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The Association of the British Pharmaceutical Industry (ABPI) has welcomed the new research guidance published by NHS England for the integrated care systems. The guidance is said to reflect the benefits of delivering research, for patients, staff and healthcare system performance, including the economic benefits for the NHS. Jennifer Harris, ABPI's Director of Research Policy, said: "This guidance is clear on what good research practice looks like and it's great to see it out and available for the NHS to use. "A research-active NHS delivers huge value to patients, staff and the system itself. We hope that putting this guidance into action will help Integrated Care Systems realise the huge benefits that research can offer, and help make the UK once again a destination of choice for developing the medical breakthroughs people need."

The Department of Health and Social Care (DHSC) announced on Monday (November 22) that it would integrate NHS Digital, NHSX and Health Education England into NHS England and Improvement (NHSE&I) as part of major workforce planning and technology reforms. The merger is part of the government's long-term strategy for the recruitment, training and retention of healthcare staff coupled with a digital transformation of working practices. The overhaul is based on recommendations made by NHS Digital chair Laura Wade-Gery who led a government-commissioned review to improve patient care, centralise the NHS workforce and accelerate digital delivery. Commenting on her recommendations, Wade-Gery, said: "In the rest of our lives, digital has really changed how we live and we must now make this true in healthcare. The goal of my review is to equip the national centre with the right capability to support Integrated Care Systems to deliver better citizen health. We need to have the culture, operating model, skills, capabilities and processes to put data, digital and technology at the heart of how we transform health services."

The NHS Confederation and the Association of the British Pharmaceutical Industry (ABPI) has published a report that demonstrated the importance of the collaboration between industry and the NHS to improve patient outcomes across the UK. Analysis from the report has shown a significant variation in access to innovative medicines for patients across the UK and showed that uptake of new treatments in these areas continues to be below the average of similar countries in Europe. The report, 'Transforming Lives, Improving Health Outcomes', has highlighted four initiatives where effective partnerships between the NHS, patient organisations and industry have helped to tackle unwarranted variation in the uptake of innovative medicines. Transforming Lives, Improving Health Outcomes also called for a systemwide secondary prevention strategy covering all parts of the health system creating a barrier to wider and consistent uptake of innovative medicine. It also noted that newly created Integrated Care Systems have the potential to improve preventative treatment. The report data also showed a 51% variation of uptake of three types of medicines related to diabetes between NHS Trusts in England.

Keith Ridge, who retired from the role of England's chief pharmaceutical officer this month, has written to the NHS regional directors regarding a package to empower community pharmacies to implement clinical services in their integrated care systems. Though details about this letter are not available, Malcolm Harrison, chief executive officer of the Company Chemists' Association, welcomed the move saying: "It is a positive step towards the greater integration of community pharmacy care into the NHS. "It is vital for the NHS that patients can benefit from the clinical care services set out in the Community Pharmacy Contractual Framework." Harrison, however, highlighted that while pharmacies are being pushed to do more, the efforts to introduce new clinical services should be supported with "sustainable funding and material actions to increase workforce numbers in the sector." "We are concerned that without the funding and people in place, the desired volume of necessary services cannot be delivered, no matter how well coordinated."

As we transition in England through yet another NHS organisational change, I ask myself what does this mean for community pharmacy? I would like to think that this change will bring about opportunity and a chance for community pharmacy to showcase and continue the excellent work that was carried out during the height of the pandemic and is still ongoing today. I hope that it allows community pharmacy to be regarded as part of the NHS rather than sitting on the side lines. This change has to lead to better funding for community pharmacy, without sufficient funding we will see more pharmacies close. We are hearing a lot about winter pressures but this year it feels like all year round pressure. What I have seen, whilst the NHS is under such pressure, is North East London (NEL) CCG transitioning to an integrated care board (ICB) almost seamlessly. I have seen people transitioning into new roles, whilst working hard to ensure that all plates are still spinning, which at the moment is no mean feat. I spent a day out recently visiting pharmacies with the chief medical officer of NHS NEL, Dr Paul Gilluley. The visits were positive, we felt listened to and understood. The feedback was great, it was recognised that community pharmacy is often the informal front door to the NHS and that we have so much to offer in terms of ill health prevention. Community pharmacy can offer a total solution as long as we have the tools to do so, which can save so much time and money. An example is the GP CPCS service, which has launched well across NEL.

