Down on the pharmacy

PhilHunt2015.jpgPhil Hunt on the government’s muddled thinking on the future of community pharmacies

With GPs and the NHS under pressure, the government’s decision to cut both the number of community pharmacies and their capacity seems pretty perverse. Not least when you consider the flexible opening hours and potential to advise millions of patients.

The overall budget will be reduced by £170m in the coming financial year, with more cuts likely to follow. Up to 3,000 pharmacies could close, as Ministers claim there are too many across particular parts of the country.

A 6.1% funding reduction will be compounded by the expanding volume of prescriptions being processed from fewer outlets. To compensate, the government is encouraging the development of large-scale automated dispensing, such as ‘hub and spoke’ arrangements. Ministers are also considering extending the duration of prescriptions to keep down the number of visits to pharmacies.

Inspired by the last Labour government, the expansion of community pharmacy has been a real success. Particularly with services aimed at maintaining independence for vulnerable users, including home delivery of compliance aids. Not only is there clearly room for expansion. The Isle of Wight reablement service has in two years reduced hospital readmission rates of frail patients by 63%.

Recent research meanwhile, shows the potential for 3% of A&E consultations and 5.5% of GP consultations to be managed in community pharmacies – a possible cost saving of £1bn to the NHS. Given that the 95% four hour target for A&E has been missed every month bar one since August 2014, it seems quite inexplicable to ignore such potential.

Community pharmacists offer smoking cessation advice, methadone support and flu injection programs – all of which relieves pressure on the remaining primary care sector. Analysis of almost half a million consultations under the ‘Minor Ailment Services’ provided by 30 community pharmacies showed 92% of users would have visited their local GP if the service was not provided.

At the forefront of the use of digital technology, community pharmacy is in a good place to develop online services. But it has to be done in a way that doesn’t bypass the actual value of the advice that pharmacists can give to individual patients.

Whilst increasing a prescription’s length of time may mean fewer visits to the community pharmacy, it may be a false economy. Patients often give up a course before they reach the end, so longer prescriptions could add to the huge and costly problem of medicine wastage.

Instead of cutting community pharmacy, Ministers should be doing all they can to increase the capacity to help patients, increase accessibility and reduce the load on hard pressed primary care and hospitals.

Lord Phil Hunt of Kings Heath is Shadow Health Minister in the House of Lords. He tweets @LordPhilofBrum

Published 2nd March 2016

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