Pharmacy must grow as ‘key clinical provider’, says NHSE primary care lead

Community pharmacy must ‘grow’ as a ‘key clinical service provider’ within primary care, NHS England’s national director for primary care and community services has suggested.

Speaking at the NHS Confed Expo healthcare conference in Manchester on Wednesday, Dr Amanda Doyle said she recognised that community pharmacy felt ‘underwater currently’ but that she wanted its clinical offering to continue to develop.

Her comments came as the sector and wider NHS is waiting for the publication of the government’s highly anticipated 10-year health plan.

In recent weeks pharmacy leaders have been calling on ministers to ensure the plan is used to help expand the offering of community pharmacies, including through Pharmacy First.

Speaking at NHS Confed Expo, Dr Doyle said the health plan would be ‘GP-centric’ and that it would not include huge shifts of funding from secondary to primary care immediately.

She said: ‘We can’t talk about the 10-year plan because it hasn’t yet been signed off, but what we can say is that it is going to be very GP-centric, but it is also going to be very people-centred.’

On pharmacy she added: ‘Community pharmacy is increasingly emerging as a key clinical service provider in primary care and we need that to grow.

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‘I am also really aware that the pharmacy sector feels underwater at the moment and there is no disputing the challenges around sustainability. But that’s got to drive reform.’

Dr Doyle said incoming changes such as hub and spoke and around skill mix within the sector should be utilised to help free up pharmacists to deliver more clinical services.

‘We’ve got to take advantage of the opportunities around automation of dispensing and around skill mix use so that we can really let our clinicians, our pharmacists focus on that wider neighbourhood clinical service,’ she said.

From October, new legislation will enable pharmacies across separate legal entities to take advantage of hub and spoke dispensing, pending parliamentary approval.

And since June 2024, registered pharmacy technicians have been able to supply medicines under patient group directions (PGDs).

Responding to Dr Doyle’s comments, director of corporate affairs at the National Pharmacy Association (NPA), Gareth Jones, said it was ‘good to have this public recognition of the growing clinical role of community pharmacies, by a senior figure in the NHS’.

He added that Dr Doyle was ‘also right to acknowledge the intense pressures the sector is under’.

‘A relatively modest amount of new investment in community pharmacy, compared to overall NHS expenditure, would help unlock the potential of the network as a centre piece of community-based care,’ he said.

‘Astute deployment of skills are undoubtedly part of the solution, but without sufficient funding the current dire situation cannot be transformed into a position where pharmacies are playing a full clinical role within the NHS.’

Meanwhile, Janet Morrison, chief executive of Community Pharmacy England (CPE), said that years of underfunding and real-terms cuts ‘have left community pharmacies struggling to survive – and it will take more than automation to fix the issue’.

‘Pharmacies already have an astonishingly strong record on efficiency – the best in the NHS – and they have even more to offer if they can be properly supported, funded and integrated into primary care,’ she added.

‘We’ve been saying for a long time that community pharmacy has so much to offer to improve care for patients and the public.

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‘The government’s healthcare shifts align well with the value that pharmacies can bring and with the upcoming NHS 10-Year Health Plan, there’s no better time to harness the sector’s full potential.’

Ms Morrison added that the government must ‘deliver on its commitment to build the sustainable funding and operational model that community pharmacy so desperately needs’.

‘We look forward to discussing this with government and seeing demonstrable action very soon,’ she said.

Separately, chief executive of the Company Chemists’ Association (CCA) Malcolm Harrison welcomed Dr Doyle’s view that community pharmacies must take advantage of the opportunities of automation and skill mix.

‘We want a strong clinical future for community pharmacy and know it offers many solutions to the challenges facing the NHS,’ he said.

‘Reform and new opportunities, like automation, require investment which has been lacking.’

Mr Harrison said that while the recent Community Pharmacy Contractual Framework ‘has started to change that’ pharmacies required ‘more and sustained investment to allow the sector to thrive and deliver’.

‘If we get the necessary investment, and ambitious commissioning of new clinical care services, community pharmacy will continue to grow as a clinical service provider in primary care,’ he commented.

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In yesterday’s government spending review, the chancellor pledged that NHS funding would rise by 3% a year until 2028/29.

She also committed to increase the NHS technology budget ‘by almost 50%’ and to invest £10bn to ‘bring our analogue health system into the digital age, including through the NHS App so patients can manage their prescriptions, get their test results, and book appointments all in one place’.