By Henry Gregg
The forthcoming expansion of pharmacist prescribers is a historic and strategically significant development, which will ultimately benefit our sector, the NHS and most of all patients.
But amidst the excitement, which I share, it must be understood that any new NHS services, including prescribing, need to be funded with new money. There’s no point in the Government trying to squeeze more from less, by raiding a budget for dispensing that is already woefully inadequate.
Let’s say it clearly. We need real reform of our broken NHS contract - proper funding for dispensing, ending clawbacks and dispensing at a loss and creating a level playing field among pharmacy contractors.
The formula for future success must include a real-terms increase in NHS funding and a roadmap to developing clinical services, whilst also recognising the true value of safely supplying medicines. Dispensing is a vital healthcare service that saves lives and keeps the wheels on the NHS - it is not just a matter of shifting products from A to B.
The current system assumes a fixed fund for pharmacy, whatever it delivers - that might be convenient for Treasury accountants, but it’s ‘robbing Peter to pay Paul,’ and it’s a sure way to set people against each other and create division without funding care properly. If the Government wants community pharmacy to expand its services and put more capacity into the system, it needs to be paid for.
A sustainable future means opening up new opportunities alongside our bread and butter. The NPA’s vision is a future where clinical services in community pharmacy are not just an add-on, but a core function of community pharmacy, delivering accessible, clinical, high-quality care to patients in their neighbourhoods. Doing the work now to start creating opportunities for the growing number of prescribers among the pharmacist community will help make that happen.
We know from other parts of the world, notably Canada, but also closer to home in Scotland and Wales, that this can ultimately drive very significant income for all pharmacies, not just leading-edge clinical practitioners.
In England, meanwhile, the NHS 10-year plan sets out a decisive shift toward neighbourhood-based care and expanded clinical roles in pharmacy. We now have a time-limited opportunity to work through the many issues involved in creating that expanded care in community pharmacy - and it’s a lot less than 10 years!
That’s why NPA members have access to a comprehensive package of IP support, to help make prescribing a win for all. What’s more, we’re joining forces with ThisCovery, and the Health Foundation, along with Q and the NHS Confederation to identify opportunities over the coming years, plus enablers to keep the agenda moving forward. Through this project, we will engage GPs, commissioners and the wider NHS system to build momentum.
In driving forward community pharmacy’s clinical agenda, we need to think years ahead, which means having new things to offer as well as pushing hard for a fair deal for the status quo.
Government and regulators need to do preparatory work so that issues with services, access to patient records, funding and organisational changes are in place. And we need culture change in primary care to bring practitioners together so pharmacies can play a bigger role.
Above all, the government must provide sufficient funding to develop and sustain dispensing and clinical services, and the enablers such as prescribing.
There should be no false choice made between investment in clinical services and NHS dispensing. Both need to be properly resourced to sustain a vibrant community pharmacy network and shift more care into the community.
So, let’s get our core funding right, let’s get a clear roadmap to services, and let’s get enablers like pharmacist prescribing in place - to do the job of community-based care properly, not on a shoestring.
(Henry Gregg is the chief executive of the National Pharmacy Association)
