Podcast transcript

Andre Yeung

Welcome to this Transforming Primary Care podcast series. My name is Andre Young. I’m a clinical lead in the North East and North Cumbria ICB.

Joining me today is Amanda Smith, pharmacy manager at Heath Pharmacy Limited in Calderdale, West Yorkshire, Ruth Buchan, Community pharmacy clinical lead at West Yorkshire Integrated Care Board., Mark Burdon, Superintendent pharmacist at Burdon Pharmacies in Newcastle upon Tyne and Claire Smeaton, regional operations manager for Well Pharmacy in Yorkshire. Now I’m going to give a brief overview of what we’re going to cover in today’s session and then we’ll get straight into those questions and hear the views of our guests.

The first point I’d like to make is that the role of Community Pharmacy has been changing with the recent introduction of new NHS services. We’ve got Pharmacy First, which enables patients to be referred into community pharmacy for minor illness or urgent repeat medicine supplies. This includes the supply of appropriate medicines for seven common conditions such as sore throat, shingles etcetera. This aims to address health issues before they get worse.

Pharmacies also provide blood pressure checks and contraception services. They also take their first steps towards all pharmacists providing prescribing in the community and all of these new functionalities will help relieve pressure on practices and improve accessibility of services for patients.

In this episode, we’re going to discuss how the role of community pharmacy has been evolving and with a new wave of public awareness campaigns having taken place, are practices and patients now used to thinking pharmacy first and what else will the community pharmacy of the future be able to do for patients.

I’d like to kick it off by asking our colleagues, what are the benefits of these new services for practices and patients? I guess by practices we mean kind of like the broader primary care system. So, thank you Amanda. I’m going to come to you first, do you want to let me know what you think?

Amanda Smith
Thanks, Andre. So, I work as a community pharmacist in Calderdale and we’ve been providing these services for quite a few years now. And I think the Pharmacy First service is really taking off locally, the surgeries love it because they can free up appointments by sending patients to the pharmacy for a consultation and the patients absolutely love it as well. I think it’s brilliant. So, I think it’s working really well.

Andre Yeung
That’s great to hear. Thanks, Amanda. Any other comments from colleagues? OK. Ruth, could you come in? 

Ruth Buchan
Yes, of course, Andre. So I think Amanda’s correct -the benefits for patients are really great and it enables a community pharmacist to complete more episodes of care for patients so that patients can actually have their episode of care completed within community pharmacy which shortens their route into healthcare, enables them some direct access.

We also need to remember the benefit benefits to Community pharmacy as well because we see the Community pharmacist using more clinical skills.

We also see in the great user team skill mix within the pharmacy team to really help increase that job satisfaction to better use a clinical skill. So the community pharmacists that we already have out there.

Andre Yeung
Yeah, some really good points. So you actually have benefit to the pharmacy profession as well in terms of those you maximising the use of those skills, but also given that job satisfaction from a personal perspective as a pharmacist, I’m someone who’s been championing or at least wanting to move forward in a clinical role that you know will reward me better in the future than I’ve previously had access to. So that’s a really good point. Claire, can you come in now?

Claire Smeaton  
Yeah, I think as well, just echoing what Ruth said there, I think kind of convenience as well for the Pharmacy First just being on the doorstep – it’s a busy world that we live in for our busy working mums that might be on the school run and you know really pushed for time or anybody that working that’s got a busy life, you know or anybody for pharmacy first –  think it’s a really good platform to access care that is convenient, it is local and just really accessible for our community. I think that’s a key part of it as well.

Andre Yeung
Yeah, absolutely. I think that’s really important. It’s probably the most important part. I was shooting Pharmacy First videos within general practices and one of the nurses within one of the practices, one of the most important statements that were made throughout those videos was her personal recollection of when she took her son to a pharmacy. She works in a general practice, but she took her son to the pharmacy to access. Pharmacy First and her personal sort of comments about that was that it was just so convenient for her, and actually it was out of hours. It was on a weekend, so accessibility for patients, I think is going to be massively improved by that. Just having more sites out there, but also those opening hours as well as you rightly point out, you know weekends and later hours on a weekday – Ruth.

