Now is the best time for community pharmacy to integrate its model of NHS representation and support to ensure better outcomes for contractors, said James Wood, director of Contractor & LPC Support, Pharmaceutical Services Negotiating Committee (PSNC).
It is important for the sector to adapt to the new landscape and address challenges such as workforce, digital data, integration of pharmacy services, and medicines optimisation, he said during the first session of the sixth annual Pharmacy Business Conference held online on Tuesday, September 21.
Under the new system, every part of England will be covered by integrated care systems (ICSs) from April 2022. ICSs have been created to bring about big changes in how health and care services in England are planned, paid for and delivered. They are a key part of the direction of travel for the NHS as outlined in the NHS Long Term Plan.
The hybrid professional and leadership session underscores the Sigma Conference's significance in offering hope and inspiration to its delegates. This
pioneering venture unfolds following meticulous planning, months of deliberation, and the collaboration of experts from various health disciplines across the UK.
This session, rich in diversity and expertise, aims to elevate the role of community pharmacy in the ever-evolving landscape of the NHS.
It comprises three key components and delves into multi-professional collaboration, insights from NHS Chief Professional Officers from the four devolved nations
complimented by the Royal College of Nursing Directorate Wales, and the evolving landscape of Pharmacy Professional Leadership.
Multi-Professional Collaboration: Breaking Boundaries
The crux of this ground-breaking session lies in appreciating and fostering greater multi-professional collaboration to set the stage for a thought-provoking
session on how community pharmacy can be recognised as an important cog in the wheel of an integrated NHS. This convergence creates a dynamic platform for community
pharmacy to form wider partnerships and explore opportunities, particularly with the recently launched NHS Pharmacy First Service.
The Health Committee's new report has reminded the government of a much-needed pharmacy workforce plan to support recruitment, training, and retention of staff.
The report makes a number of recommendations to optimise workloads across primary care, reduce pressure on general practice and hospitals, and support the integrated
care systems.
It also recognises the potential of pharmacist independent prescribers to support patient care, backed by appropriate supervision, training, and opportunities for
professional development.
RPS England gave evidence to MPs on the Committee at a public hearing in May, highlighting key issues to support the pharmacy workforce.
RPS director for England, Ravi Sharma, said: "Today's report underlines the urgent need for the Government to set out a comprehensive workforce plan for health and
care.
"It rightly recognises that boosting recruitment and retention, supporting staff wellbeing, fostering inclusion and diversity, and investing in education and
training will be crucial to the future of the NHS.
The Royal Pharmaceutical Society (RPS) has called for urgent action to ensure wellbeing of pharmacists after the publication of its annual workforce survey.
The survey, conducted in partnership with the charity Pharmacist Support, revealed that 89 per cent of respondents were at high risk of burnout, showing ongoing high levels of workplace stress.
It stated that 57 per cent of respondents reported often being unable to take a rest break or were not offered a break at all.
Around 68 per cent noted weakening of their mental health and wellbeing due to work or study, and 33 per cent considered leaving the profession, indicating high
percent levels of disaffection.
Besides seeking urgent action to allow proper rest breaks for pharmacists, RPS has sought "governments, the NHS and employers to urgently address the workforce issues that are impacting pharmacists' wellbeing."
It said prioritising essential work, effective workforce planning and better access to information is needed.
Commenting on the survey report, RPS president Professor Claire Anderson said: "Our survey demonstrates the continued pressure on pharmacists and trainees across the workforce".
The pharmacy inquiry will explore issues impacting different types of pharmacy, with a particular focus on community, primary care and hospital pharmacy
services.
It will also consider current challenges around funding, workforce and the digital infrastructure.
Planned developments within the profession will enable future pharmacists to be independent prescribers from day one of registration, giving them a greater role
within primary care teams.
Health and Social Care Committee Chair Steve Brine MP said: "It is clear that pharmacy has a central role to play in the future of the NHS. With a greater focus on
personalised and patient-centred healthcare, we will be asking what more must be done to make sure that the profession is in the best shape to meet demand.
"Better use of the pharmacy workforce would reduce pressures on general practice and hospitals. However, this will not happen without a planned workforce with the
funding, supervision and training to support it.
