encourage the delivery of NMS. Personalised asthma plans, inhaler technique checks and the anticoagulation audit – included in the PQS – can both prompt an additional NMS.

The rewards professionally can be profound. Conversations with patients that genuinely use shared decision making can provide both the patient and the pharmacist with a sense of achievement. The follow up element of the service allows an opportunity for the pharmacist and patient to get the best from shared decision making and really make a difference.

This is what being a community pharmacist is all about. I and many others have worked all our professional lives to see clinical services extended into community pharmacies at this scale.

Alongside the hypertension case finding service, the smoking cessation service, vaccination services and a whole range of clinical services, being delivered day in day out in our community pharmacies, and with new clinical pilots due to commence over the coming months, the expanded NMS signals a very clear direction of travel.

Core Belief: There Is a Clear Choice of Future

‘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

Core Belief: Community Pharmacy Can Do So Much More

‘Our premises are conveniently located health & social care assets in neighbourhoods across the country.  Our skilled people have the capability to do so much more if liberated to do so.’

Chris Ford is the Head of Parliamentary Affairs at the NPA. He has previously worked for several MPs, a US Senator and as a political advisor to a number of large corporations. He is also a politician himself, having been elected as a Parish and District Councillor in May 2015.

With a title like this you probably think I am going to talk about the fabulous untapped potential of community pharmacy, and how this can transform primary care forever. If you’ve been in any way involved in the sector over the last 30 years you will certainly have heard these words before.

I don’t know about you, but I’m rather tired of talking about potential – after all, it’s just another word for missed opportunity; and as we face an existential health crisis that threatens the very existence of the NHS as we know it, I don’t think we can afford too many of those.

Don’t get me wrong – there are vast reserves of potential within pharmacy and we have plenty of evidence to make our case; but there is the rub – we need to get far better at making our case.

It is perhaps understandable that, following a relatively successful national campaign that nonetheless resulted in significant funding reductions, community pharmacy has lost some of its confidence, but I think the key to securing the sector’s future is recapturing that confidence. In a world where everyone is more sensitive to risk than potential, it is our role to prove to Government that our vision of the future is the right one– and that we have the commitment and passion to see our plans through.

Permission to do more will never come; instructions from Government on what the future of pharmacy should look like just isn’t going to happen.

It is our future, and the choice about what we do with it is ours to make and so, when I meet with politicians, I want to represent a sector that is self-assured, knows who it is and what it stands for and, most importantly of all, what it wants.

Such assertiveness and confidence is far more effective at taking people with you than a smorgasbord of laudable ideas with no clarity on how to deliver them at scale and pace and no commitment to take on some of the risk.

That’s why I think, ironically, pharmacy doing more requires us to narrow our focus, take a risk and decide the area of health we really want to make a difference in. Once we make that decision we then need to go for it, grasping the opportunity with both hands and proving just how effective we can be.

We should choose to do this, not because we asked for permission, but because we are the experts, we know what is best for patients and the sector and – put simply – it’s the right thing to do.

When we make a success of this, we will find Government and NHS England coming to us and asking ‘If you can achieve this in this area, why not this one too’ – creating the opportunities for a more clinical future for pharmacy, on our own terms, that we have so longed for. The NPA, building on the forward view, and working with the PSNC, RPS and others is now working tirelessly towards defining that goal.

Potential? In this humble blogger’s view, realising it is not about what you ask for, but how you ask for it.

Author: Chris Ford, NPA, Head of Parliamentary Affairs

Core Belief: ‘Change is inevitable and necessary’

'Pharmacies must be progressive and modern, while at the same time being true to the historic values of pharmacy as a personal, caring profession. In particular, the sector must work to optimise the use of technology to strengthen pharmacy’s locally based service proposition.'