Ruth Buchan
Yeah, I think it’s really important to have the satisfaction rate is high with patients, as you say, a lot of patients have a really positive experience and part of the skill of the community pharmacists doing Pharmacy First is that they will pick out if a patient needs to be seen elsewhere. So, although we can complete the episodes of care for most patients, we know that some do get escalated either back to the general practice or back to an appropriate place of care. But satisfaction is great. We know that for every 10 patients that access Pharmacy First , only one of them has to be escalated, so most patients do get dealt with in community, but there will be a small proportion who are escalated quite clinically appropriately for further care and I think that again really helps that patient satisfaction, indeed the satisfaction in general practice,  that although they may get some escalations, most of the patients are dealt with.

Andre Yeung

Mark, do you want to come in?

Mark Burdon
Yeah, just picking up on the general practice theme, I agree with everything that’s been said so far, all you know really useful points. I think from the general practice side and I work in general practise myself – I prescribe in general practice, I think the key thing is getting the reception teams on board with this and you know, asking them to work with us to Identify the right people to refer in and that works really well, but from their side I think you know when you talk to the reception staff and those teams who are dealing with, you know many, many hundreds of phone calls a day in some cases.

It’s a useful outlet to send patients to a pharmacy rather than, you know, kind of turning people away and asking them to attend A&E or out of hours centres or whatever it is. So once that appointment book is full, then you know pharmacy then comes into its own as a you know, the next disposition and as Ruth mentioned, you know not always can we complete the episode of care through Pharmacy First anyway. So for example somebody something that might present as a simple UTI might be more indicative of suspected pyelonephritis. And in those circumstances, we would want to refer that urgently back either into general practice, A&E or an Urgent Treatment Centre.

Andre Yeung
Thanks, Mark. Yeah, an important role of the reception team in the administration team within the practices and obviously that link as well to get those escalations as and when they are needed. I think Ruth’s data is about right, which is that you know a tenth of the patients referred need to be referred back, which is a fantastic arrangement between pharmacy and practices. But really important that you do have those escalation arrangements in in place.

Can I come to you, Amanda?

Amanda Smith
And yeah, just a little bit about the data that we do have, although we’ve not got much, we are seeing an improvement in the service as it progresses. So as the pharmacy teams get more used to providing the service and also as the reception teams get more familiar with the type of conditions that they can send to the pharmacies, I think the service is developing and getting better for everyone as it as it progresses, and we’ve seen that just recently locally.

Andre Yeung  

Could I just ask you, Amanda, you know Pharmacy First suggests that patients should be going to pharmacies first. And I wonder about the referral side of things, because patients are going to be coming and learning that the pharmacy has these opportunities to attend- the referrals are important because they create that audit trail between practices and pharmacies and vice versa.

Ideally in in the future we’re going to have people knowing that pharmacies can help them, attending there first and therefore avoiding the impact on practices. Is that kind of your understanding of what’s happening in and kind of what the direction of travel is? 

Amanda Smith 

I think we’ve definitely seen that locally, especially since the recent advertising campaign. We’ve definitely had more people coming to us for help not, not always necessarily for the conditions that we can help with unfortunately. But yeah, definitely, I think if people can come straight to us, then that is definitely probably the better way for the service to work because it relieves that pressure on the surgery to send referrals through as well. So ideally, patients would be able to just present straight to the pharmacy and be treated, which they can do for the clinical pathway conditions. But if they don’t meet those criteria, then that’s where the service perhaps becomes a little more awkward to deliver.

Andre Yeung
Thank you. Amanda, can I come to Claire? And then I’ll come to Ruth after Claire. 

