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Integration of primary and community care is key to health service improvement - Lords Committee has said in a new report published on 15 December. The report highlighted the need for better staff training, improved data-sharing, flexible healthcare structures and collaboration across different professions in the healthcare system to support more integrated care. Royal Pharmaceutical Society (RPS) England has welcomed the report, and highlighted the important role pharmacy teams can play in improving patient care. Tase Oputu, Chair of RPS England Pharmacy Board, said: "Pharmacists and pharmacy teams play a vital role in supporting more integrated care, working with multidisciplinary teams across the health service.

The Independent Pharmacies Association (IPA), in collaboration with the Association of Optometrists (AOP), the British Dental Association (BDA) and the NHS Confederation has written to health secretary Wes Streeting, urging him to ensure sustainable investment in primary care to strengthen the NHS and better serve patients. In their letter, the group congratulated Streeting on his recent appointment as Secretary of State for Health and Social Care and requested a meeting to provide their joint constructive input towards improving health outcomes. They expressed concern that recent administrations have failed to follow through on promises to properly integrate and fund primary care, leading to deteriorating health outcomes. "Our collective experience is that our National Health Service (NHS), and health outcomes generally, have suffered at the hands of recent administrations that have talked much about the importance of properly integrating and funding primary care but not followed through with action," they wrote. The associations emphasised the need to transition the NHS to a Neighbourhood Health Service, where more care is delivered within local communities to identify problems earlier.

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."

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.

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.

NHS England and NHS Improvement published on May 26 the findings of the Fuller 'stocktake' - setting out how primary care can work with partners across health and care to best meet the needs of their local communities. Dr Claire Fuller's report lays emphasis on the essential role of primary care and the potential of integrated neighbourhood teams in reducing the burden of ill health and tackling health inequities. It commends community pharmacy for keeping "its doors open to the public throughout" the pandemic whilst being "among the most recognisable of a multitude of dedicated staff delivering care around the clock in every neighbourhood in the country". The report highlights "recruitment and retention challenges across the wider primary care workforce" including in community pharmacy. Stressing the importance of community pharmacy teams in urgent care and prevention, including early diagnosis of cancers, the report points out that pharmacists could play "a more active role in signposting eligible people to screening and supporting early diagnosis, building on a number of successful pilots such as those from the Accelerate, Coordinate, Evaluate (ACE) programme".

The recruitment of pharmacists in Primary Care Networks (PCNs) has exacerbated a general shortage of pharmacists, revealed an independent review of Integrated Care Systems (ICSs) published on Tuesday (4 April). The review, Rt Hon Patricia Hewitt, highlighted the impact that the Additional Roles Reimbursement Scheme (ARRS) roles for pharmacists are having on the community pharmacy sector. "Contracts with national requirements can have unintended consequences when applied to particular circumstances. For instance, the national requirements and funding of Additional Roles Reimbursement Scheme (ARRS) roles for community pharmacists within PCNs, has on occasion exacerbated the problem of a general shortage of pharmacists, with some now preferring to work within primary care rather than remain in community pharmacies or acute hospitals, compounding the problem of community pharmacy closures and delayed discharges." It set out to consider the oversight and governance of ICS in England and the NHS targets and priorities for which Integrated Care Boards (ICBs) are accountable, including those set out in the Government's mandate to NHS England. As part of this work, Hewitt and her team engaged with a wide range of stakeholders representing various local health and social care settings, including LPCs.

Wes Streeting's speech at the Labour Party Conference 2024 outlines several key health and social care reforms, which hold significant implications for community pharmacy in England. His focus on reforming and rebuilding the NHS to ensure fair, universal access to care, with prevention and early intervention at its core, presents both opportunities and challenges for community pharmacy. Here are the potential implications: 1. Prevention Focus Streeting's vision of a shift from a reactive, hospital-based model to a preventive healthcare system presents a promising future for community pharmacies. These changes could significantly reduce pressures on GPs and hospitals, integrating pharmacies more closely into primary care networks and enhancing their role in preventive care. 2. Digital Transformation The move from an "analogue to digital" NHS could see community pharmacies adopting more digital tools and systems for service delivery. This would likely involve greater use of digital prescribing, telehealth consultations, and AI-driven services. Pharmacies will need to invest in digital infrastructure and ensure that pharmacy professionals are trained to operate within a more tech-centric environment. 3. Reform and Redistribution of Services Streeting's plans to extend choice and equitable access to services mean that community pharmacies could become integral to providing care in underserved or disadvantaged areas. With a focus on decentralising healthcare and bringing it closer to local communities, community pharmacies could play a more significant role in supporting healthcare delivery in areas where GP services are stretched. This may include expanding access to pharmacy services in the most deprived areas, aligning with Labour's emphasis on addressing health inequalities.