Mike Hewitson is an independent pharmacy contractor for Beaminster Pharmacy, West Dorset and sits on the board for the NPA and PSNC. Mike has contributed to a number of pharmacy publications including Chemist+Druggist and Pharmacy Magazine, and has acted as a spokesperson for the NPA on many occasions for media channels in the UK, including BBC, Guardian, Independent on Sunday and The Observer.

Given that we find ourselves in stormy waters with funding cuts and numerous other threats on the horizon, it is natural to want to park up in a safe harbour and wait out the storm, but if we are all not careful, we could end up trapped and at risk of sinking. Change is not only inevitable, it is healthy and an essential part of any successful business. The Government reform programme in my view is exactly the wrong type of change, delivered in the worst possible way, but if we don’t like the path they are laying out for us, we must aim to progress along a different path, not seek to stand still.

Customer service expectations now are in a completely different place than they were 15 years ago, not only do people want a fast and efficient service, but they also want to access it when and how they choose to. For some this will mean longer opening hours, for others it will mean technological solutions and use of the dread word digital. This term is often used to describe a whole raft of different things from websites, apps, right the way through to new health technology. Whatever the technology, for me digital is about providing a new front door for the traditional pharmacy, a virtual front door which patients and customers can chose to walk through when they want to.

Although the march of pure internet pharmacy has been slow in the UK, there are signs that the colossal investment by venture capital firms in the largest internet pharmacy in the UK is starting to have an impact on patient behaviours. Amazon too has just hired a superintendent pharmacist to examine whether it can make pharmacy work with its business model in the UK – if they can’t make it work, nobody can. Personally I don’t think they will make it work because of the low value, high frequency nature of the NHS pharmacy business, and the demographics of current service users, but that will change as millennials (sorry hate the term) start to develop long term conditions.

A typical community pharmacy is more than capable of competing on this front. Remember the two drivers of internet commerce have generally been price and convenience. Price isn’t a factor for NHS business, and arguably internet services are much less convenient, particular for acute conditions than the local pharmacy who will be able to help you on demand. More often than not people want information and advice (from someone they trust, not just a nameless and unaccountable page on the internet), we’ve all been used to doing this as part of the day job since forever if you think about the number of phone calls your pharmacy handles in a day. Perhaps we need to open a number of new communications channels. You should certainly be  talking to customers via social media, as that’s where the customers of tomorrow are. This isn’t difficult to do, and will become second nature after a short while.

Nobody could have missed how much the NHS is struggling right now. Two to three weeks in some areas to be able to see a GP. Weeks of waiting for diagnostic tests…Those same customer service demands that we face will become a relentless wave of pressure for the NHS and politicians, but in the short to medium term, one option is to look at private services like online doctor services and Patient Group Directions to fill the gap left by the state. Flu is another example where pharmacy is stepping in to the space that GPs are struggling to fill – every patient I talk to says they prefer to get their flu jab in a pharmacy because they can do it when they want toThese are not difficult services to offer, but we need to get better at offering them. Many colleagues are now running high quality travel clinic services which are bringing in significant revenue, and making up for some of the shortfall in NHS receipts. They have adapted and reduced their reliance on the NHS.

I hope when the current wave of interest in GP practice pharmacists dies down, that we start to see a long term vision for the development of the community pharmacy service. Canada has gone the furthest down this route, and is seeing real benefits not only to costs, but also to the care of patients with long term conditions. There is a real partnership approach there which has seen all pharmacists able to declare themselves competent to prescribe medicines for their patients.

We cannot wait for the Government to catch up, every community pharmacist needs to be pushing boundaries, leading change in their own businesses and making their customer experience the best it possibly can be. Change is nothing to be scared of, it is exciting and empowering, but we need to demonstrate the right type of change, it is only though pace and scale that we will show the folly of the Government’s thinking about the model. We have to make community pharmacies easier for patients to deal with, no doubt, but there are already a range of tools available to give you access to new customers and new channels. Don’t wait for permission, get out there and be the change.

