The way the NHS views community pharmacy must change if the sector is to be properly integrated into Integrated Care Systems (ICSs), the Association of Independent Multiple pharmacies (AIMp) has said.
Leyla Hannbeck, the CEO of AIMp, called on NHS leaders to place more ‘trust’ in the sector in response to the Fuller Stocktake report on primary care integration published on 26 May.
In a statement sent to The Pharmacist, Ms Hannbeck said that while the NHS-commissioned report was ‘welcomed’, it could have been ‘more radical and substantive with respect to community pharmacy.’
The report looked into ‘bringing together previously siloed teams and professionals’ in primary care services, ahead of the implementation of ICSs on 1 July.
It said that community pharmacy could play a more active role in cancer diagnosis and referring patients to mental health services.
Ms Hannbeck said: ‘When we think of the end game of integrated pathways – namely: improving outcomes and population health; tackling inequalities; improving access, while enhancing productivity and value for money – then local pharmacies really do have the tried and trusted credentials to deliver within the communities they reside.’
However, to make full use of the pharmacy sector, there must be a ‘cultural shift’ in the way NHS leaders see pharmacy as there is still barriers to the sector’s acceptance, she said.
As it stands, the community pharmacy sector is ‘substantively underfunded, unstable, and demoralised at all levels,’ she argued.
‘Trust is a huge problem for integration at the best of times. Silo working is a problem across all strands of frontline, multidisciplinary working. The frustration is even more acute because right now, pharmacy is not given even a fighting chance in the current system,’ she said.
She added: ‘The transformation of primary care networks to neighbourhood teams will only exacerbate that instability and uncertainty. It feels like we are embarking on a jigsaw only to find the pieces are not making the picture, so we hurriedly redesign to make the pieces fit.
‘The aspirations, we believe, are fine, but community pharmacy needs real commitment at the integrated care board and integrated care partnership level to ensure we are not overshadowed once again. That will require intervention and strong leadership, which firmly believes in our sector’s credentials,’ she said.
Meanwhile, Thorrun Govind, the RPS England Chair said that to maximise the contribution of pharmacy teams, there needs to be ‘pharmacy leadership at system, place and neighbourhood level to ensure they are involved in decision-making.
‘There needs to be a strong voice for primary care and pharmacy within new Integrated Care Systems, supported by new ICS Pharmacy Leads working with pharmacy colleagues across the system,’ she added.
‘This also needs to be supported by investment in education and training, protected learning time, and the long-awaited roll-out of read/write access to patient records,’ she said.
The recruitment of 42 community pharmacy clinical leads – one for each integrated care system – was announced in February.
In March, Sajid Javid said pharmacists and other providers in primary care will be expected to play a large role in preventive care under new health reforms set out by the Government.
A report by NHS Confederation's PCN Network, Primary Care Federation Network, National Pharmacy Association and Primary Care Pharmacy Association calls for community pharmacy and general practice towards work towards changing their relationship as competitors to a more collaborative ‘single voice for primary care’ if pharmacies are going to be fully utilised in ICSs.
In November last year, NHS leaders urged the government that the pharmacy sector should be better integrated into the healthcare system in England.
This may sound controversial but the pharmacy sector appears to be its own worst enemy. Our docile and cup-in-hand approach to negotiations, coupled with our lack of unity as a profession has left an otherwise buoyant sector down on its knees. For any negotiating partner to take us seriously we need to adopt a more militant approach. No one takes us seriously because they know we will always settle for the crumbs after everyone else has grabbed a meatier chunk of the loaf. If our style has largely failed us in the best part of the last two decades, where is the guarantee it will achieve anything substantive in the foreseeable future ? We either reform or die a painful, slow death. I have never believed in trade unionism but to save the sector, unionism may be a powerful weapon we cannot ignore.