NHS England has commissioned the Royal Pharmaceutical Society (RPS) to develop guidance that helps community and hospital pharmacy teams across Britain to reduce the impact of pharmacy services, pharmaceutical care and medicines on the environment. The RPS said the Greener Pharmacy Guidance will enable pharmacies to self-assess their impact against the standards, benchmark and improve through evidence-based activities and actions. "I'm delighted our strong commitment to helping pharmacy reduce its environmental impact can now be taken to the next level through developing guidance and accreditation for pharmacy teams," RPS president Professor Claire Anderson said. "Medicines account for 25 per cent of carbon emissions within the NHS and this initiative underscores our commitment to promoting sustainable healthcare and supporting the NHS's goal of achieving 'net zero' emissions by 2040." Peter Morgan, medicines assistant director at NHS England, commented: "Pharmacy staff are involved in the purchasing and dispensing of almost every medicine used in the NHS and the new Greener Pharmacy Guidance and Self-accreditation scheme will provide support for pharmacy professionals by outlining clear actions to deliver more environmentally sustainable pharmacy practices." The RPS said the guidance and digital self-assessment toolkit will integrate with carbon calculator tools to help pharmacy teams to measure their carbon footprint, action plan to reduce use of carbon and improve sustainability.

Dr Amanda Doyle has been appointed as NHS England as director of primary and community care. Prior to her new role, Amanda had joined NHS England and NHS Improvement as North West Regional Director on 2 August 2021 and previously she was the Chief Clinical Officer for West Lancashire Clinical Commissioning Group (CCG), Blackpool CCG and Fylde and Wyre CCG. Amanda was also the Integrated Care System Lead for Lancashire and South Cumbria, leading a large health and care transformation programme across the patch. She has been a GP for more than 20 years, practising in a large practice in a deprived area of Blackpool, which, in addition to primary medical services, provides a range of urgent care services for patients across the Fylde Coast. Amanda was the Co-Chair of NHS Clinical Commissioners from 2013 to 2018. She was Senior Responsible Officer for the primary care component of the Long Term Plan and was involved in the leadership of the health inequalities, prevention and personalisation elements.

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 Department of Health and Social Care (DHSC) made a recent announcement that the Incubator for Artificial Intelligence (i.AI) and NHS England (NHSE) have joined forces in a groundbreaking move by signing a Collaboration Charter on AI. This pivotal partnership aims to equip the NHS workforce with the tools and resources to leverage AI technology for enhancing patient care, improving staff experience, and driving operational efficiency. The Charter, endorsed by Minister Burghart, Parliamentary Secretary for the Cabinet Office, and Lord Markham, Parliamentary Under Secretary of State at the DHSC, signifies an important step towards integrating AI into the fabric of the NHS. Under this collaboration, the i.AI team, comprising elite technical experts within the government, will identify opportunities where AI technology can be deployed responsibly to support the NHS. This initiative is expected to streamline processes, optimize resource allocation, and ultimately enhance patient outcomes.

NHS Somerset is aiming to grow its referral rate through GP Community Pharmacist Consultation Service (GP CPCS) to between 4,000 to 6,000 patients a month. Since June 2021 GPs in Somerset have successfully referred around 1,000 patients a month through the Somerset GP Community Pharmacist Consultation Service (GP CPCS) Currently, 59 of NHS Somerset's 64 GP practices and all of Somerset's 102 community pharmacists are using the Somerset GP CPCS. NHS Somerset found that providing the right training for GPs and for reception staff and practice managers was key to a smooth rollout and uptake of the service. As was making sure the technology worked when making referrals from general practice to community pharmacists. NHS Somerset is using software called Patient Access Connect, which seamlessly integrates with the EMIS Web GP system used in Somerset, to give practices a quick and easy way to capture the patient information needed to deliver a referral.

