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A report commissioned by the RPS warns of a “bleak” future beyond 2020 if community pharmacy fails to change to meet NHS priorities.

A broader role for pharmacy – as described in NHS England’s recently published Five-Year Forward View – is being undermined by the profession’s tendency to introspection and in-fighting, a report published this month by the Nuffield Trust has suggested.

The paper, which was commissioned by the Royal Pharmaceutical Society as a follow-up to last year’s ‘Now or Never’ document, doesn’t sugarcoat the conclusions reached by its authors. Chief among the criticisms levelled are:

• A failure to capitalise on the wider contribution that pharmacy can make to health and social care as described in ‘Now or Never’, despite the interest the paper garnered from practitioners and policy makers outside the profession
• Innovation continuing in a “patchy” manner that “lacks scale”
• “Disappointingly little progress” in shifting funding and commissioning away from dispensing and towards patient services
• Leadership that continues to be “fractured”

The 32-page report, entitled: ‘Now More Than Ever: Why Pharmacy Needs to Act’, drives the point home by stating: “NHS England has set out a direction of travel that is about integrated local care providers, working in new networks that maximise the use of technology and new professional roles. If pharmacy fails to rise to this challenge, its role in the community beyond 2020 looks bleak.”

Lead author and Nuffield Trust policy director, Judith Smith, commented: “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.”

Crumbs of comfort

The gains that have been made over the past year warrant a mention. Some of the highlights include the RPS taking on an advocacy role for pharmacists as care-givers, the move made towards increasing pharmacy involvement in areas such as urgent care, public health and general practice organisations and networks, and the innovative services that have been commissioned on a local level in some areas.

In order to move forward, ‘Now More Than Ever’ makes a number of recommendations:

• Pharmacy to speak as one voice so a clear and consistent message is given to those outside the profession about how the sector is crucial to helping meet the challenges facing the NHS
• Changes in how community pharmacy is funded at a national level to enable a wider care-giving role in areas such as minor ailments to support NHS priorities
• Pharmacy becoming stronger at a local level – which requires guidance and support from employers and national bodies – with the aim of becoming more involved in the new multi-speciality community providers and other care models the NHS is looking to use in the future
• Pharmacy leaders to be at the centre of national and local debate and planning for all sectors of the profession

The original ‘Now or Never: Shaping Pharmacy for the Future’ paper was the result of work completed by the Commission on Future Models of Care, which was established by the RPS but chaired independently by the Nuffield Trust’s Judith Smith, to identify how pharmacy could best meet the needs of patients in England.

In putting together ‘Now More Than Ever’, Dr Smith and her team spoke to the Commission’s 15-strong advisory group as well as stakeholders both within and beyond pharmacy, and analysed media coverage, policy literature and parliamentary records.

The researchers also took into account other relevant activities that took place during the year, including NHS England’s ‘Call to Action’, which elicited an extensive response from community pharmacy in terms of what it felt it could do for health and social care; the Department of Health’s Transforming Primary Care plan, which set out plans to improve the quality and efficiency of primary care services; and NHS England’s Five-Year Forward View.

The report can be accessed at www.nuffieldtrust.org.uk.