Community pharmacy must adapt to the NHS’ vision of population healthcare 'or die’, community pharmacy consultant Hemant Patel told delegates at the 2023 Sigma conference.

‘Community pharmacy must adapt or die. And I think we are dying’, he said, adding that there was currently ‘no alignment of values or aims’ between community pharmacy and the NHS.

From next month community pharmacy services will be commissioned by local Integrated Care Systems (ICSs), which are focused on improving health outcomes, tackling inequalities and enhancing productivity and value for money.

There is money in the system – but you need to know how to play the game

Mr Patel said that the sector must learn to present solutions in line with these priorities at a local level.

‘There is money in the healthcare system, but it is going to flow in a particular way and you need to know how to play the game’, he said.

In particular, he said that funding would be invested in services that targeted the most deprived 20% of the population, as well as core clinical areas defined locally as well as five national priorities: maternity, severe mental illness, chronic respiratory disease, early cancer diagnosis and hypertension case-finding, in line with the NHS’ CORE20PLUS5 strategy.

Moving from contracting to commissioning

Funding would be available at a local level from ICS’ for commissioned services, which could provide opportunities for community pharmacies to bid to provide services that might have previously been provided by general practice.

‘National contracting is going to die, local commissioning is going to survive and grow’, he said.

Mr Patel said that community pharmacy would need to understand other professions within primary care, as well as voluntary organisations, who would also be involved in ICSs and might be competing to provide services.

He suggested that a change in contractual structure might help pharmacies secure funding at a local level – for instance, commissioning services through a provider company that subcontracts to local pharmacies, similar to the model used by GPs.

‘Without a provider company, there is going to be no contract,’ he said, adding: ‘we are five years behind the GPs’.

Solutions over strikes

He also said that the sector needed to present more strongly what solutions it could provide to the NHS, and would need to pilot services so that it could present data to the NHS.

For example, he suggested that pharmacy could use its expertise to present a strategy on making Britain the safest place in the world to take medicines.

‘I think that is something the government is more likely to be interested in than strikes’, he said.

Need for integration

Mr Patel suggested that community pharmacy was ‘falling between two stools’ – the competition on product distribution from providers like Amazon, internet pharmacies and home care, and on cognitive services from surgery-based pharmacists, artificial intelligence and voluntary organisations.

Without a strategy in place, ‘the question is how hard are we going to hit the floor’, he said.