Claire Smeaton  
Yeah, I think just while we’re talking about referrals coming in to us in the pharmacy as well. I think for us at Well Pharmacy, it’s really kind of given us the opportunity within our organisation to look at how we interact on the ground with our patients as well and look at things differently and you know work on those GP relationships to get the referrals in, but ultimately upskill our workforce that are on the ground to be able to kind of deal with that first hand and link that in with the Pharmacy First, and not always just relying on the referral from the GP as well. So it definitely has given us opportunity to look at things in a different way and care for that patient in a different capacity – just been a real positive for us. 

Andre Yeung  
Thanks, Claire. And I’m going to come back to upskilling and clinical skills in just a second. But if I can come to Ruth, please now.

Ruth Buchan
Thanks Andre. It’s around that referral point really. And I think the services is predicated on a digital referral from general practice or indeed from NHS111 or the other places that referrals can be made from. So, while patients can present, as Amanda outlined, that does limit when Pharmacy First can be, you know used and offered to the patient. So essentially, it’s limited to the seven clinical conditions and there’s age, sex and actually some clinical gateways that have got to be met before the person can access.

If a GP practice makes a digital referral, it doesn’t matter, it can be any minor illness which can be managed by the community pharmacy, so actually it means that more patients can access Pharmacy First from referrals so whilst, you know, you’re right, it doesn’t have to be made by referral – actually it’s a much better way to refer patients in. There’s also a safety element to that as well. So, if there are referrals made to the pharmacy and the patient doesn’t present to the pharmacy or contact the pharmacy, the pharmacist will make the clinical decision as to whether to contact that patient back. If somebody just signposts them to pharmacy, there isn’t that kind of safety netting that goes on. So you know, digital referral is absolutely preferable to signposting – a lot of people can present as well.

Andre Yeung
So that’s a really important point. So I guess what we’re saying is that you know, the way that practices and pharmacies should work together is referrals and good communication, good visibility of what’s happening with patients. But that patients do have that freedom and that choice to access the service when they want on the terms that they choose by just attending the pharmacy or calling the pharmacy. So yeah, I think that’s the way that most people would see that the kind of the optimal way of using Pharmacy First in primary care?

I’m going to come to those upscaling and clinical skills of pharmacists in a second, but Amanda, can you come in? 

Amanda Smith
I was just going to mention that an added bonus that the practices have if they do send referrals using the PharmRefer channel or EMIS Patient Connect access, they can actually create a report of the referrals that they sent and get their own data about those referrals, which is really useful for practices to see if they want to see how the service is going in their local area.

Andre Yeung
Yeah, and you’re right to point out that this is available to all practices irrespective of what system they’re using. They can access referrals to pharmacies for Pharmacy First consultations, which are minor illness consultations, but also emergency supplies of medicines that have been previously prescribed.

OK. Can I come to the clinical skills of pharmacists because it’s been mentioned a couple of times now and you know as a pharmacist, I think we have been on a journey as a profession. I remember a time when we didn’t do a lot of services. That’s probably telling my age a little bit and how old I am. But I do remember a time when we, you know, we’re providing some basic public health services and substance misuse services. But we’ve come a long way from then and actually I think our skills as a kind of member of the primary care team have come a long way as well. So I wonder whether any of the colleagues panel have kind of got any thoughts on where we’re currently at with the skills of pharmacists and where we might be going over the coming years, Mark, can I bring you in?

Mark Burdon
Yeah. Thanks, Andre. It’s a bit of a journey really. I think we started off, do you remember back I mean, Andre and I were in the same university just as a spoiler.

But we started off with things like EHC. That was really the first sort of proper clinical thing that we did. Then we moved into stuff like flu vaccines and then obviously the vaccine side has just gone massive, hasn’t it with COVID and all the rest. But I think we’ve got to start off somewhere and build confidence amongst our people out there and allow them to be able to identify what these conditions are and look for red flags and differential diagnoses for various conditions that they might come across.

So I think we’ve got to you know build that confidence amongst people. That’s the first thing and one of the key things that is one of my kind of greatest tips is talk to somebody nearby. So get one of the local GPs on side.

For them to get involved in the learning of teams, that works really well and I think they value the service more as well when they’re part of that upskilling and they understand what we are going through in, you know, our development. So that’s my kind of key thing really.

