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Good community pharmacy practice is breaking through despite the system - not because of it, delegates heard at a recent Westminster Health Forum event. Ailsa Colquhoun reports 

Discussing the topic of 'Next steps for pharmacy services in England', Mike Farrar, former NHS Confederation chief executive turned independent consultant, told the conference that pharmacies could become a community authority €at the centre of preventative care€.

Addressing senior officials from the Department of Health and NHS England in the audience, he told them that community pharmacy needed enablers to be put in place if it was to develop at scale and pace. It was €frustrating€, he said, that NHS England lacked the strategy to enable and empower community pharma- cists to work in this way.

A priority is to change the commissioning of primary care. He told policy chiefs that the NHS has €over-medicalised€ the primary care response.

€If we don't develop community pharmacy we will lose people €“ and that puts pressure on the wrong bit of the system. We will spend more money than we should to support people as they use the NHS,€ he said.

Different contracts

€Commissioners of community pharmacy [services] need to understand where [the sector] fits and should empower that resource,€ Farrar continued. This would mean increasing the level of resource and integrating budgets. It should also mean thinking innovatively €“ for example, having different contracts for different community pharmacy contractor types, and entering into €prime contracts€, where one organisation subcontracts services to providers, including pharmacy.

€We need to have different ways of working in different environments. Providers have different estates, and different models and they need different solutions.€ However he admitted that GP funding could be a major obstacle in achieving these aims.

€The elephant in the room is the issue of whether [GP and pharmacy services] are competitive,€ he said. €We need to ask questions about value: is the GMS contract offering the value that it should? Is there money trapped in GMS that might be better directed at community pharmacy?€

Discussing self-care, Farrar said: €We need to see it not as a weak 'we can't do anything, so do it yourself' response, but as a way to respond to a growing consumer appetite for supported self-care.€ This could include moving traditional services online, he ventured.

Value proposition

Ash Soni, vice-chairman of the RPS English Pharmacy Board, called for pharmacists to become NHS England's €co-ordinators of medicines€ and said that pharmacists work more effectively in a multidisciplinary care environment. Pharmacist prescribing was crucial to ensuring patients got the best out of their medicines.

He urged the NHS in England to €move to a position whereany unplanned admission amounts to a system failure. We need to see medicines not as a cost but as a value proposition €“ and if we don't see that happening, patients will end up in hospital.€

New General Pharmaceutical Council chair Nigel Clarke said that services such as MURs had to be evaluated in terms of oPutcomes and not just outputs. €Counting heads€ is not sufficient enough for MURs and does not equate to good patient care, he suggested. He also made clear the regulator's interest in achieving pharmacy access to the summary care record.

€This is crucial. Patients are at risk if there is no sharing of information. We need [pharmacy access to] a single patient record. Harm is being done because this doesn't exist. We see this as a regulatory issue and one we can't run away from.€