An online post that appeared to suggest that a Pharmacy First service could commence from late October this year should not be interpreted as an announcement of the service, government and pharmacy leaders have advised.
A notice shared on the National Institute for Health and Care Research (NIHR) website last month seemed to suggest that plans for the service were progressing, but the National Pharmacy Association (NPA)’s director of corporate affairs, Gareth Jones, said that the sector ‘should be careful not to read too much’ into it.
And the Department of Health and Social Care (DHSC) confirmed to The Pharmacist that the notice was not an announcement of the service or a guarantee for research into a potential service.
Rumours of research into Pharmacy First
The NIHR alert, which was posted on 20 March 2023, said that from Spring 2023, it anticipated that research teams will be invited to apply to conduct a study ‘focused on understanding the impact, safety, cost effectiveness and acceptability of an expanded service to treat common conditions in community pharmacy’.
It also said ‘any implications for antibiotic use and antimicrobial resistance’ would be explored.
Following this, ‘successful applicants will be expected to contract and start work rapidly, and to report meaningful intermediate data early in the contract period’, the NIHR said.
The body, which is funded by the DHSC, also said that ‘subject to successful commissioning’, the subsequent Pharmacy First service ‘will commence no earlier than the end of October 2023’.
Not a guarantee or announcement
The NIHR told The Pharmacist that the topic of an English Pharmacy First service had been worked up with a number of stakeholders, including DHSC, as part of its Health and Social Care Delivery Research (HSDR) programme to identify research questions which will affect practice change and inform delivery of health and care services nationally.
But it said that an evaluation into the service has not yet been commissioned as the call for research has not been launched, explaining that the notice on its website was a ‘pre-call alert’ to allow potential applicants for funding to prepare to apply should the call be advertised.
Even if a call were advertised, the HSDR programme would only commission an evaluation if suitable good-quality applications are received, the NIHR said.
DHSC also confirmed to The Pharmacist that the online post was not an announcement of a new community pharmacy service, saying that a pre-call alert does not guarantee a research call will be advertised.
The department added that it had not commissioned any research regarding the feasibility, impact and cost of a Pharmacy First Service in England, although it had looked carefully at existing locally commissioned schemes in England and the devolved administrations.
Meanwhile, NPA’s director of corporate affairs, Gareth Jones, told The Pharmacist: ‘We should be careful not to read too much into the NIHR notice.
‘It is a pre-call notice and does not guarantee research will be advertised imminently. Nor is it a government commitment to a fully funded Pharmacy First service.’
Research could demonstrate value of service
Mr Jones added that the NPA was ‘confident that any high-quality research into the effectiveness of a properly-funded Pharmacy First service will find that the sector’s calls for such a scheme are thoroughly justified’.
Dr Leyla Hannbeck, chief executive of the Association of Independent Multiple Pharmacies (AIMp), also welcomed any potential research that would examine the impact and cost of the service.
She said: ‘All of us in community pharmacy are very deeply fed up that for too long services are planned in offices then dumped onto us at patient level with both the operation of them and the funding being inappropriate to the real world that we have to function in.
‘At the moment community pharmacies are struggling to meet the day to day demands due to lack of funding and cash flow problems – they are paralysed to offer any additional services without additional appropriate funding.
‘We have urged the government to boost the funding to pharmacies to allow them to keep their heads above the water.’
She added that AIMp member pharmacies would be ‘extremely eager to give their feedback’, which the organisation hoped ‘will be taken seriously before any scheme is rolled out’.
However, she expressed disappointment that the government had not explored commissioning an impact evaluation of the service sooner.
She said: ‘The government has been talking about Pharmacy First scheme [for] months and months, why on earth did the commissioner not start this pilot earlier?’
Thorrun Govind, England board chair at the Royal Pharmaceutical Society (RPS), also welcomed ‘any research that helps to demonstrate the effectiveness of a pharmacy first service’, which she said would give patients a ‘valuable’ alternative to GP appointments for common conditions and infections.
‘But for this service to be implemented successfully, this must be backed and enabled by appropriate additional funding and technology,’ she added.
Awaiting Primary Care Recovery Plan
Janet Morrison, chief executive of the Pharmaceutical Services Negotiating Committee (PSNC) said that a Pharmacy First service in England would be ‘a key solution to help improve patient access to the NHS and to support our colleagues in general practice’, as well as ‘the best chance to get significant additional funds into community pharmacy’.
She said that PSNC had proposed the service to ministers in March 2022 – revealing to The Pharmacist in November 2022 that plans were yet to go ahead since DHSC ‘didn't have the scope’ to offer the £350-£400m needed due to parameters set by the Treasury.
This week, she said that PSNC was still awaiting news as to whether an English Pharmacy First Service would be commissioned as part of the Primary Care Recovery Plan, which is yet to be published by NHS England.