Leadership divisions and fragmented funding arrangements mean that pharmacists could miss out on new plans giving them the chance to treat patients more directly unless the profession can make a coherent case for change, the Nuffield Trust says.
The Nuffield Trust’s report, commissioned by the Royal Pharmaceutical Society (RPS), comes soon after NHS England’s Five Year Forward View opened the door for pharmacists to take on the provision of many more front-line NHS services. The NHS England proposals echo recommendations from last year’s independent RPS commission on pharmacy, which called for pharmacists to shift their focus from dispensing and supplying medicine towards care-giving.
The Nuffield Trust’s research was conducted to examine progress one year since the independent commission’s report. Drawing on interviews with local and national health care leaders and an online questionnaire, it finds that the RPS has taken these recommendations seriously, and that NHS leaders are increasingly considering pharmacists for roles once filled by doctors and nurses, such as giving vaccinations.
But progress towards the idea of pharmacists as care-givers has been less marked:
- While pharmacists in some areas are already providing patient services like anti-coagulation treatment and flu vaccinations, working in GP surgeries to support people who take many drugs to help manage their long-term health problems, and doing rounds in care homes to ensure safe and appropriate use of medicines, progress is patchy and lacking in scale.
- At a national level, divisions between different national pharmacy representative groups are preventing the profession making a coherent case to the wider health service.
- There has been a disappointing lack of progress in shifting the funding arrangements governing pharmacy away from the dispensing and supply of medicines and towards direct patient care.
Dr Judith Smith, lead author and Director of Policy at the Nuffield Trust, said:
“The last year has seen some real progress in the way that NHS leaders see pharmacists, as the Five Year Forward View demonstrates. There’s an increasing understanding that pharmacy has a lot to offer an NHS on an urgent hunt for savings, patients looking for easy treatment on the high street for common illnesses, and people needing support to help them manage long-term conditions.
“But we are still not on course for pharmacists to become a care-giving profession in the way they can and should. In most areas, there just hasn’t been a change patients would notice. The leaders of the profession are still not speaking with one voice. And even when they hear what pharmacists have to say, NHS leaders are still not putting words into action through changes to contracts or alternative forms of funding.”
Dr David Branford, Chair of the Royal Pharmaceutical Society said:
“There have been some excellent examples of innovative practice amongst pharmacists since the independent commission reported last year, which should be celebrated. But this momentum needs to snowball fast. It’s not acceptable for patients to be denied the proven improvements to their care that pharmacists can offer, or for the NHS to miss out on the efficiency savings they can bring.
“Making use of pharmacists’ clinical skills in every hospital, every care home and in all community, primary and social care settings would undoubtedly relieve pressure on the rest of the NHS. But this cannot wait for another year: we are calling on commissioners, employers and the wider NHS to work with us to integrate pharmacy fully into the models outlined in the Five Year Forward View.”
As well as calling for pharmacists to rise to the challenge locally, and for leaders to speak with one voice, the report calls on the Department for Health and NHS England to: shift the national community pharmacy contract more towards patient care; ensure that pharmacy can be part of new contracts designed for the models of care set out in the Five Year Forward View; and take other steps to give pharmacists confidence that they mean business about a wider and more patient-focused role.
Notes to editors
- Now More than Ever was carried out by the Nuffield Trust, commissioned and funded by the Royal Pharmaceutical Society. The report draws on interviews with local and national health care leaders, an on-line survey questionnaire of pharmacy stakeholders, and analysis of policy and media sources. It is available on the Nuffield Trust website.
- The report reviews progress in pharmacists moving into care-giving roles, a year after the Royal Pharmaceutical Society Commission on New Models of Care Delivered through Pharmacy found that this was crucial to pharmacy’s future, and of great potential benefit to patients. Dr Judith Smith, Director of Policy at the Nuffield Trust, led both projects.
- Now or Never, the final report of the original Commission, can be seen here on the Royal Pharmaceutical Society website.