Author: Mike Hewitson, NPA Board Member, South

Core Belief: Supply and service belong together

The link between supply and service is our history and our future. This link is a crucial element of the established, trusted service model of community pharmacy – namely convenient, face-to-face care from health care professionals, locally responsive and community based.

Mark Burdon has been a practicing pharmacist since 1999, and a committee member of the Pharmaceutical Services Negotiating Committee since 2006. In addition to running a group of five pharmacies in the north east of England, Mark is a fellow of the Royal Pharmaceutical Society and has recently been appointed Treasurer of the World Pharmacy Council.

There have been attempts recently to break the link between service and supply; facilitated primarily by the ill-conceived “hub and spoke” consultation. Large automated warehouse dispensing is thought to be more efficient (i.e cheaper) than dispensing in community pharmacies, yet no evidence of the economic benefits has been put forward. Neither has the effect on patient safety been properly assessed. Despite this, the government proposals predicted that half of all medicines could be supplied in this way

Promoted as a capacity releasing measure, this transformation is said to make community pharmacy more clinical, by removing the pharmacist from dispensing. Proposals to remove the requirement for pharmacist supervision of dispensing will supposedly allow pharmacists to leave the premises to perform these (yet unspecified) clinical tasks.

Meetings of the so-called ‘Rebalancing Board’ have been discussing just this.

Others may think this is all new. It is not. The Civil War from 1642 to 1649 as well as the Great Plague of 1665 and the Great Fire of London (1666) amounted to chaos in London. Most physicians left town but the majority of apothecaries stayed behind to treat the sick. The apothecaries took the opportunity to enhance their reputation as medical men for the ordinary citizen, being the first port of call for medical treatment.

Turf wars between the apothecaries and physicians ensued once normal service had resumed in London. In 1701, an apothecary called William Rose unsuccessfully treated a man and a complaint was made to the College of Physicians. The case went to the House of Lords, who found in favour of Rose. They found that Rose had not illegally practiced medicine (which was prohibited in law), as what he was doing was custom and practice. In addition, apothecaries, unlike physicians, could not charge for their services – only for drugs.

As they were more expensive than the “chemist and druggists”, which became popular due to consumerism of that time, most (but not all) apothecaries left their premises and became part of the medical profession. The general practitioner came into being.

Will the latest attempts to price pharmacists out of the supply market drive community pharmacists towards new roles, as with the apothecaries? Or is this the road to oblivion

For my part, I believe that service and supply belong together and that maintaining this link is key to a sustainable future for the sector.  The model is safe and convenient for patients, fundamentally cost-effective for the NHS, and plump with potential for service development within the bricks & mortar community pharmacy network.

Author: Mark Burdon, Burdon Pharmacy Group

Core Belief: Community Pharmacy Works

‘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

Core Belief: A pharmacy without a pharmacist is not really a pharmacy at all

Martin Astbury is a community pharmacist who works in England and Wales, currently for Morrisons Pharmacy, and was first elected to the Council of the Royal Pharmaceutical Society of Great Britain (RPSGB) when it was still a regulator as well as a professional body. In 2006 he was the chair of the RPSGB Health Act working group that helped stave off dangerous proposals to changes to the Supervision laws and help to get Responsible Pharmacist absences capped at two hours rather than the original unlimited that was proposed!

Martin is currently the President of the RPS which is the professional leadership body for pharmacists and pharmacy, influencing the production of legislation and healthcare policies, producing professional standards and guidance, in addition to providing accreditation and world class publications.

Pharmacists have a vital role to play in the NHS of the twenty-first century, indeed pharmacists should be involved wherever medicines appear, from production all the way to the patient.

Pharmacists are the third largest healthcare profession – they are also by far the most accessible, and see more patients per day than any other – yet they are not recognised for how important they truly are. Some pharmacy leaders when talking up potential new “clinical roles” within community pharmacy, make the mistake of appearing to talk down the vital “Clinical” roles Community Pharmacists do now, most of which goes unpaid.

