Shilpa Shah shares her reflections on the past year and her thoughts or the future of community pharmacy as she ends her service at Kent LPC…
I have always been passionate about Community Pharmacy and am proud of the way that the sector navigated itself through Covid-19 and is currently navigating itself through all the changes in the NHS landscape.
When I started my role in Sep 2019 as the CEO of Kent LPC, I used to say that community pharmacy has changed more in the last five years than the 15 before that, however, I now believe community pharmacy has changed more in the last two years than the 20 before.
The year 2019 saw the start of the five-year Community Pharmacy Contractual Framework which set out how community pharmacy would support delivery of the NHS long term plan. What PSNC (or any of us) when negotiating this deal had not envisaged was the Covid-19 pandemic.
Whilst the world turned upside down, we saw high street shops close their doors and immense pressure fl ood the NHS. Community pharmacy did what they always do, they adapted, teams came together, worked through, and showed resilience in the face of adversity.
In Kent, I saw us integrate into primary are and into the NHS structure very quickly, in the first few weeks after Covid-19. All the usual red tape was removed, we all worked together to implement services to help patients in a matter of weeks when they would have normally taken months.
We brainstormed together through virtual meetings and thought out of the box. Remuneration was fair and ensured that what we were doing was viable. An example of this was a Palliative Care service which was put together in less than three weeks, simply by having the right people focused, attending virtual meetings, and working with pace to land the service. This service is still in place now and is likely to stay.
Whilst the public saw us all as ‘healthcare heroes’, what they didn’t see was the strain that Covid-19 was putting on businesses and the detrimental effect to the emotional well being of pharmacists and their teams. As professional as ever, they all carried on working through.
Almost 20 months later it still feels as though there is no light at the end of the tunnel and even after everything that has been delivered over the past 20 months it still feels as though we are not fully integrated into the NHS nationally.
Taking Covid vaccinations as an example. There are approximately 11,500 community pharmacies, the majority of whom offer flu vaccinations. If they were all given the opportunity to offer Covid vaccinations, imagine what we could deliver!
The government has strong ambitions, which are often shared with the public before we get to hear about them, to achieve these ambitions they need to include the entire primary care network so that the pressure is not on just one sector. We also need our non-urgent workload, such as PQS and CPPQ, to be taken away from us so that we can support these government ambitions without struggling.
Patients should be able to get the best care in the best place by the best person. This means that services such as GP CPCS should be fully embedded in all surgeries so that we begin to educate patients on the best place they need to go to have their healthcare needs met. We would like to move to self-referral for patients into CPCS and this needs to be done with pace.
I would also like to see the NHS utilise community pharmacy independent prescribers for minor ailments as we need to start forward planning on how we will utilise Independent Prescribers so that we are ready for 2026 when all pharmacists will qualify as IPs.
This will also avoid us having to send patients back to the GP which can be frustrating for everybody involved.
Services such as the DMS are still not consistent in so many areas. By not having consistency nationally this leads to a post code lottery which is something I believe that we can play a big role in decreasing.
Covid-19 has widened the gap between affluent and deprived areas, we have a role to ensure that the gap for healthcare provision is getting smaller instead of larger. How can we do this? The key word is community.
Generally, the staff working in a pharmacy are from the local community, they may be from the same culture and speak the same language.
We are accessible with long opening hours, you don’t have to book an appointment, you can just walk in.
We have a real opportunity to support patients in deprived areas with their healthcare needs and this is something that was highlighted during Covid-19 as many populations didn’t have access to technology for virtual appointments so would instead come to their local community pharmacy.
In 2022, I would like to see more women and diversity in leadership roles in community pharmacy. We still see too many all-men panels or committees that are made up predominantly of men, yet our profession and sector is predominantly women.
Everybody needs to play a role in making that happen.
I would like to see community pharmacy fully integrated into the Integrated Care Systems and nationally into the NHS, so we are not seen as a separate organisation on the side lines, helping out, as an afterthought.
All national services should have a clear expectation that it’s not an optional service as it will make a huge difference to patients if it is utilised.
My dream is to see interoperability between primary and secondary care, from an IT point of view, as this is often a barrier for services being rolled out. All healthcare professionals should have read and write access to patient records so that patients get the best care whichever HCP they see.
Community pharmacy has shown time and time again what they can deliver. It’s time for us to stop needing to prove ourselves, no more pilots, less non-urgent, non-essential work and more service delivery that will really make a difference to patients.
I wish everybody a Merry Christmas and a Happy New Year. I hope that you all get a well-deserved break over the holiday period.
Shilpa Shah is CEO of Kent LPC.