With the upcoming general election on the horizon, Proprietary Association of Greater Britain (PAGB) is leading the charge to integrate self-care into the core of all political party manifestos. The aim is to ease strains on the NHS and forge a sustainable healthcare system for the future. In a significant move, PAGB unveiled a comprehensive general election toolkit on Wednesday, laying out a compelling argument for the prioritisation of self-care among stakeholders. The toolkit underscores the importance of public interest, potential NHS cost savings, and the economic advantages of the over-the-counter (OTC) sector. Aimed at unlocking the full potential of self-care and nurturing an enabling environment for its implementation, PAGB's toolkit advocates for greater integration of pharmacy services into primary care.

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.

Pharmacists and pharmacy technicians are set to receive up to £15.9 million over the next four years which will help them thrive in multidisciplinary healthcare teams and enable expansion of frontline staff in primary and community care. The funding, which is part of the Pharmacy Integration Programme allocation, will improve registered pharmacy professionals' skills, through a range of training and development opportunities. The programme is a part of education reform for pharmacy professionals and will allow them to identify career pathways. Health Education England and NHS England will work in partnership to develop "a formal portfolio recognition process to identify the existing skills, training and experience gained by pharmacists working in primary care, allowing them to work more flexibly and better support GP services", HEE said in a statement today (November 8).

England's chief pharmaceutical officer (CPhO) David Webb has promised his "wholehearted support" for the community pharmacy sector at the board meeting of the National Pharmacy Association (NPA) on 28 June in St Albans. After hearing the CPhO at the meeting, NPA chair, Andrew Lane, later declared: "David is someone we can do business with." Webb thus listed his priorities as head of profession: integration of independent prescribing as part of pharmacy practice by 2026; promotion of inclusive pharmacy practice for all pharmacy professionals; assurance of post-registration practice; developing the role of pharmacy technicians; support for Integrated Care Systems and Primary Care Network pharmacy teams (including community pharmacy); medicines optimisation; and strengthening of professional leadership for community pharmacy. He also reported that NHS England had recently increased its team of regional pharmacy integration leads from seven to 14, creating seven new senior posts. Webb told NPA board members: "I want sincerely to thank community pharmacy teams for everything they are doing and to say that you have my wholehearted support. I believe in the importance of community pharmacy and will listen and engage as I've already demonstrated.

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.

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The Proprietary Association of Great Britain (PAGB) has called on the new Labour government to prioritise six key actions within its first 100 days to harness the benefits of self-care for the public, the NHS, and the wider economy. Aimed to ease the burden on the NHS, the PAGB hopes that the suggest six key actions would help during the incoming winter illness season. According to PAGB, the NHS deals with approximately 25 million GP appointments and 5 million A&E visits each year for self-treatable conditions. By empowering individuals to manage their own health more effectively, the NHS could potentially save up to £1.7 billion annually. In her letter to Wes Streeting, Secretary of State for Health and Social Care, Michelle Riddalls, CEO of PAGB, urged the government to act promptly.

Pharmacy minister Stephen Kinnock has pledged to enhance the role of community pharmacies, particularly in deprived areas, by making better use of the skills of pharmacy teams. In a video message at the SIGMA UK Community Pharmacy Conference 2024 on Sunday, Kinnock also announced plans to expand the Pharmacy First initiative and introduce an independent prescribing service, making prescribing an integral part of the service delivered by community pharmacies. He said: "Since taking on the role of minister of state for care in government, my message has been very clear: we must get our fantastic primary care sector back on its feet to be able to deliver for our patients. "This government is committed to shifting care from hospital to community, from analogue to digital, and from sickness to prevention, and pharmacies will play a vital role in that." Kinnock acknowledged the pressures faced by the sector and expressed concerns that so many community pharmacies have exited the market over the past decade.

