Pharmacy can help ease pressure on frontline services

NHS England has published a series of Quick Guides around urgent care. They include ‘Extending the role of community pharmacy in urgent care’, developed to provide practical tips and case studies for System Resilience Groups and local commissioners showing how to help relieve pressure on frontline services. Andre Yeung, a pharmacist consultant and public health advisor in Newcastle, explains its importance:

The challenge facing the NHS is now well known: How can the organisation do more in the future with less?

Services this winter will again be put under pressure by the inevitable increase in demand but without change these same services may always be ‘under pressure’ and never reach a comfort zone of high performance.

For those with the responsibility to meet this challenge – that is NHS decision makers, budget holders, clinical leads, operational leaders and commissioners – change is less about making incremental adaptation to how things are ‘currently done’ and more about system wide redesign or innovation to deliver services for patients in completely new ways.

For all organisations, environmental change is inevitable and therefore continual readjustment is necessary in order to remain relevant.

Making better use of national community pharmacy for urgent care is increasingly being talked about as one such way for the NHS to ‘readjust’. Public Health has in recent years supported development of an increasingly competent pharmacy workforce through the commissioning of public health services – for example smoking cessation, sexual health and Healthy Living Pharmacies.

This fact, combined with the high number of community locations – more than 11,500 in England – long opening hours and the fact that appointments are for the most part not necessary, and you have the makings of a very attractive partner for an under pressure NHS.

An example of one such partnership would be, for example, the development of community pharmacy for the assessment, triage, advice and treatment of low acuity conditions. Pharmacy can of course, do some of this work already, in time for this winter. However, a more sustainable and robust commissioned service could really revolutionise the way patients access healthcare in this country. If balanced correctly, then self-care closer to home would finally become a reality and the average cost of consultations for minor illness would be massively reduced for the taxpayer.

Yet, for those like me who work closely to areas like these, there seems to be a surprising lack of action. Despite calls for increased use of community pharmacy, data still shows that under one per cent of NHS111 calls are referred to community pharmacy and there is still no standardised mechanisms for referral of patients into community pharmacy from General Practice.

This represents a huge missed opportunity to increase capacity to hundreds of thousands of patients annually and to deliver savings.

Numerous case studies have looked at traditional pharmacy ‘minor ailments services’ and have consistently established their value to the NHS. However, these services were often missing key elements which could have amplified their effectiveness, things like: a standardised formulary, pharmacist clinical training, service management processes, service innovation, branding and marketing to the public etc.

Lastly, and perhaps most importantly, these services were never actually used by NHS 111 or GP colleagues to release capacity as there was no awareness of their existence or formal referral pathway put in place.

This quick guide, ‘Extending the role of community pharmacy in urgent care’, considers these issues and a whole host of other ways that community pharmacy could be used to help NHS colleagues and patients this winter.

The document was produced by a group of key organisations and individuals from across community pharmacy and seeks to promote working in partnership to deliver innovative solutions.

As you read through, please try to think about what conversations you could start with pharmacy colleagues (Local Professional Network) in your area.

Andre Yeung

Andre Yeung works as a Pharmacist Consultant, as a Local Professional Network Chair at NHS England (Cumbria and the North East) and is Senior Specialist Advisor at Newcastle City Council Public Health Department.