"At the end of the inquiry, the committee will be making recommendations to the government on what action needs to be taken to ensure the potential of pharmacy is
realised.
Since the introduction of the 2019 NHS Long-Term Plan, several policy commitments have surfaced, presenting a definitive 'blueprint' for community pharmacy
in England. The Company Chemists Association has identified four crucial commitments that, when integrated, hold the potential to revolutionise patient care
through community pharmacies.
"Each commitment is like a crucial piece of a puzzle," CCA said. "For the transformation of patient access through community pharmacy to be successful, all these
pieces must come together harmoniously. Otherwise, the picture will remain incomplete."
The four major pieces of the puzzle coined by CCA include:
* Building on education and training reforms to increase the size and capability of the workforce.
* Expanding the number of clinical services commissioned and delivered in community pharmacy.
* Introducing digital enablers which underpin service delivery.
* Introducing legislative changes to increase capacity and allow the delivery of more patient-facing clinical care.
A new report published today (June 29) by the think tank Policy Exchange highlights key role for community pharmacy in management of primary-secondary care
interface.
The report called Medical Evolution has received cross-party support. It says an equivalent of 15 million GP appointments per year are spent dealing with issues
managing care between GP practices and hospitals.
Research from the think tank also finds 150,000 people could be on 'hidden' waiting lists (where a patient has been referred by a GP for further treatment, but
not included on official hospital waiting lists).
On the eve of the NHS Long Term Workforce Plan, the report calls for the development of 'interface specialists' - which could be undertaken by doctors, nurses or
community pharmacists to enable them to work more routinely across settings and to strategically plan interface working.
The Royal Pharmaceutical Society (RPS) in England has published a review of its 10-year Vision for Pharmacy Professional Practice that was launched in
December 2022 in collaboration with The King's Fund.
The 'one year on' vision report highlighted key milestones achieved in the first 12 months since its publication as well as opportunities for further progress.
It identified the publication of the NHS Long Term Workforce Plan, which recognises the significant role that pharmacists play in healthcare and commits to growing
and expanding the pharmacy workforce, as one of the positive policy developments made since the launch of the vision.
The development of a Vision for Community Pharmacy by Community Pharmacy England, the Nuffield Trust and The King's Fund; work on digital integration to enable
community pharmacists to update a clinical record; the launch of Pharmacy First scheme; and the publication of the public consultation of pharmacy supervision
were other key milestones mentioned in the report.
The NHS England last week released a survey report on the involvement of pharmacy professionals in research, and proposed the implementation of a
clinical academic training pathway for pharmacy professionals by 2030.
Recommendations were made to support the embedding of research at all stages of a pharmacy professional's career.
The report presented the findings of two surveys that NHS England launched in May 2022, one for individual pharmacy professionals and one for organisations,
calling for evidence on clinical academic careers in pharmacy.
The survey found that only a minority of the pharmacy workforce take up clinical research training opportunities.
"Just under a quarter of individual respondents had applied for the National Institute of Health and Care Research (NIHR) or other research project grants, and
just under half of the organisational survey respondents had supported individuals to apply for such a grant," it said.
A new survey by the Royal College of Nursing (RCN) has made a concerning revelation about the rise in nursing students contemplating quitting.
Nearly half of nursing students in England are contemplating quitting their courses before completion.
This alarming trend threatens the NHS England Long Term Workforce Plan, published a year ago, which aims to significantly expand the nursing workforce by 2036/37.
The survey also highlights a dramatic 20 per cent decrease in the number of students enrolling in nursing degree apprenticeships over the past two academic years.
This decline underscores the urgency of addressing the challenges faced by nursing students, including increasing financial pressures due to the cost of living,
insufficient teaching and supervision, and mental health issues as the primary reasons for consifdering quitting.
The UK government will lay legislation today (13 December 2023) to allow the General Medical Council (GMC) to begin the process of regulating medical
associates to expand their roles in the NHS.
This will support plans to reduce pressure on doctors and GPs and improve access for patients, the Department of Health and Social Care (DHSC) said.
