Pharmacy Magazine is delighted to be the editorial partner of the Keynote conference sessions at this year’s Pharmacy Show. As implementation of the NHS Five Year Forward View gathers momentum, new models of care are beginning to take shape. Professional leaders at the cutting edge of these new models of care will tell Pharmacy Show delegates what it means for them.

Vanguard sites, integrated care pioneers, regional devolution agreements and national disease prevention programmes are all set to change the way health services are planned and delivered.

Ongoing efforts to transform culture and practice across the healthcare system also mean that healthcare professionals and their employers in all sectors are being pushed to think more proactively about how they deliver safe, high quality, patient-centred care, says Elizabeth Wade, director of policy at Pharmacy Voice.

“As healthcare hubs at the heart of local communities, and as the guardians of safe, effective medicines use, community pharmacy teams have a critical role to play in these efforts to improve health systems and outcomes,” she says. All of this comes, however, against the backdrop of a monumental £22bn in NHS efficiency savings.

“Community pharmacy needs to be on the front foot in thinking through how to respond, taking ownership of change, not waiting to be ‘done to’, and demonstrating how we can work with colleagues to help address the challenges the NHS faces. There has never been a more vital time to discuss the future for our sector.” Pharmacists are starting to acquire the tools they need to unlock this potential, with access to summary care records (SCR) and the national flu vaccination service marking two important steps – but too many obstacles still prevent pharmacy from delivering the services and support it could offer, says Ms Wade.

“The complexity and variability of local commissioning arrangements is a significant barrier to strategic business development; dealing with the impact of medicines shortages has a major operational impact, diverting pharmacy team members away from front-line care; prescription direction that goes unchecked by commissioners and regulators damages reputation and relationships between local primary care providers and between pharmacy teams and their patients. 

“Meanwhile owners are grappling with the impact of changes in the wider economic and policy environment that impact on businesses and employers.”

SCR access is an important step in pharmacy’s development and health minister Alistair Burt, who will be speaking at the Pharmacy Show, identifies it as one of his current priorities. “Patients want fast, effective treatment. SCR access will allow pharmacists to help many more people, with their consent, without the need for them to go to other NHS care settings,” he says.

“That is why we are investing up to £7.5 million of the Primary Care Infrastructure Fund for this year to support community pharmacists with training and tools so they can access a patient’s summary care record where appropriate.”

Integrate for patients’ sake

A common theme running through many current professional initiatives is greater integration of pharmacy into the wider NHS. The Royal Pharmaceutical Society will be explaining its leadership role in integrated care and discussing plans for future processes and models. The Society recently shared its thinking on this issue in a consultation document on closer working with GPs, jointly published with the National Association of Primary Care.

Integrating care involves moving from cliniciancentred care towards a system centred on patients, says RPS president Ash Soni. He believes it is important for the Society to take a leadership role on this matter. “Pharmacy still tends to be the afterthought in patient care rather than an equal with doctors and nurses,” he says.

“Patients need to be in a position where they think about health and social care that includes their doctor, nurse and pharmacist.” In order to deliver patient-centred care, healthcare professionals must focus on what is best for patients and remember that they care only about getting the best treatment and getting on with their lives, says Mr Soni.

He refers to an unhelpful amount of “bounce” between community pharmacy and general practice, reflected in the tension between the two professions when the pharmacy flu vaccination service was announced. “We all have to earn a living but we should recognise that it should be about what is best for the patient.”

Transitions between secondary and primary care are another point in the patient pathway where better integration could foster patient-centred care. For example, information about medication changes is often not passed on at hospital discharge and some patients end up returning to hospital as a result. Pharmacy could support better care across such transitions if it became more integrated into care pathways, says Mr Soni.

Forefront of public health

The creation of the Pharmacy and Public Health Forum is just one of many recent indications that the Government is serious about developing and expanding community pharmacy’s role in public health. Forum chair, councillor Jonathan McShane, reinforces the message: “My vision is that over the next few years, community pharmacy teams will be at the forefront of prevention, early detection and treatment of illness, and will play a significant role in delivering our shared ambitions for the public’s health.”

But he makes clear that, for this to happen, community pharmacy and the commissioning of services need to change. And the public needs to better understand the sort of advice and support they can get from their local pharmacy. Community pharmacists need to have a dialogue with local commissioners about what they are trying to achieve for local residents and the role pharmacy plays in this, says Mr McShane.

And commissioners need to be more imaginative in how they use various health assets in their area and understand the wide range of services community pharmacy can deliver on their behalf. “As a key part of this, we want to see a real acceleration in the numbers of Healthy Living Pharmacies commissioned by local councils and also to make it easier for pharmacies to become ‘HLP-ready’.”

Click here to register for the 2015 Pharmacy Show