The chief pharmaceutical officer (CPhO) for England has welcomed the recent cash injection for clinical services in community pharmacy as a key step on the journey towards independent prescribing (IP) in the sector.
David Webb added that workforce development and continued development of clinical services in community pharmacy were among his top priorities for the year ahead.
Last week, the government announced in its primary care recovery plan that an England-wide Pharmacy First service would launch by winter 2023, allowing community pharmacists to treat seven common conditions - sinusitis, sore throat, earache, infected insect bite, impetigo, shingles, and uncomplicated urinary tract infections in women – under a PGD.
Speaking at the Clinical Pharmacy Congress on Friday, Mr Webb described the news as an ‘exciting’ announcement that ‘supports the trajectory towards independent prescribing in NHS community pharmacy services’.
He said that the move would enable NHS England to develop work to ‘make community pharmacy part of clinically integrated pathways in primary care for the benefit of patients’.
And he added that there was potential for services developed under the national community pharmacy contract to be developed further for local neighbourhoods to meet integrated care board (ICB) population health needs.
Independent prescribing ‘transformational’
Mr Webb said that the introduction of independent prescribing on a widespread scale – when all newly qualified pharmacists will graduate with a prescribing qualification from 2026 – will be ‘transformational for all sectors of pharmacy’ and had the potential to improve medicines use and increase opportunities for deprescribing.
Towards that end, NHS England (NHSE) was working on several pathfinder pilot projects, which he said would be established in every ICB this year. These projects would ‘test different models and allow for local variation in clinical design and delivery, responding to local needs and the availability of pharmacist prescribers’.
Mr Webb said that 15 different clinical models for IP and community pharmacy had already been identified and added that NHSE was ‘working through the detail of how we allocate funding through the regions to the ICBs’.
‘When on earth do you think we're going to have time to carry out Pharmacy First?’
One delegate asked the CPhO how he expected the community pharmacy sector, who the delegate described as ‘rushed off our feet’, to be able to carry out the newly announced Pharmacy First service.
‘The press give the impression that GPs are rushed off their feet, and pharmacists in community pharmacies have got plenty of spare time. It’s so untrue,’ the delegate said.
The CPhO responded that he did recognise ‘how challenging the environment is for people’.
‘I know how hard people are working, because I have been out to see people and hear what they say about the grassroots experience,’ he added.
But Mr Webb said that he was ‘really positive about this additional resource to support pharmacy first’, adding that it signalled ‘something quite profound about policy thinking in this context and the contribution of pharmacy to be recognised for the future’.
Employers must train workforce needed
Speaking at the Clinical Pharmacy Congress, Mr Webb also repeated his call for all employers – NHS, general practice and community pharmacy – to train enough pharmacists to meet the needs of the sector.
‘Employers and pharmacy professional leaders should look to work together across systems and avoid the temptation to work in silos or even compete,’ he added.
He also said that NHSE was ‘making the case for an increase in training places for pharmacists’ and was awaiting the NHS long-term workforce strategy later this year.
One delegate raised concerns that the clinical tariff rate paid for pharmacy placements in England was significantly lower than that paid for medical students, which the Pharmacy Schools Council had warned could mean pharmacy students losing out on training places in general practice.
Mr Webb responded that he ‘acknowledged the concern about the resource’ and added: ‘I think what we have to do is sort of reflect on the fact that we have got the clinical talent, and we can make some changes and work with that.’
In March, Steve Brine, the chair of the Health and Social Care Committee, warned that pharmacists with prescribing qualifications were leaving the community sector due to a lack of opportunity to use their clinical skills.
And a recent report from the Company Chemists’ Association (CCA) claimed that the recruitment of pharmacists into direct patient care roles within primary care was exacerbating workforce and workload problems within community pharmacy.
Speaking at a Westminster Health Forum event on Friday, CCA chief executive Malcolm Harrison said that the upcoming NHS workforce plan must think about how to best use and coordinate the existing pharmacist workforce across different systems.
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