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King's Fund clinical services review – reaction

Pharmacy bodies have responded with cautious optimism to Richard Murray's clinical services review.

PSNC’s Sue Sharpe said the proposals were “positive” and “welcome”. “We are ready and keen to work to implement these as soon as possible,” she said. “The events of last year have badly dented the confidence of pharmacy contractors, but energy in moving forwards will do a lot to restore it.”

Speaking for Pharmacy Voice, Rob Darracott said that the sector had long been calling for an expanded role in the delivery of clinical and public health service and that the report “helps to reinforce that this is the right direction of travel.” The evidence review, published alongside Murray’s review, was of particular interest, he said.

However, he said, there is still a significant job to do to ensure that the ideas in the report are fully realised.

While some elements of the Community Pharmacy Forward View, produced by Pharmacy Voice with endorsement from the Royal Pharmaceutical Society earlier this year, were reflected in the recommendations, this could have “gone further” he said.

“There are areas where we would have liked these to go further to match the sector’s own ambitions. Some of the recommendations will need further reflection, to understand how NHS England would look to implement them on a practical basis, and how potential unintended consequences would be avoided.”

“Unlocking potential”

Sandra Gidley, chair of the Royal Pharmaceutical Society’s English Board said that moving “quickly to this future” would be the key to “unlocking this potential” of community pharmacy as described in the review.

The proposals must be looked at in context of the pharmacy cuts that have just been implemented in England. “It is not credible for anyone who works on the front line not to view this report without reference to the reduction of funding for community pharmacy. We are not alone in being concerned in how the circle can be squared; a reduction in resources does not help pharmacists to do more to improve patient care.”

Promised resources in the Pharmacy Integration Fund need to be translated into a “workable implementation plan,” she said. The fund should be deployed into making the proposed clinical medication reviews and independent prescribing for pharmacists move “from being aspirations to reality”.

On particular proposals outlined in the review, the RPS commented:

  • Pharmacy-based minor ailments service for England – it is encouraging that the argument for this has changed from not if, but how, will it happen
  • Smoking cessation could be provided by all pharmacies – a welcome change that this service could only be commissioned locally, and this thinking could be applied to other public health services as well
  • Increased role in services of pharmacy technicians, using PGDs – this makes senses with flu vaccinations, but variability in the training of technicians needs to first be addressed
  • Working with GPs – “We recognise our responsibility in improving the support for pharmacists to build their professional confidence and break down barriers between health professionals that can hinder new ways of working.”

Dented confidence

However, while welcoming the review, Nitin Sodha, chair of the NPA’s Policy and Practice Committee, said the Department of Health must be prepared to talk about a sensible level of funding that can sustain this kind of positive development over time.

“Our confidence in NHS England and the Department of Health has been severely dented these past twelve months. We earnestly hope that they take this opportunity to change the bleak scene they have been setting to one which maximises the potential of local pharmacies. The review sets out a positive agenda, but it is certainly not the limit of what our sector is capable of, given the right level of investment and trust.”

We are ready and keen to implement these proposals as soon as possible

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