The future of pharmacy: just do it

All too often in discussion of the NHS, pharmacy is seen as something of a niche concern. General practitioners, consultants, nurses and even managers loom large in parliamentary debates on the future of health care, in newspaper articles and the public mind.

Pharmacists, meanwhile, punch well below their weight in policy and management circles despite being the third largest health care profession.

The innovative, often inspiring services I saw as chair of the Royal Pharmaceutical Society’s Commission (RPS) on New Models of Care show vividly why this must change.

In Sheffield, pharmacists are reaching populations who tend not to attend general practices by giving flu vaccinations in pharmacies on local high streets. In Brighton, patients taking anticoagulation to reduce their risk of stroke choose their most convenient community pharmacy to have their blood levels tested and doses adjusted.

The question we must ask however is why these examples are still relatively rare – why they are still being badged as “innovative”?

In Bournemouth, pharmacists are helping many people quit smoking and improve their lifestyles; in Bromley-by-Bow they are taking pressure off general practice by diagnosing and treating common ailments; across England community, primary care and hospital pharmacists are using their professional expertise to tackle the often suboptimal use of medicines in many health and social care providers – care homes being an area of particular concern.

The pharmacists who submitted evidence to the RPS Commission didn’t need to be told to develop innovative services to help meet patient needs. They simply went ahead and did it, persuading local commissioners and health professionals about what was needed.

These new models of care are playing a part in tackling the wider concerns faced by the NHS: improving access to advice and support out-of-hours, improving care for long-term conditions, and helping people make changes to their lifestyle.

The question we must ask however is why these examples are still relatively rare – why they are still being badged as “innovative”?

The answer is that there has been a collective lack of will to make it happen. Commissioners recovering from a period of major reorganisation too often overlook evidence about what pharmacists can deliver within wider primary, social and integrated care networks.

Many community pharmacists are professionally isolated, lacking the information and support they need to join with other health professionals to design and deliver new services. And at a national level, pharmacy leaders have struggled to have a strong and influential voice in debates about new models of urgent, long-term condition, primary and social care.

In the years ahead the ability of the NHS to deliver free, comprehensive and high-quality care will rest on finding new ways to improve preventive care, deliver more treatment closer to home, and secure sustained gains in productivity at a time of flat spending.

We will however be missing a trick if we don't maximise the potential of pharmacy – the service situated in almost all communities, open long hours, and with which the public comes into contact most often.

We need rapidly to build a consensus that this is not good enough. The Department of Health, NHS England and professional leaders such as the Royal Pharmaceutical Society need to unite in a commitment to supporting new ways of working for pharmacy.

They must make sure that patients and commissioners know what new services will look like (including the impact on wider primary and social care), backing this up with bold policy decisions that ensure that change really happens.

This is not just about central commitment and policy decisions – pharmacists at a local level must get on and do what their innovative peers have done, developing new services and offering these proactively to communities and commissioners.

If I am asked what advice I have for pharmacy as it considers how to develop new models of care, I would use only three words – just do it!