An influential report by The Times Health Commission has proposed new community health centres as well as GP ‘super-practices’ to house multi-disciplinary healthcare teams, including pharmacists.
It also suggested that pharmacists could play a greater role in medicines optimisation and safety, reducing pressure on hospitals and saving the NHS money.
The report, published this week, brings together the findings of The Times Health Commission, which was set up in January last year to consider the future of healthcare, chaired by Times journalist Rachel Sylvester and supported by 18 commissioners across business, medicine, science, sport and policy background.
It proposed 10 key reforms to ‘create a healthier Britain’ and highlighted best practice already happening throughout the UK and further afield.
And it outlined challenges facing the healthcare system, including cultural issues within the NHS workforce.
Community health centres with pharmacy and more
The report proposed ‘a new network of purpose-built community health centres’, with the first sites being built in disadvantaged areas.
‘As well as GP surgeries, they could include diagnostic centres, outpatient clinics, family hubs, dentists, pharmacists, obesity support or frailty clinics as well as other services such as employment and housing advice, depending on local need,’ the report suggested.
It also suggested that more GP ‘super-practices’ should be encouraged.
‘Super-practices, bringing together several GP surgeries, are a good way of sharing the administrative burden and reducing back office costs,’ the report said.
And GPs should be encouraged to be ‘more pro-active’, ‘working closely with pharmacists, nurses, social prescribers, physiotherapists and mental health professionals’, it added.
And it highlighted technology such as eConsult, which is used by a third of GP surgeries, that can help surgeries prioritise patients and allocate them to different staff members, including practice pharmacists.
The report suggested that reform of the GP contract could help primary care providers work together at scale.
But at an event discussing the report yesterday, pharmacist Thorrun Govind suggested that the focus should instead be on changing ‘the primary care contract’, highlighting that GP-centric language could exclude other healthcare professionals.
She later told The Pharmacist: ‘You can't just tinker with parts of the GP contract, you've got to look at the primary care contract as a whole, and make sure that different parts of the system are actually working together, because that's fundamentally where the problems arise.’
And she suggested that GPs were seen more as part of the NHS than community pharmacies, when both are private businesses working under an NHS contract.
Cost savings in medicines
The report also suggested ‘there is more that pharmacists could do with medicines optimisation to prevent patients taking unnecessary drugs, reduce wastage and improve safety’, particularly with an ageing population taking multiple medications.
And it highlighted economic analysis that suggested 237 million medication errors occur each year in England, costing the NHS more than £98m; using 181,000 bed days; and contributing to around 1,700 deaths.
‘There are significant savings to be made and pharmacists have the specialist knowledge to identify them,’ the report said.
Meanwhile, speeding up the process that allows medicines to be switched to generics could have saved the NHS £128m within the last six months of 2022, the British Generic Manufacturers Association is quoted within the report as suggesting.
‘Look after the staff’
Workforce issues across healthcare professions and providers were also flagged.
‘There has been an increase in vacancy rates in pharmacies, with 16% of pharmacy roles and 20% of pharmacy technician jobs unfilled,’ the report noted.
The commission had heard ‘repeatedly and from many angles about the cultural problems in the NHS’, including bullying, discrimination and harassment as well as a lack of control and work-life balance.
And health secretary Victoria Atkins said within the report that the health service needed to do more to ‘ensure that the culture is respectful and dignified and caring, not just to patients, but to colleagues as well’.
Another key proposal outlined in the report suggests patient record sharing through digital ‘patient passports’ and incentivising pharmacists ‘to do more prescribing, consultations and community care’.