April 2008

Terry Scicluna, Pharmacy Business Column – NHS reform – are there long term benefits for pharmacy?

NHS reform certainly seems to be in the headlines at the moment with significant national coverage of the government’s proposals for delivering better patient care. We even hear the occasional mention of pharmacy amongst some of these plans; most recently the government proposal for regular health checks for heart disease, strokes etc, for the over 40s has, according to the Health Minister, offered an opportunity for widening the services remit of the community pharmacy. It seems the practicalities of this are still to be worked out but Alan Johnson believes that such health checks could quite feasibly take place in the local pharmacy. More encouraging noises from the government – but will we actually see this happen in practice?

Lord Darzi’s NHS next stage review has provided another raft of headlines for the health service but what is worrying is that many of the plans contained within this review seem to be at odds with providing a sustained future for community pharmacy at large.

A good example has been the proposals that The Economist magazine described as ‘The latest new new thing’. Polyclinics have been a controversial subject in the pharmacy sector ever since the first was established in London. According to the Economist while a national roll-out of polyclinics is popular within government, the consensus among the wider population is that polyclinics will make GP services less accessible to patients, and that patients will have to travel further to visit their GP regardless of whether they would require any of the follow-up care that polyclinics are set to provide.

These concerns are of course shared by pharmacy, as the proposal to consolidate GP services into polyclinics generates many of the same concerns that were raised following the recently announced plans for GP super-surgeries. If GP practices move away from their local area then a core link to the local community pharmacy will be moved away as well. So are polyclinics in fact at odds with the needs of healthcare stakeholders, whether they be GPs, pharmacies or the patient?

A report recently published by the London School of Pharmacy, in partnership with Alliance Boots, has indicated that what the majority of NHS users actually want is to see a wider range of care provided in convenient local settings such as the community pharmacy. The demand from the public for accessible local healthcare services in a familiar setting where they can take full advantage of the wider professional knowledge and expertise that their local pharmacist can provide is clearly there. However it seems that for whatever reason the government just isn’t recognising this.

The British Medical Association is already strongly opposed to polyclinics from a GP perspective and given that the rationale for these new centres is being questioned by a variety of stakeholders, it is important that the pharmacy trade bodies and the profession at large make their voices heard on this subject. Offering the perspective of pharmacy within the Darzi consultation is an important part of this and UniChem and Alliance Boots are inputting into the consultation. I would also urge you to make your voices heard with Andy Murdock, Director of Pharmacy at Lloyds Pharmacy, who is the pharmacy representative on the review panel.

Rather than trying to re-invent the wheel with new facilities such as polyclinics, I would like to see the government looking at how to best use the resources it already has available (i.e. community pharmacies) and making steps to provide these resources with tangible support in order to benefit patient care. Pharmacy can play a fundamental role in providing patient healthcare services – wasn’t this after all the rationale behind the pharmacy contract?

It has been said on many occasions now, but I am still convinced that given the right opportunity, pharmacy can deliver some excellent community healthcare services and the recent weight management pilot in Coventry that has been facilitated by UniChem is a superb example of this. The recent news that the pilot has secured funding for a second year demonstrates that with appropriate government backing and engagement from pharmacies, services such as this can make a real difference to the community. The government must recognise how these services benefit both the NHS and its patients in terms of affordable preventative care.

It is now more important than ever for the government to understand exactly what pharmacy can do for the NHS – so make sure your voice is heard. The Darzi review in particular is likely to shape the way the long term future of the NHS, so it is up to pharmacy to make sure that it is properly represented in the consultation.