Preet Kaur Gill, Shadow Minister for Primary Care and Public Health, has paid a recent visit to a community pharmacy in Staffordshire to personally experience the services it provides to patients, while staying updated on the latest sector developments. Her visit to Eason's Pharmacy in Tamworth on September 22nd marked her first since assuming new responsibilities for pharmacy policy matters within Labour's health team. Gill was also joined by a member of the National Pharmacy Association staff. The Minister received a comprehensive briefing on Eason's Pharmacy from its third-generation owner, Kieran Eason (R). He outlined the NHS services, which include the New Medicines Service and blood pressure monitoring, and showcased two consultation rooms and an operational dispensary. "It's great that Preet came to learn firsthand about the challenges we face and the substantial potential of community pharmacies nationwide," Eason said. "As an independent prescriber, I have the expertise to provide even more convenient care, but the current funding levels severely limit our contribution."

Workforce issues, staff retention and capacity continues to be a big concern for the Local Pharmaceutical Committee as it discussed the topics at a recent meeting with the Pharmaceutical Services Negotiating Committee (PSNC). The meeting, attended by delegates from 66 LPCs, focused on the current challenges faced by community pharmacies as well as the planning for the next year. Around 64 per cent of delegates said workforce was the top challenge faced by pharmacy contractors, and suggested reducing the migration of pharmacists to Primary Care Networks (PCNs). Other suggestions included - "improving the development opportunities available for pharmacists and their teams, and rebranding the profession to make community pharmacy a more attractive route for young graduates." On the development of Integrated Care Systems (ICS), the majority of respondents were positive about their LPC's engagement in the new setting.

People who use pharmacies in parts of Pendle have suffered shortages or delays in buying prescription medicines such as insulin, councillors have been told. In the Barnoldswick area, a number of pharmacies have been impacted and some councillors hope a new regional NHS organisation might look into the problems. However, pharmacies in the neighbouring town of Nelson are facing shortages with other medicines. A pharmacists in Nelson Pharmacy told Pharmacy Business that he was struggling to meet local demand for children's paracetamol due to ongoing shortages. Pendle Council's West Craven Area Committee heard about the issues at its latest local meeting, held in Earby. An agenda for the committee stated: "Pharmacy provision in West Craven. It is reported that there is an acute problem with people being unable to get prescriptions filled, with Whitworth chemists suffering a breakdown in service. Previously, Well chemists has suffered similar problems." Speaking at the meeting, Lib-Dem Coun David Whipp said: "It's quite an appalling situation where people are queuing 30 minutes to get a prescription filled but when they get to the counter they are told it's not ready. They have to go home and come back at 5pm. It's an ongoing problem. "It includes insulin, which is critical for people with diabetes. I know several people who have failed to get insulin, It's a very serious problem." He added: "I think the committee should contact the local integrated care service. I think they are responsible for primary care which includes pharmacies. We need to find out what's happening and improve things in future. "

Community pharmacy could play an important role in proactive detection of heart valve disease (HVD), which remains under-recognised and under-detected in England, suggested a new report published by Wilmington Healthcare. Pharmacy bodies, including Royal Pharmaceutical Society (RPS), National Pharmacy Association (NPA) and Community Pharmacy England (CPE), have also endorsed the report, which encourages Integrated Care Boards (ICBs) to consider the innovative approach of detecting HVD with the help of community pharmacists. Despite HVD detection being a priority listed in the NHS Long Term Plan, a large number of people with HVD remained undiagnosed and untreated in the country due to lack of awareness of the disease prevalence. In June 2022, a pilot study was launched in Farnborough Primary Care Network (PCN), Hampshire, to evaluate the feasibility of using e-stethoscopes (digital auscultation) to detect this heart condition by a community pharmacist.