The vital role for pharmacists on the front line

[UrgentCareReviewTeam]

Dr Jill Loader, Assistant Head of Primary Care Commissioning (Pharmacy), looks at helping to provide better quality and resilient urgent care:

OUR urgent and emergency care system is stretched more than ever before.

The time has come to transform the way we deliver urgent care services so they are much more accessible and better meet the needs of patients by being available closer to home and out of hospital - where this is clinically appropriate and accessible for longer hours.

Pharmacists are highly qualified health care professionals, training for five years to become experts in medicines and in giving health and wellbeing advice. They are often available during evenings and at weekends. They give respected advice to many other health care professionals and for some patients they are the first port of call. However, many people are unaware of all the services a modern pharmacy can provide.

NHS England Chief Executive Simon Stevens outlined recently in the NHS Five Year Forward View how we need to make far greater use of pharmacists: in prevention of ill health; support for healthy living; support to self-care for minor ailments and long term conditions medication review in care homes; and as part of more integrated local care models.

Increasing the use of community pharmacy also forms part of the future vision for urgent care set out in NHS England’s Urgent and Emergency Care Review, End of Phase 1 report, published November 2013. You can read the vision here:

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So how do we achieve the vision of both the NHS Five Year Forward View and the Urgent and Emergency Care Review?

Locally, GPs and community pharmacists need to build stronger working relationships, while patients and the public need to better understand how and when pharmacies can help them.

We need to integrate community pharmacy services more fully into the NHS, and to allow patients to choose to share health records with community pharmacists. We also need our commissioning mechanisms to enable urgent care services to be commissioned from community pharmacy.

To help local commissioners to realise the potential of community pharmacy as providers of urgent care, we have published “Community Pharmacy - helping provide better quality and resilient urgent care” and an associated toolkit. This aims to share innovative practice happening in some parts of England and give others the tools to quickly spread effective models.

You can find the document and toolkit here:

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This is an update to Community Pharmacy –helping with winter pressures published last year which local commissioners found useful in supporting their commissioning of:

•flu vaccination through community pharmacy

•access to supply of emergency medicines and

•support to self-care for deprived populations.

We have updated the resource to look at what can be learned from those who implemented some of these initiatives last year.

We also have new evidence, such as the Pharmacy Research UK publication, Community Pharmacy Management of Minor Illness showing that common ailments such as coughs and sore throats cost the NHS an extra £1.1 billion a year when patients are treated in emergency departments or GP surgeries rather than at community pharmacies, with treatment results being equally good regardless of whether patients were treated at a pharmacy, emergency department or general practice.

We have also provided commissioners with a checklist around the five key elements for change identified by the Urgent and Emergency Care Review to work through and take action to ensure that community pharmacy is playing its full part in relieving pressures on the urgent care system.

Delivering the vision for urgent care will depend on a local willingness for true transformational change. Are both GPs and pharmacists in local communities throughout England ready to build relationships and trust so they can pool their complementary skills to deliver accessible, high quality, and sustainable urgent care for their communities?

Dr Jill Loader has recently been appointed as Assistant Head of Primary Care Commissioning (Pharmacy) for NHS England from her post as Regional Pharmacist, NHS England South.

She has been leading work nationally on making the best use of pharmacy to support pressure on the urgent and emergency care system and has published materials to support local commissioners to use pharmacy more effectively.