Several pharmacies have joined the inhaler recycling scheme in Wolverhampton, West Midlands, to support NHS England's Greener NHS programme, which aims to achieve net zero emissions by 2040. It is part of a collaborative working initiative between the Royal Wolverhampton NHS Trust and AstraZeneca UK Ltd, supported by the Black Country Integrated Care Board and Wolverhampton City Local Pharmaceutical Committee. Under this scheme, old and used inhalers are recycled and transformed into new products, such as coat hangers and waste bins. Simon Evans, group chief strategy officer for The Royal Wolverhampton NHS Trust, emphasised the importance of prioritising the reduction of carbon footprint while maintaining high-quality care, to protect the planet for future generations. "The Trust has already made significant achievements in several areas including the physical estate, clinical services, waste recycling, catering and medicines - with this inhaler recycling scheme from pharmacy being the latest string to our bow," he said.

The Pharmacists' Defence Association (PDA) is supporting pharmacists in England whose employment has been impacted by the creation of new NHS structures. As a result of the 2022 Health and Care Act, Integrated Care Systems (ICSs) were established in England, and Clinical Commissioning Groups (CCGs) were closed on 1 July 2022. Each of the ICSs includes two key parts: an Integrated Care Board (ICB) and an Integrated Care Partnership (ICP). The association said: "The previous structures in England, established by the Health and Social Care Act 2012, originally had over 200 clinical commissioning groups. This number had reduced over recent years via mergers." "However, this latest shift to just 42 commissioning entities means a significant change to significantly larger geographies and populations covered by each ICS. Although each ICS and its activity can be subdivided into 'places', and within places into 'neighbourhoods', it is at the ICS level that the employer is formed." "Whereas CCGs previously employed many local health professionals, including pharmacists, the new arrangements mean that ICBs are now that employer. The PDA is supporting members who have contacted its Service Centre about the impact of these changes."

The Local Pharmaceutical Committees (LPCs) has rebranded to be known as Community Pharmacy to present a strengthened and unified identity to the local NHS, local government and other stakeholders, as the local voice of community pharmacy. "There are now 58 LPCs in England. The number of LPCs has reduced from 69, with further consolidation expected by April 2024 to a network of 48 local organisations," said Community Pharmacy England. "The changes mean there will be better alignment between LPCs and the 42 NHS Integrated Care Systems in England, who have taken on the responsibility for commissioning pharmaceutical services delegated by NHS England." "This marks a significant milestone, as similar to Community Pharmacy England, LPCs have been undergoing changes to respond to the Review Steering Group (RSG) recommendations on pharmacy representation. The sector voted in favour of the RSG proposals in the summer of 2022, and since then progress has been made on many of the changes at both local and national level as part of the Transforming Pharmacy Representation (TAPR) Programme."

Titan PMR has been accredited by the NHS to provide electronic prescription services (EPS) to dispensing doctors. Over 1,000 of these doctors, who provide a vital service to almost 10 million people in rural communities, can now offer their patients the same level of benefits and efficiencies that electronic prescriptions and Titan PMR have brought to pharmacies around the UK. These features will also increase efficiency for dispensing doctors, who will reduce dispensing errors and improve organisation, increasing their capacity while enjoying the ability to integrate with other technologies. After a full year of testing, including six months of compliance testing at a practice in Cumbria, the new accreditation for Titan also has potential to help the NHS fulfil its target of all prescriptions being issued electronically. Currently written paper prescriptions from dispensing doctors account for around seven per cent of the total prescriptions in England - around 6.5 million each month. "Until now dispensing doctor surgeries have basically been in the digital dark ages when it comes to dispensing medicines," said Tariq Muhammad, a tech entrepreneur and CEO of Bristol-based Invatech Health, which developed Titan PMR.

