Community pharmacy can help London to become the world’s healthiest global city

In the latest in our series of blogs about #primarycare month – an NHS England (London) campaign to promote and publicise the many exceptional things going on in primary care across the capital – Donal Markey, talks about his new role and how community pharmacy has changed:

It is week eight in my role as Regional Lead for Dentistry, Optometry and Pharmacy in London.

The workload and associated pressure is relentless as I climb my learning curve in this new role but I am really enjoying every second of it. I am very lucky to have the support of an experienced team. As I get to grips with the dentistry and optometry portfolios I find myself becoming very reflective on the changing role of community pharmacy in the capital.

Community pharmacy is entering a period of great change with the announcement in December 2015 by Department of Health of changes in funding streams and the arrival of a new NHS contractual agreement in October 2016 which could result in a more clinically-focused role for the community pharmacists as we progress with the Five Year Forward View.

Change is not easy for many clinical groups but community pharmacy has shown great reliance and resilience in the past.

As a pharmacist myself I recall my first meeting around 12 years ago in a primary care trust (PCT) to discuss the advantages of community pharmacists gaining access to the patient summary care record (SCR) and here we are, in 2016, rolling out access to pharmacies.

Our first event in London is this week with a whole network of events to follow as we roll out training to all 1,862 pharmacies in the capital during 2016. This is a really exciting time for primary care and community pharmacy.

The rollout of SCR represents a significant investment into pharmacy and an opportunity for us to demonstrate that we are ready for future healthcare challenges. I still practice on weekends and I will finally be able to look at accurate prescribing histories as I counsel and review my patients.

The most exciting aspect to community pharmacy in the capital at present is the engagement with the Healthy London Partnerships programme (HLP). This is London’s transformation programme to support the 5 Year Forward View and the NHS response to making London the world’s healthiest capital city. The programme seeks to transform services through innovation and focusing on providing the best possible patient experience.

Community pharmacy has specifically engaged with the children and young people workstream. Through the development of London-wide Asthma Quality Standards in children and young people, the community pharmacy’s role in asthma management has been highlighted. The first piece of work produced was a London-wide audit on asthma management in children and young people. The audit was the first of its kind in design and scale in how it utilised community pharmacies to gather real-time data from parents, carers and adolescents in the capital.

It has provided highly valuable information in areas that the capital is progressing well in asthma management and areas that it could do better. Data was gathered on almost 9,700 children in just 10 weeks, approximately 2.5% of children and young people living with asthma in London. This is now being shared with CCG commissioners to help inform commissioning intentions for asthma services for children.

CCG commissioners have responded very positively to this data and the challenge is now how it can be used to improve our services to children, in particular how community pharmacists are better utilised within local health economies to provide capacity and clinical input within pathways.

Initial discussions with CCGs have been encouraging. Examples of how the audit results are being used include the design of medicines optimisation audits, training and development for GPs and, in one case, the inclusion of community pharmacies in a CQUIN. (The Commissioning for Quality and Innovation payments framework encourages care providers to share and continually improve how care is delivered and to achieve transparency and overall improvement in healthcare).

A common theme across the capital has been the readiness of community pharmacists to reinforce the importance of good inhaler technique. To support this, HLP will launch a virtual learning hub to pharmacists on World Asthma Day – 3 May 2016 – which will provide free training and support on inhaler technique assessment for children and young people.

With some careful thought and planning we could see pharmacists playing a meaningful and effective role in asthma management in children across the capital from 2016 onwards.

This will make a change in how pharmacies are currently being used and it provides an excellent research opportunity. I am very proud to be part of this work.

Donal Markey is the new Regional Lead for Dentistry, Optometry and Pharmacy for NHS England (London). He has responsibility for the strategic commissioning of NHS services across all community pharmacies, dental practices and community optometry practices in the capital.

He also leads on the commissioning of all acute, community and urgent care dental services within the London region.

In addition, Donal works within the London NHS transformation programme, the Healthy London Partnership as the Pharmaceutical Advisor supporting the Children and Young People programme.

He is also part of the Asthma Clinical Leadership Group Donal still practices as a community pharmacist in Berkshire.