The “substantial expansion” of the role of “clinical pharmacists” in primary care networks will be financed out of a “£4.5bn new service model”, while community pharmacy may undergo “further efficiencies,” according to NHS England’s Long-Term Plan document.
Published today (Monday January 7), the long-awaited plan sets out a strategy that the NHS claims will save almost half a million lives, e.g. by preventing 150,000 heart attacks, strokes and dementia cases. Announcing the launch of the plan, Prime Minister Theresa May said it would "secure the health service for generations to come".
Key focus areas include better prevention and detection and ensuring more people receive care in the community rather than attending hospitals, as well as improving staff retention in the NHS and using digital tools such as the NHS App to improve the planning and delivery of services.
NHS England says that pharmacists “have an essential role to play in delivering the long-term plan”. The document mentions activities carried out by “clinical pharmacists” working in hospitals and GP surgeries, such as medicine reviews and advice on using inhalers.
The funding for the new primary care networks announced last November “will be used to substantially expand the number of clinical pharmacists,” the document says.
NHS England says this is the “first time in the NHS’s 70-year history when there will be a new guarantee that investment in primary, community and mental health care will grow faster than the growing overall NHS budget.”
This investment “will fund a £4.5bn new service model for the 21st century across England, where health bodies come together to provide better, joined-up care in partnership with local government”.
It is now up to sustainability and transformation partnerships (STPs) and integrated care systems (ICSs) to develop their five-year strategies incorporating the ambitions set out in the long-term plan, NHS England says.
Contrastingly, while NHS England seeks to “make greater use” of community pharmacy, funding for the sector may be reduced further, the document suggests.
It says: “In community pharmacy, we will work with Government to make greater use of community pharmacists’ skills and opportunities to engage patients, while also exploring further efficiencies through reform of reimbursement and wider supply arrangements”.
Health screening is one area where community pharmacists are expected to play a greater role. “Working with voluntary sector partners, community pharmacists and GP practices will also provide opportunities for the public to check on their health through tests for high blood pressure and other high risk conditions”, the document states.
NHS England chief executive Simon Stevens said that as the NHS marked its 70th birthday, “there has been concern – about funding, staffing, increasing inequalities and pressures from a growing and ageing population. And there has also been legitimate optimism about the possibilities for continuing medical advance and better outcomes of care.”
The plan “acts on all three of these realities,” Mr Stevens claimed, adding: “It keeps all that’s good about our health service and its place in our national life. It tackles head-on the pressures our staff face. And it sets a practical, costed, phased route map for the NHS’s priorities for care quality and outcomes improvement for the decade ahead.”
PSNC chief executive Simon Dukes commented: “It is good to see more of what the NHS, community pharmacy’s key customer, wants to achieve in the long-term and how it plans to get there. The crucial thing for pharmacy now is to work out how it fits into this, and our next step will be to work with the NHS and HM Government to explore what community pharmacy’s contribution to the plan will be. We are ready to begin those conversations, and with the NHS now clear on its own ten-year plan, we want to begin negotiations on a similar long-term plan for community pharmacy, setting out how pharmacies can do more, working closely with primary care colleagues, for the benefit of the NHS and patients.
"We are pleased that NHS England is committed to making greater use of community pharmacists’ skills and look forward to working with them to ensure that this happens. In our contributions to the NHS plan we and the other pharmacy organisations set out a range of ideas for how pharmacies could be used to help deliver on the key ambitions of the NHS – including case-finding and medication reviews – and we will continue to work together to make the case for those and to explore how they can be implemented.
"Community pharmacies ensure that millions of patients safely receive the medicines they need, when they need them. But we know that for community pharmacy to make a real contribution to this plan we will need to see transformative change in the sector, shifting our funding from a focus on the dispensing of medicines to patient care, and freeing up pharmacists’ time to offer more clinical services to patients.
"PSNC has been pressing for reform of community pharmacy’s reimbursement arrangements for a number of years so we are keen to begin discussions on this. Our ambition is to work with HM Government on a multi-year settlement for community pharmacy, setting out what pharmacies are working to achieve and what money will be available for doing so, and helping the sector to move towards a future in which pharmacies are fairly rewarded for providing a range of clinical services that benefit patients and the NHS."
Malcolm Harrison, Chief Executive of the Company Chemists’ Association (CCA) said: “To help translate the ambition of this plan into reality, we need to see the right funding and regulatory framework to ensure that community pharmacy can reach its full potential in delivering services to patients and the public.
"We look forward to working with the NHS and other partners to understand how we can support them to enhance patient care by delivering fuller digital interoperability between community pharmacy and other services, including general practice, to achieve the goal of a ‘digital first’ NHS."
National Pharmacy Association chief executive Mark Lyonette commented: "The NHS is planning for the next decade. A new, multi-year, funding settlement for community pharmacies in England is needed, to give pharmacy owners the confidence to invest in services that will meet the priorities described in the Plan.
“The document published today probably represents the start, rather than the finish, of discussions about NHS service provision in the period ahead. The NPA looks forward to being involved in the ongoing conversations about how community pharmacy can make its full contribution to meeting the challenges outlined in the plan.”