Andre Yeung
Thanks, Mark. Yeah, and that confidence thing is, is so important. Yes for general practice and yes for the other colleagues who work in primary care, but you’ve also got members of the public as well -as an anecdote before I come to, to Ruth and then Claire, I was interviewing patients as part of my research into pharmacy First. And I’ve got to say that’s one of the things that came through. I remember one patient in particular told me that she has great confidence in her pharmacy team and that she has even remarked on the new services and the kind of growth that’s happened in community pharmacy. So I think we are on a journey, but I think we are getting there is what I’m probably trying to say, OK, I’m going to come to Ruth and then Claire and then I’m going to move on from Pharmacy First and we’re going to go to some of the other services that we’ve previously mentioned. So Ruth.

Ruth Buchan
Thanks Andre. You know and the question you asked was around where we’re going, and I think we’re seeing an increasing use of the skills of community pharmacists and also other team members including the professionally registered pharmacy technicians and that we are on a journey to better use those skills that we’ve got within community pharmacy. And the two things that I’m seeing that really helping to support at the moment is supporting that access into primary care and also the early detection and prevention, which is so important because we know access to the challenge across primary care and we also know we have lots of people out there who have got undetected hypertension, for example. So really positive and Mark’s absolutely right with his comment about where to start. You know what’s interesting, Claire Fuller, you know, has been very clear that fundamentally she sees Pharmacy First as a shared responsibility for primary care teams and actually working together and we’ve certainly had to experience this in West Yorkshire where we see the service working really well is where the clinician. the Community Pharmacy clinician and the general practice clinician make time to sit with each other and talk – to share, you know, this didn’t go well, when and it’s not been done in an accusatory kind of way, it’s been done very much in a collaborative and supporting each other. We’ve had examples where the pharmacist actually spent some time in clinic with general practice to help to get more skilled at looking into ears with the otoscopes. So the more you see, the more you know what you’re looking at, which has really then helped both improve the quality of and the confidence I think really for the community pharmacists. But actually, you know. more episodes of care again can be completed.

So I think it’s really important to think about this as a whole, you know- how do we tackle these issues together in primary care? 

Andre Yeung

Thanks Ruth for discussing the letter that was shared by Claire Fuller. Claire Fuller is the national medical director for Primary Care at NHS England. We’re going to get on to detection and prevention, which you mentioned in in just a second with hypertension. Can I come to you, Claire?

Claire Smeaton
Yeah. I think Ruth just took the words out of my mouth actually there.  I think, you know, I think the confidence has been a huge thing for our pharmacists out there. And when certainly kind of you know, within our organisation, some individuals felt nervous, it was all new. And you know, our pharmacist that did maybe qualify some time, but all they needed is just to a little bit of confidence and they’re away now. And you know they’ve been giving great service and great advice for years and years and years, it’s just in a different way. I do think Pharmacy First now really has given them the confidence to kind of operate at the top of their registration kind of clinically and professionally. And I just see that growing more and more as that evolves. But you know the foundations were there, they they’ve just been used in a different way now and I think that’s great for them.

Andre Yeung
Thanks very much, Claire and again, personally speaking, I’m involved in the independent prescribing for the roll out of prescribing in community pharmacies. I know some of you will be involved in that as well and that’s just, you know, going to be such a benefit for our role within a changed primary care system in the future. I think that’s important for colleagues to be aware of who were working in primary care that you know that is going to be in the background developing and all pharmacists coming out of university in 2026 are going to be coming out with that prescribing qualification. So the functionality improvements we’re going to see over coming years are only going to get more and more important for the NHS and for patients and – Ruth.

Ruth Buchan
Yeah, thanks, Andre. Would it be helpful if I said a little bit more about the independent prescribing Pathfinder programme, so that people who are aware of what’s going on, so NHS England are leading a programme called the Independent Prescribing Pathfinder programme within Community Pharmacy and most ICBs and certainly all ICBs in North East and Yorkshire are involved for that programme.

