A government report has advised NHS England to write to sustainability and transformation partnership (STP) leaders, encouraging them to include pharmacists as they implement plans for the organisations.
A Faculty of Medical Leadership and Management (FMLM) report titled ‘Barriers and enablers for clinicians moving into senior leadership roles’ said discussions with pharmacists, as well as allied health professionals and biomedical scientists, revealed that “the system should be drawing more on leadership from within these groups”.
But the report, which was commissioned by the Department of Health and Social Care and published on 15 November 2018, added that pharmacists “can struggle to get round the table, for example in the current STP process in England”.
It said that this was partly owing to “structural barriers”, such as how boards are mandated to include a nurse director and a medical director but no other clinical professions, preventing these professions from demonstrating and developing board-level skills.
The report therefore recommended: “NHS England, in partnership with NHS Improvement, should write to the STP leads asking that they put in place procedures to ensure the STP process draws on the contribution of leadership across all relevant clinical professions including allied health professionals, biomedical scientists and pharmacists.”
In March 2016, NHS England tasked the partnerships with overhauling regional health and social care systems in an effort to save £22bn by 2020/2021. Later that month, the Royal Pharmaceutical Society (RPS) wrote to all 44 STP leads calling for the involvement of pharmacists in drawing up the plans.
But a survey in July 2017 showed that a third of local pharmaceutical committees were not given any opportunity to take part in development plans.
Robbie Turner, director of pharmacy and member experience at the RPS, told The Pharmaceutical Journal: “It was really good to see that FMLM had also recognised, like the RPS has done over the past 12 months, the benefit that pharmacists would bring to STPs, or indeed integrated care systems (ICSs) in the future, when they’re looking at how care is provided across their local health economy.
“The report was clear that pharmacy services — wherever they’re delivered in the community, care homes or general practice — are a bit of a blind spot for STPs. When medicines are such a significant part of STP budgets it’s not tenable for the future for them not to have pharmacists in the senior board level of STP, helping to advise them.”
The FMLM report also highlighted that pharmacists “can be their own worst enemies by taking a siloed perspective” of local healthcare systems, instead of “taking a strategic system-wide view”.
But Turner said: “Pharmacists have often been brought into these roles to act as pharmacists so the system has expected a certain conversation from them.
“I think we’re seeing things change now. Pharmacists recognise that what they can bring from their experience can actually be used across the whole system.”
Alastair Buxton, director of NHS services at the Pharmaceutical Services Negotiating Committee, said: “The engagement of local community pharmacy leaders within the work of STPs and ICS is variable, so we support anything that can improve that situation, including the proposal from the FMLM.”
“NHS England has recently started to pilot support for pharmacy and medicines optimisation leadership across STP/ICS areas; community pharmacy leaders are engaging in this programme and it is a very welcome development.”
In August 2018, NHS England launched a pilot project creating a new role for pharmacists to review medicines use across seven STP areas.