Pharmacies are effectively NHS walk-in centres; keep the well healthy and taking in anyone who’s feeling unwell, performing triage, applying their vast knowledge to help patients with anything from a cold to a long-term condition, in many cases making life-saving interventions.

Estimates suggest that 1.6 million people go into pharmacies every day, with over one billion prescriptions dispensed each year. GMC research publicised in 2012 to investigate prescribing errors pointed out that two million prescribing errors per year were seamlessly and discreetly corrected by pharmacists, in some cases saving lives in the process.

When a patient goes into the pharmacy, they can have confidence in the services we provide; and confidence that a trained healthcare professional, with a pharmacy degree, is in the building. They can be confident that there are protocols in place to deal with any eventuality. The pharmacist will get involved if any one of a number of these protocols is triggered or if they spot that the support staff have missed something subtle said to them. The pharmacist being present in the pharmacy means that we can operate as NHS walk-in centres, and in doing so we take untold pressure off the already overstretched health service.

If the pharmacist isn’t there, then the support staff will come under pressure to act outside of their competency, and the ethos that the public can walk in and get competent advice will be a thing of the past. Take away the highly trained healthcare professional and you might as well be in a garage or a shop.

Pharmacists must on behalf of the public remain legally responsible for the over-arching supervision of the safe sale and supply of medicines; the guardians of medicines, give this function to anyone else and policymakers will have downgraded a vital function of the NHS – meaning that many of those prescribing errors the GMC have talked about will slip through undetected to harm patients.

At the moment, it’s estimated that no patient waits more than six minutes to be seen by a pharmacist, even in the busiest of pharmacies. That beats four hours at Accident and Emergency!


Author:  Martin Astbury Community Pharmacist, President of the Royal Pharmaceutical Society


Core Belief: Face-to-face contact is vitally important

‘Even more in this age of increasing automation and digitalisation, the face to face relationship between health professionals and patients matters.’

Thorrun Govind is a community pharmacist from Bolton with strong media presence, including a monthly slot as the resident pharmacist at BBC Radio Lancashire. Thorrun has recently appeared as a guest on BBC’s Newsnight to discuss the consequences of cuts to pharmacy services.

Community pharmacy is the front line of the NHS, helping to alleviate the strain on other services. Local face to face care, without an appointment, with a clinical professional is the unique selling point of community pharmacy. The clue is after all in the name- ‘community.’

It’s about taking the time to encourage vulnerable patients to feel comfortable with coming to see you. It’s about helping patients that are feeling depressed, and working together with other healthcare professionals locally to find the right balance of medication and psychological support.. It’s about comforting someone who has had a fit and calling their mum. It’s about the pharmacy delivery driver who is Dementia-trained and is the only person that a patient sees apart from a carer.

It’s about providing treatment via a local minor-ailment scheme to save the NHS the cost of a £45 GP appointment. It’s about the lady who unwraps her pregnancy test in the consultation room and asks you to check is she is pregnant. It’s about the pharmacist who spots during a medication use review that a patient has had a stroke.

It’s about people.

An Amazon style delivery service can’t check a patient’s blood pressure. It can’t comfort a lady when she comes in and tells you her husband has passed away and it definitely can’t instantaneously provide you with the antibiotics you need to start immediately.

Pharmacy is changing, but we need independent prescribers in community pharmacies who have established a level of trust with their patients.

Community pharmacy always wins in the community.


Do you agree with Thorrun? What are your opinions on the NPA’s statement of core beliefs?

Come back next week for another instalment of the NPA Core Beliefs series, where the next guest blogger will be covering one of the following topics:

  • Community pharmacy works.
  • Community pharmacy can do so much more.
  • Face-to-face care is vitally important.
  • A pharmacy without a pharmacist is not really a pharmacy at all.
  • Community pharmacists are clinicians.
  • Supply and service belong together.
  • But change is inevitable and necessary.
  • There is a clear choice of future. 