So we’re working with – it is a small number of community pharmacies, but we’re working with the small number community pharmacies in each of our ICBs to actually look at, as you say, Andre, how do we use NHS prescribing within community pharmacy. So we’re all using slightly different models, extended minor illness is one which is common to us all and that’s about going beyond Pharmacy First. So, it is limited. There’s only 7 clinical conditions -vas an independent prescriber, we can go beyond and complete even more episodes of care.

A couple of us are also looking at cardiovascular disease. So again, going beyond the blood pressure, high potential case finding service to look at actually, so we’ve identified somebody’s hypertension, can we now manage them? What are their lipids like? What’s their cardiovascular risk and how do we give them the best advice to manage that for them? So you know, and we’re also across North East and Yorkshire we’re also looking at, you know, how do we work the general practice medicines optimisation. So you know, a few of us have also exploring an option of how can we help manage drug shortages within community pharmacy for the simpler things which could be swapped between captures and tablets without having to go back to general practice. So there’s I think there’s a real scope there for us to test it out.

You know it is a Pathfinder, we are developing a load of things as we go on, but our ultimate aim is to really use those clinical skills for Pharmacists as prescribers and their team. So it isn’t just a few Pathfinder sites, but as you say, Andre, all pharmacists will qualify as prescribers in 2026. How do we best use that skill within community pharmacy to help support access into primary care and the early detection/prevention and possibly other things, we’ll see what comes out the Pathfinder, but it’s a really, you know, as a pharmacist, it’s a very exciting programme.

It’s something which I feel very privileged to be part of, and the feedback we’re getting from the general practices involved, community pharmacists and indeed the patients has been really positive. So a great start.

Andre Yeung
Thanks so much for that summary, Ruth. I know that that’s going to be of great interest to colleagues who are listening to this podcast so that they understand that really significant role of independent prescribing, that central role – it’s connected to pretty much everything else that we’re doing. So thank you for providing that overview and that summary, we’re going to move on or I’d like to move the conversation towards contraception service and blood pressure just for a few minutes. Because I know that Pharmacy First is obviously a flagship service, it’s incredibly important, everyone knows that. But we’re doing good work and Ruth’s kind of alluded kind of alluded to some of this already on both hypertension, which is blood pressure screening, but also on contraception services within pharmacies. I wondered if anyone could just give me, I don’t know, an anecdote or some comments about one or both of those services.

Amanda Smith
So in my role in Community Pharmacy, we’re obviously trying to do as many blood pressure checks as we can and one of the great things about the blood pressure service, it does allow us to do those checks off site.

So as part of the promotion for the service, we actually created a cartoon character, Captain Blood Pressure or Captain BP just to try and make it a little bit more interesting and attract people to come and get the blood pressures done.

So we decided to get a stand at the local Halifax agricultural show and do blood pressure cheques there. So to try and attract more people over, we brought our characters to life and I created costumes for the staff members to wear which worked really well. Everybody was curious to see why we were dressed up with red wigs and capes, so they all came over to see what was going on and we managed to do 116 blood pressure cheques that day, which was absolutely brilliant. We had some really good conversations with people about the blood pressure and I think everyone really enjoyed it.

Andre Yeung
There’s nothing like fancy dress to get people’s attention and get people focused on something so well done and hopefully that won’t spread to the NE anytime soon (!) No, I’m joking. Thanks, Amanda. And I guess the question is what happens after that?

Amanda Smith
Yeah, that’s a good question. So once we’ve identified someone with high blood pressure, then we always offer them the ambulatory blood pressure check, which we did do that to the people that we checked at the show. And I think we provided, I don’t if it’s five or six of those afterwards. And I think probably two or three of those, we did identify as having high blood pressure and they were then referred on to the GP practice for further treatment. So yeah, it’s really worthwhile doing.

Andre Yeung
And Ruth, do you want to come in?