The Integrated Care Systems (ICSs) provide an opportunity to break the silo mentality in the health and care sector, National Pharmacy Association (NPA) chair Andrew Lane told MPs. While giving evidence to the Health and Social Care Select Committee on 6 December about the effectiveness of ICSs, Lane also poured cold water on newspaper reports that community pharmacists will be drafted in to break the NHS strike, as he reiterated the call for a "properly costed and funded environment." "We've been in different silos historically and ICSs are an opportunity to pull all systems together for the benefit of patients," he told committee members. Lane pointed to dementia-trained pharmacy delivery drivers and the Discharge Medicines Service as instances where the influence of community pharmacy already stretches beyond primary care into hospitals and social care. "We've seen pharmacists prescribe and get UTIs off doctors' desks, so we are starting to release capacity [in the system] and we're on that clinical journey. We welcome that, but it has to be with the right level of funding," he added.

A new NHS-funded training course on clinical examination skills has been announced by Health Education England (HEE) for 10,000 community pharmacists. The training will be provided by CliniSkills and be coordinated by HEE with the Pharmacy Integration Programme at NHS England. With pre-registration now open to all community pharmacists, the programme will be available from 17th April 2023 and will until March 2024. It will be delivered online, with optional face-to-face attendance for pharmacists who would find this beneficial. Pharmacists will be required to complete a module on history taking and identification of serious conditions and can then choose from four optional modules, which cover the following themes: dermatology; cardiology; paediatrics; and ear, nose and throat. The training is designed to be complementary to the independent prescribing training and can be completed prior to or after an independent prescribing training course. It is open to all community pharmacists including those that work part time and locums.

Responding to a new National Audit Office (NAO) report that indicated that NHS England's Long Term Workforce Plan (LTWP) needs improvements, the Royal College of General Practitioners (RCGP) has expressed concerns that the plan may not adequately address the needs of GPs. Published in June 2023, the workforce plan estimated that the NHS's health workforce will need to grow from 1.4m full-time equivalent (FTE) staff in 2021-22 to between 2.3m and 2.4m FTE workers in 2036-37, an increase of 65 per cent to 72 per cent. However, the NAO report highlighted that the workforce modelling has significant weaknesses, including a complex design; manual adjustments; optimistic future assumptions and limited public communication of their uncertainty; and modelling outputs that could not be fully replicated. To improve the modelling, the report recommended exploring the uncertainty of these assumptions and considering potential outcomes if they do not materialize as expected. Additionally, it suggested including full integration of the different parts of the modelling pipeline to minimise manual adjustments.

David Webb, the Chief Pharmaceutical Officer for England, acknowledged that the "pressure in the system is high", but urged everyone to "keep our eye on the design" of the NHS plan, adding that the "the objective is to bring the different parts of primary care together" in the patient interest. Speaking during the opening keynote session at the the National Pharmacy Association (NPA) conference held on Thursday (13 October), he added that the NHS plan intends to bring different parts of primary care together to help patients. He said the new integrated care boards (ICBs) are a key strategic framework as they provide the "potential to form partnerships to deliver integrated services across larger populations". "ICBs will want to work with Local Pharmaceutical Committees to plan for the local population and the new community pharmacy clinical leads in ICBs, who have been funded by NHS England, are there to advise." He explained that once an ICB takes over the commissioning of pharmaceutical services (which they are all due to do by April 2023), it could use its funds to commission a local enhanced service as an add on to an advanced service. For instance, a CVD risk assessment could be added to the blood pressure check service.

Community pharmacy should be involved in key decisions in neighbourhoods and systems to help reduce workload and increase patient access, a roundtable organised by the National Pharmacy Association to discuss a recent review on primary care integration has concluded. The NPA said it would be sending the recently published report on the roundtable to local pharmaceutical committees (LPCs) and other local pharmacy leaders as a tool to help them engage with Integrated Care Systems (ICSs) which will become statutory bodies from July 1. The 'Fuller Stocktake: Community Pharmacy Roundtable' report, published on June 13 by the NPA, is based on a meeting hosted by the association on behalf of the NHS team running a key review of primary care integration, the so-called 'Fuller Stocktake'. NPA integration lead, Michael Lennox, said: "The NPA recognises the critical importance of our LPC network colleagues being there for contractors at the 42 local systems level and influencing to fulfil the laudable ambitions of the Fuller Report. "We ensured that community pharmacy voices were heard in the stocktake process and now that conversation needs to be amplified locally."

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.