I read with interest ‘What would you like to see in the new community pharmacy contract?’, published by The Pharmaceutical Journal in May 2018. I think it is interesting that everyone has talked about managing some form of long-term condition. These are very much services linked to supply.
Given the frontline nature of community pharmacy, there are three layers to a modernised contractual framework.
The first part is in disease prevention and health promotion. This is an area in which GPs are not as strong (generally). Well, people don’t go to the surgery and ask what they can do unless they have reason to.
The second layer is in supporting urgent and emergency care by acting as the first point of contact and triaging the public as appropriate and reducing demand on other services. This involves supply, if appropriate, through sale or free supply, but prescription supply is potentially less necessary.
The third part is about supporting patients with long-term conditions to maximise their health and wellbeing outcomes and recognising mental and physical health equally. This also involves supply, but only through a managed care programme, so if patients don’t get their routine tests done, then supply is more restricted and there are longer periods between reviews. Patients using warfarin are managed through care programmes, although they have less input into their outcome goals than I believe we should see in a programme like this.
Ideally, pharmacists would also eventually all become prescribers if they are public facing and managing more complex cases.
This type of model will integrate pharmacy care within primary care and meet the expectations of the new integrated models of care that NHS England is trying to create through sustainability and transformation plans and as described in the National Association of Primary Care’s ‘Primary Care Home’.
Ash Soni, president, Royal Pharmaceutical Society