Ruth Buchan
I think that’s a really good, great example, Amanda, of how you’ve done something to help support identifying those patients that didn’t know they had hypertension. And there’s a few other bits that I’ve heard going across, you know, West Yorkshire. I know they’ve happened elsewhere. So when it comes to the working in collaboration with general practice and community pharmacy, general practice have sent a text out to patients to say would you like to have your blood pressure check done. You can either do a home blood pressure reading and drop it in the practice or (and they’ve put the link!) So the NHS website’s got some really helpful pharmacy service finders so you can search for a pharmacy that does the contraception service or the hypertension service and they’ve put the link to the hypertension service. Patient can put their post code in and find their closest pharmacy that does that service and then can choose. The results from the hypertension check will be then fed, because that’s part of the service specification, back to the general practice who can update their record for QOF purposes, for example. So that’s a really good example of working together, and another one where and I don’t know if Amanda’s got reflections on this, but I get reports from pharmacies that sometimes patients don’t want to do an ambulatory and they say, well, we’ll just go to the GP practice. But I’ve had again in collaboration GP practices have said no, the pharmacy service has requested the ambulatory – go back to the pharmacy, have your ambulatory done. Then they’ll send me the results and then we can take it from there. So again, I think working together can really help maximise benefit patients in those service and reduce some of the impacts of those services between Community banks and general practice.

Amanda Smith
I think we have had that, Ruth, where people have been a bit reticent about having the ambulatory check done, but usually they come back after a couple of days and ask and ask her to book them in. 

Andre Yeung
Really good practical observations on how the service is working – Claire.

Claire Smeaton 
Yeah, I think what kind of well pharmacy do as an organisation as well and I’m sure this goes on in, in other organisations, we actually have a couple of mobile health clinics. So it’s like a little bus, it’s fab and that does go across the country and it is parked in kind of prominent locations, a lot of shopping retail parks and we will have a pharmacist and a couple of colleagues on there.

It’s usually in a location for about a week’s period of time, and that’s really good capturing patients that may be exactly that, don’t know they’ve got hypertension, maybe don’t have any reason to be in a pharmacy and it’s not something, you know, the place they choose to choose to be. Capturing them when they’re shopping is really good and we get through a lot of tests a day on the bus, mobile health clinic should I say – we like to refer to it as a bus. It’s not a bus! but that works really, really well. And I think that is really spreading out the care.

And you know, we’ve done some vaccinations and things like that on there this winter season as well. So just an extension of the good stuff that everybody’s doing out there on hypertension, pitching out in different avenues to patients, which is brill.

Andre Yeung

Could I come to Mark, please? Can I bring you in?

Mark Burdon
Yeah. Thanks, Andre. So on both of those services, really, I think the first one on the BPs I was chatting to a GP colleague yesterday and he was talking about receiving some referrals for a regular pulse from pharmacy and we established that they were coming from the devices that we use. So what we generally do is we’ll do a clinic blood pressure using a normal cuff that people would be familiar with.

And if that reading is high, we then do what’s called an ambulatory blood pressure, which is something that we attach that stays on the body for a bit longer.

Normally through the day – it can stay on for 24 hours in some circumstances. But what we found is that was flashing up some irregular pulses and you know when you send them back to a GP practice though, they’ll order an ECG at which is a test that, you know, put the leads on the body and that tells you how the hearts are beating and how the rhythms are looking. And then I think what my solution to that is to use another device which would actually give us an ECG reading. You know, this is fairly technical terms, but you know what that would do is it takes a reading from the thumbs and you hold a little device and that gives us not, you know, not the full reading, but it gives us an indication of whether that person’s heart rate is irregular. So I think that was that that was a really good anecdote about working together to come up with some solutions to things that we’ve identified.

On contraception pharmacies always been associated with contraception in different guises, whether that’s emergency contraception and I mentioned this earlier on, what we call EHC or emergency hormonal contraception. That’s used if somebody has unprotected sex and you know they have an unplanned incident where they could be at risk of a pregnancy. And in those cases, pharmacy has been seeing those, those type of you know episodes for many years and adding on the ability for pharmacists to start oral contraception is really beneficial for women. It’s so much more convenient. Pharmacists can give up to a year’s worth of contraceptive pills and the benefits for general practice has been largely around the pill checks that women have to go through when they are initiated and are on maintenance of oral contraception, and the benefit for the general practice is easing the pressure, not necessarily on the GP but the wider general practice team and in that instance it’s usually the practice nurse who does these pill cheques and you know, they’re under enormous pressure.