Physician associates (PAs) and anaesthesia associates (AAs) will have the same levels of regulatory oversight and accountability as doctors and other regulated
healthcare professionals once the regulations come into force, which is expected at the end of 2024.
The GMC will design and deliver detailed regulatory processes for registration, education, standards and fitness to practise for both professions.
Community Pharmacy England (CPE), the Company Chemists' Association (CCA), the Royal Pharmaceutical Society (RPS) and the National Pharmacy Association
(NPA) on Tuesday (5 March) released a joint manifesto for community pharmacy in anticipation of the upcoming general election expected later this year.
The manifesto has been designed for widespread use within the community pharmacy sector to facilitate engagement with political parties and parliamentary candidates.
In their #VotePharmacy manifesto, the pharmacy bodies have highlighted a robust six-point plan to unleash the potential of pharmacy.
Election candidates are urged to express their support in six key areas, which include:
Filling the funding gap and committing to long-term sustainable funding to empower pharmacies to deliver more NHS care.
Enhancing the community pharmacy workforce to ensure they can meet the evolving needs of patients.
Pharmacy bodies are "bitterly disappointed" that the latest deal on the national contract makes no commitment to "fresh funding", with one organisation calling
it "the biggest dis-service ever done" to community pharmacy.
The only commitment made in monetary terms was one in which NHS England agreed to write off a sum of £100m in excess margin earned by contractors in previous years.
This allowance, which can't be seen as new cash injection, was said to have been made in recognition of the pressures facing the sector.
The figure - reached after what the the Pharmaceutical Services Negotiating Committee called "a tense period of negotiations" with the Department of Health and Social
Care and NHS England - will cover the final two years of the current five-year Community Pharmacy Contractual Framework.
The deal was announced by PSNC chief executive Janet Morrison at an annual LPC Conference in Manchester on Thursday (22 September). Welcoming the attendees, she
assured everyone that the committee was well aware of the pressures the sector was facing.
"I heard how contractors are feeling and their frustrations over growing pressure and lack of financial support from the government. They confirmed that many now
are unable to deliver the full range of services, and others are struggling to maintain core levels of services. And the ongoing impact of capacity and workforce
crisis is critical, leading to temporary closures.
National pharmacy bodies have welcomed two VAT changes related to community pharmacy services announced in the Spring budget on Wednesday (15 March) but were
disappointed that the budget brought no further relief for the sector in a crippling funding crisis.
It was announced that from 1 May 2023, VAT exemption on healthcare would be extended to include medical services carried out by staff directly supervised by
registered pharmacists.
The government will also extend zero rate on prescriptions to medicines supplied through Patient Group Directions. This measure will be introduced in autumn 2023.
HM Treasury said these measures were being introduced to ensure that the VAT system keeps up with changes to how the NHS operates and how healthcare is delivered
across the country.
More widely, Chancellor Jeremy Hunt promised to halve inflation and said that the NHS would soon publish its long-term workforce plan.
The Pharmaceutical Services Negotiating Committee (PSNC) has launched a four point plan at its parliamentary drop-in event for MPs and peers hosted on Tuesday
(15 November).
The event lasted for two hours, during which MPs had the opportunity to drop-in and have their blood pressure measured by pharmacists with experience of working on
the front-line and were briefed on the urgent need for action to address the pressures on the sector.
Outline of the four-point plan:
Resolve the funding squeeze: Community pharmacy needs an immediate funding uplift to prevent large-scale pharmacy closures, as well as emergency business relief to
get through this winter.
Tackle regulatory and other burdens: Pharmacies must be protected from medicines market shocks, supported to help them weather the workforce crisis, helped to free
up capacity and freed from red tape that does not enhance patient care.
Help pharmacies to expand their role in primary care: Pharmacies could do more to support the delivery of primary care for example through offering clinical services
for long-term conditions - like hypertension, diabetes and respiratory disease, supporting people to adopt healthier lifestyles and prevent the development of
long-term conditions, medicines optimisation, and a much wider variety of NHS vaccinations.
The Department of Health has published 'A Guide to Developing the Role of Consultant Pharmacists' in Northern Ireland on Thursday (22 June).
