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Community pharmacy should be able “to refer [patients] onward directly” to other services, including those for mental health, an NHS-commissioned report has said.
NHS England commissioned the report ‘Next steps for integrating primary care‘ to look into “bringing together previously siloed teams and professionals” in primary care services, ahead of the implementation of integrated care systems (ICSs) on 1 July 2022.
In the report, author Claire Fuller, chief executive-designate of Surrey Heartlands Integrated Care System, said that she had “heard very clearly … that the wider primary care team could also be much more effectively harnessed, specifically the potential to increase the role of community pharmacy” in prevention.
The report said that community pharmacy could play a more active role in cancer diagnosis by “signposting eligible people to screening and supporting early diagnosis, building on a number of successful pilots such as those from the Accelerate, Coordinate, Evaluate (ACE) programme”.
It added that “there is also scope for efficiencies in pharmacies being able to refer onward directly (e.g. to mental health or other neighbourhood services)”.
The report was compiled following discussions held with “close to 1,000 people” through “workstreams, roundtables and one-to-one meetings”, as well as using a dedicated website for people to submit their views.
However, it noted that, during discussions, the authors heard about “recruitment and retention challenges across the wider primary care workforce, particularly NHS dentistry and community pharmacy”, adding that in this respect there is “significant variation across different parts of the country and across employers”.
A survey of community pharmacies conducted in July 2020 revealed a 9% full-time equivalent pharmacist vacancy rate across England, rising to 15% and 18% in the South West and South East, respectively.
Thorrun Govind, chair of the Royal Pharmaceutical Society’s English Pharmacy Board, said in a statement that the report “highlights some clear opportunities to use pharmacists’ clinical skills”.
“To maximise the contribution of pharmacy teams, we will need to foster pharmacy leadership at system, place and neighbourhood level to ensure they are involved in decision-making.
“There needs to be a strong voice for primary care and pharmacy within new ICSs, supported by new ICS pharmacy leads working with pharmacy colleagues across the system,” she said, adding that the report’s recommendations will also require “investment in education and training, protected learning time, and the long-awaited roll-out of read/write access to patient records”.
The National Pharmacy Association (NPA) said the report’s findings offer “a significant opportunity for pharmacies to engage with the NHS at a local level”.
Mark Lyonette, chief executive of the NPA, added that the report “is a clear signal to ICSs to break through silos in primary care and to engage community pharmacy in a multidisciplinary push on prevention, urgent care and long-term conditions”.
James Wood, director of contractor and local pharmaceutical committee support at the Pharmaceutical Services Negotiating Committee (PSNC), said that, while the community pharmacy contractual framework (CPCF) will continue to be negotiated nationally, the “delegated commissioning and assurance of CPCF and local commissioning will all happen at the ICS level”.
“This makes these emerging ICSs particularly important players for community pharmacy, so it is vital that the sector continues to do all that it can to fully engage with them,” he said.
Sajid Javid, health and social care secretary, said that Fuller’s recommendations “will improve patients’ access to services, including those with the most complex needs, and help people live well for longer”.