You know, there is a dearth of practice nurses out there like all parts of professions there aren’t enough of them. And you know, if we can take off some of the easy stuff for them, it’ll allow them to concentrate on some of the more complex cases, looking at long term conditions, hypertension or diabetes or, you know, kidney problems. So yeah, just two real examples of where we’ve had some success locally and in my pharmacy. And I see this, you know, as a pharmacist day in, day out.

Andre Yeung
Thanks, Mark. And yeah, you’re right to point out that you know all of these services, not just Pharmacy First, but these other services is about relieving pressure on general practice, but also improving accessibility for patients, particularly the contraception services. An obvious one, isn’t it? A lot of these patients are going to be younger, they’re going to be at work and accessibility is going to be important for them after work.

Mark Burdon
Yeah, and just a follow up, Andre on that mention of you know an extra test that we’re doing, this isn’t available in all pharmacies, it’s just something that we’ve I’ve identified with the local GP is something that might help and it just so happens we have one of these devices and we’re testing this at the minute to see if it is a helpful intervention.

to back up what Ruth said, the practices that I work with really value the ability to send a message to a patient to get them to turn up at the pharmacy and that becomes so important towards the end of the QOF year – they have to record blood pressures amongst many other things and just having another possible place to have those done is really helpful. And again, it just builds that relationship between pharmacy and general practice.

Andre Yeung
It’s such an important point. It’s always important to have those incentives pointing in the same direction so that we’re not working against each other in primary care.

Andre Yeung
Thanks, Mark. And we are going to move on in just a second. we’re going to talk about the workload. That’s on community pharmacy teams. I’d like people’s reflections on that because these new services, obviously there’s work involved in providing them. So how are we going to cope in in the coming months and years? Amanda, do you want to come in first?

Amanda Smith
Yeah, I mean, there is always a pressure when a new service comes out. Obviously, it’s difficult in a busy pharmacy to find time to train everyone up on it. And a lot of the training that we’ll have to do is quite often done in our own time.
So yeah, that that it is challenging when during the first initial stages of getting a new service up and running, just making sure that everybody in the team knows what’s happening and knows the right thing to tell to people. So it does take quite a bit of time generally – setting things up and getting them up and running, but then once you’ve got them up and running, they tend to work fine after that.

Andre Yeung    
Any kind of final comments on the capacity side of things on Community pharmacy in terms of the workload – Mark.

Mark Burdon
It’s taken us years to get ourselves into a position where we can build the capacity to do these things and that involves several things really. And my key 3 pillars of the service are premises. So getting our premises right and you know we have all invested a lot of time, effort and resource in, in you know getting our premises to the state that they’re, you know, the right for patients. The second thing is technology and IT and having the correct, not just the hardware, but the software that allows us to integrate in some of the, with some of the RGP colleagues, let’s say. So that’s really beneficial. It also helps how we communicate with patients. Some pharmacies are using things like SMS or text messages. Some are using e-mails, some are using phone calls, some are using video calls. So using that technology where it exists is really helpful.

And the third thing, and probably the most important thing is, and it has been touched on several times here is at workforce, so upskilling our teams to make sure that the right person is doing the right job. It’s not just about the pharmacist or indeed the pharmacy technician -it’s about using the whole team to the best of their abilities.

Andre Yeung
Thanks, Mark. I like those 3 pillars premises, tech and of course the workforce, which is critical. I’ll, I’ll come to Claire.

Claire Smeaton  
Thanks, Andre. Community pharmacy is changing and very rapidly there’s no doubt about that, but it’s changing for the better. I think you know as when we was approached to be involved in the Pathfinder trial, you know, we felt honoured that we could be part of trying to shape the future of pharmacy. I know my pharmacist, you know, that’s been involved in that she’s been wonderful, and she’s really embraced the change.

