Community pharmacies are a lifeline for people who need healthcare the most, says NPA vice chair and chair of policy and practice, Andrew Lane.
The prevalence of chronic medical conditions is greater in communities that are challenged by multiple levels of deprivation. People living in these neighbourhoods often have a more distant relationship with health professionals and health systems. Appointments in primary care will be more difficult to obtain, often a daily grind of call after call to access an appointment and then a significant wait before any consultation.
Services that need to be nearer to home might be more remote and the front-door of A&E will seem increasingly more welcoming than the engaged tone or unheeded ring of a practice telephone system.
This is the experience of many and, whatever model we choose to address this healthcare situation, it must be person-centred – but for communities that have seen the healthcare estate remove itself from their streets, this might seem a hollow offer.
Where the health estate has diminished and health professionals are harder to access; where opportunities to help people feel supported with chronic and long-term conditions have declined; where presentations in urgent treatment centres and A&E have increased as a result, there is a lifeline – community pharmacies are still very much present, operating in places that are seen as unviable to other health professionals and providers.
Access was certainly a factor in the decision to commission the NHS Community Pharmacist Consultation Service, which will embed pharmacies formally in the urgent care pathway, beginning later this year. Yet for some time now, community pharmacy has been heavily squeezed, between rising costs and the NHS mantra of doing more for less.
Many pharmacists have addressed this by operating efficiencies but that approach is limited in the long-term. So what do we need to see change?
• Pathways: Community pharmacy needs to be part of the total patient pathway
• Practice: NHSE needs to widen the GP lens on community pharmacy as a vehicle to allow them to provide better care for patients, free up time and focus on more complex cases
• Profile: Community pharmacists need the same status as ‘professional partners in care’ as that enjoyed by pharmacists working in hospitals
• Policy: Community pharmacy needs to be recognised as a ‘go to’ place for the patient and professional experience, to inform policy making
• Payment: Sustained investment is needed in systems and infrastructure.
When all this is in place, we’d begin to see pharmacies thriving and patients enjoying the benefits, including in the most deprived communities. We’ll have tech-enabled community pharmacies, better integrated with other health services, operating efficiently as neighbourhood health and wellbeing centres, providing excellent patient care and recognised as the front door to the NHS.
We operate in places that are seen as unviable