Find out more about the NPA’s statement of Core Beliefs.


Author:  Thorrun Govind Community Pharmacist

Core Belief: Community pharmacists are clinicians

‘A solution to primary care access, pressure lies in liberating the clinical potential of all pharmacists, especially those available without an appointment, in community pharmacies right across the country.’

Nick Kaye is the Superintendent Pharmacist of S.Kaye & Son Ltd in Newquay, Cornwall. The pharmacy has won several awards including, C&D Finalist 2013 and Pharmacy Business Award winner Entrepreneur 2012. Nick is an NPA national media spokesperson and was elected to the NPA Board in 2014 to represent the South West. 

Today, Health Education England is holding a symposium entitled Clinical Pharmacists in General Practice.

NHS managers, government officials, politicians and we ourselves as pharmacists must be wary of using language that draws a false distinction between with pharmacists operating from GP surgeries and pharmacists serving patients in local pharmacies.

The language of ‘clinical pharmacists in general practice’ implies that community pharmacists do not have a clinical role.

The NPA recently issued a statement of core beliefs, to be a unifying reference point for everything people say and do in the name of community pharmacy.  Amongst those beliefs is that ‘Community pharmacists are clinicians’.

Here are some clinical interventions that have happened in community pharmacies recently (as reported by the NPA in Pharmacy Magazine).  I present them here not because they are unusual, but because they are in fact fairly typical of community pharmacy practice:

An elderly female with a large weeping gash on one shin following a fall at home.  On questioning, she could not remember or account for her fall and admitted having had several dizzy spells.  We referred her to A&E and advised her to be candid about her symptoms, as she would need investigations to exclude atrial fibrillation, TIA, and kidney infection. 

Patient on holiday from Scotland on the Saturday of a bank holiday weekend had left one of her insulins at home. She attended in a bit of a state, having been too scared to eat since she missed her dose.  With her permission, I was able to view her Summary Care Record which detailed the insulin she needed.  Luckily we had some in stock and I was able to make an emergency supply. 

A patient complaining of tachycardia. Examined pulse.  Fast and not normal sinus rhythm. Ectopic beats but no AF. Sent to GP for an ECG.  Returned in an hour with a diagnosis of intermittent AF and started on Apixaban to prevent stroke.

Pharmacist next to small GP surgery – surgery was shut – the patient had an allergic reaction to peanuts – pharmacist stabbed them with an EpiPen – first responder arrived, they don’t carry EpiPens, and the ambulance took 20mins.  Paramedics said pharmacist probably saved patient’s life. 

This is the second in a series of blogs about our core beliefs – those to follow will be written by other NPA members who each have a unique and personal perspective on one or all of these:

Community pharmacy works.

Community pharmacy can do so much more.

Face-to-face care is vitally important.

A pharmacy without a pharmacist is not really a pharmacy at all.

Community pharmacists are clinicians.

Supply and service belong together.

But change is inevitable and necessary.

There is a clear choice of future.

Find out more about the NPA’s statement of Core Beliefs


Author:  Nick Kaye, NPA Board Member, South West

NPA Core Beliefs Blog Series

Hello members, and welcome to the first in a series of blog posts that we'll be running over the course of the next few weeks, to correspond to the NPA's recently issued ‘Core Beliefs’ statement.

The hope is that by producing this, and having members agree on them, we can create a sense of unity across the pharmacy sector – the core beliefs are a series of simple, but hopefully meaningful statements that we hope to utilise as a reference point for everything people say and do in the name of community pharmacy.

You can find this statement in full on the website.

Throughout July and August, we will be hearing from a number of guest bloggers, each talking about a different Core Belief; including NPA Board Member Mike Hewitson, locum pharmacist Thorrun Govind and President of the Royal Pharmaceutical Society Martin Astbury.

Please revisit the NPA blog to stay up to date with the latest from our community, and follow @NPA1921 on Twitter.

Author:  Ian Strachan, NPA Chairman