But I think ultimately all of these new services, they are kind of empowering our professionals to work as I’ve referenced earlier clinically and professionally at the top of their registration. And I do think that is wonderful that pharmacists now, and our technicians as well are getting the recognition that they’re very capable, they’re very skilled and actually if we build that partnership up with the general practice, we can be a, wonderful kind of duo – tag team if you like, out there, free up nurses time with contraception so that they can go and use their skills in a different part of the practice as well. Also, you know, Pathfinder, Pharmacy First are kind of driving patients in as well for the BP checks, the contraception, the vaccination, things that they might not have even thought about going to the pharmacy for – telling their family members and again, we’ve spoke about the benefits of the opening times, the convenience and all of that. But I think it’s really exciting for me. It’s challenging. It’s tough. We’re never going to sit there and say that working in any form of healthcare is not challenging, but it’s so rewarding, isn’t it? I firmly believe anyway, when actually we can genuinely between us all make such a difference to patients’ lives.

We have mentioned throughout our session today about job satisfaction. The stories I hear when I go into my pharmacies, and you know when we’ve got use of the mobile health clinic of when we have identified a high reading that that patient does need urgent care that whilst it’s not good for the patient but we’re obviously then getting them to the, right place for that care. The job satisfaction and the pride that the professionals then tell that story to me and they know that they have really made a difference to that patient and now going to change their lives. And I think that is key. When we look at all of the services, that is a key part of the job satisfaction that they, you know, you cannot argue that they’ve made a difference that day. They’ve got up out of bed. They really have changed somebody’s lives with some of the scary readings that we see sometimes and got them pointed in the right direction. So -and quickly, and that that’s wonderful to see.

Andre Yeung
Thanks, Claire. Yeah, that’s so important. And I don’t know, we’ve all got probably had experience of pharmacists telling us the same thing- that you know that they’ve made a difference. And you’re right, that’s so important for people.

Thanks for that summary and really positive listeners won’t be able to see this – but you were getting a lot of nods as you were talking there from the other panel members, because I think we’re all excited about that future. Ruth, can I come to you?

Ruth Buchan 

Thank you. Andre. You know, we were talking about capacity for community pharmacy, and we can do these new clinical services and it is new and it does take us, on reflection, time to get upskilled and get make that adjustment really to taking on different patient flows, taking on different kind of clinical assessments. In my experience as a community founder clinical lead you know community pharmacy is really good at doing that, being flexible, but you know inevitably it will take a little time to get from zero to, then adapting that service and getting it embedded.

One thing that I see really helps is that where the referrals into services like Pharmacy First are routine and regular. So, if you know you’re going to get 10 referrals each day for your practice, a pharmacy can manage that. If that happens every day because they can adjust their workforce, I think what’s really hard for community pharmacy is if you get, you know, 10 patients on the Monday, nothing on a Tuesday, Wednesday, then you know 10 again on a Thursday, that is more difficult to manage. So again, goes to Claire’s, really important point around working together.

It was general practice and community pharmacy and how doing that together, talking to each other, trying to support you in the best ways we can actually get the best out for our patients and reduces our own workload as well.

Andre Yeung
Thank you, Ruth. Really important points bringing us to almost the end of this particular episode. It’s been great to talk to all of you panel members about these new services and about the direction for community pharmacy. I think we all agree that the future is really bright for community pharmacy and for primary care and actually that we’ve all seen progress on the relationships that Ruth has just mentioned, but also on things like premises where we’ve seen a lot of investment by community pharmacies and that’s going to continue into the future, the technology will be coming more integrated into primary care systems and our workforce is becoming more skilled as well. So we’re in a great position. We’re moving forwards. I think that bright future is coming closer towards us with all of these new services and all of the hard work that’s been done by frontline pharmacy teams.

So thank you to all of you for taking part in this podcast and I look forward to seeing you soon.