The guidance provides direction on supporting a consistent approach to the introduction of senior clinical pharmacy roles within and across HSC organisations.
The Chief Pharmaceutical Officer Professor Cathy Harrison said: "There is a recognised need for increased clinical pharmacy and medicines focussed leadership
across our HSC."
"Consultant Pharmacists have an essential role in healthcare as clinicians and as leaders who make a significant impact to medicines optimisation and clinical
governance, providing a vital link between clinical practice and service development by generating and disseminating evidence to drive improvements in care.
"I am delighted that this guidance has been published to take forward the strategic development and appointment of the consultant pharmacy workforce in both
primary and secondary care and to enable pharmacy to be at the forefront of healthcare in NI".
The Royal Pharmaceutical Society (RPS) has published Pharmacy: Delivering a Healthier Wales that outlines a plan focusing on what can be achieved by end of 2025.
The society has urged people to share their views by responding to the consultation on four key themes which were already set out in Pharmacy: Delivering a Healthier
Wales -enhancing patient experience; developing the pharmacy workforce; seamless pharmaceutical care; and harnessing innovation and technology.
"We want to hear from as many of you as possible. It is important that the aims for pharmacy over the next three years are right. So please take a look at the draft
2025 goals, the proposed activity and measures and complete our consultation response form by 11 September," said RPS.
"We have been proud to continue to manage this important ambition for Wales, working on behalf of the Welsh Pharmaceutical Committee and with colleagues from all
over Wales. Over 300 of you have already contributed to our face to face and virtual engagement sessions we held over the past three months and we thank you for your
valuable input.
The National Pharmacy Association (NPA) has called the future prime minister to deliver on the commitments made by the previous health secretaries to reform
primary care through a 'pharmacy first' approach and fairly fund community pharmacies to avoid closures.
In an open letter, the NPA has urged Rishi Sunak and Liz Truss, the two leadership contenders of the Conservative Party and prime ministerial candidates, to think
radically about the role of England's 11,000 pharmacies, which are on the frontline of healthcare across the country.
NPA also highlighted how pharmacies could help clear the NHS backlog, free up millions more GP appointments, dramatically improve access to primary health care and
do more to prevent ill health and support people with long term medical conditions.
"Because of our unparalleled presence in deprived areas, we also have great potential to level up access to healthcare and address health inequalities. We set these
ideas out in How We Can Help, which is an improvement plan already welcomed by many of your colleagues."
In an oral parliamentary debate on community pharmacy held on Monday (20 March), the government was asked for an indication of 'how much it would cost to
make the best use of community pharmacies'.
A number of Peers at the House of Lords spoke out in support of pharmacies, while others asked when would the government address the current crisis in the sector.
Kicking off the session, Baroness Hodgson asked the responding minister, Lord Evans, about recent pharmacy closures as well as underfunding. She asked whether the
government would 'enter into discussions with PSNC to look at introducing a fairly funded pharmacy first service as soon as possible which will help relieve the
work load on GPs'.
The minister responded: "We have already introduced and funded a range of service in community pharmacy that make use of the clinical skills of pharmacy teams… we
continue to discuss with PSNC how the government can best support the sector to provide support to patients."
The House of Lords oral questions session was opened by Baroness Hodgson on behalf of Baroness Cumberlege as follows: "To ask His Majesty's Government what plans
they have for making the best use of community pharmacies".
The Department of Health and Social Care (DHSC) has finally published its response to the 2022 consultation on hub and spoke dispensing.
Considering the consultation evidence and further discussions, the government has expressed its intention to progress the proposals for enabling hub and spoke models
across different legal entities as soon as possible.
This will be achieved by using the enabling powers outlined in Part 2 of the Medicines and Medical Devices Act 2021 (MMDA) to amend the Medicines Act 1968 and the
HMRs.
Furthermore, the DHSC has decided to proceed with the implementation of the two models of hub and spoke dispensing that it consulted on.
The government response to the consultation reads: "Having considered the responses, the government intend to proceed to implement the necessary changes to medicines
legislation to remove the current restrictions that prevent the hub and spoke dispensing models from operating across different legal entities found in section 10 of
the Medicines Act 1968.