The current services and funding structures available to community pharmacies are not conducive to their playing an active role in helping patients manage their medicines, a government-funded digital health start-up has claimed.

In its submission to the parliamentary health select committee’s inquiry into the community pharmacy sector, Connect Care – which works with councils and NHS trusts to support elderly patients with their medication adherence – called for a more defined role for community pharmacists as primary care networks phase out funding for structured medication reviews, which are delivered by pharmacist working in general practice.

“Pharmacies are not incentivised nor reimbursed fairly for the time taken to understand people’s meds management needs and dispense in ways that make medicine management easiest and fit for purpose,” it said. 

“This creates a space where those who shout loudest (usually carers or family members) het dosettes as part of the pharmacy’s statutory duty placed on them to make ‘reasonable adjustments’. This openly disincentivises them from understanding people’s needs.”

The start-up criticised the lack of funded services that allow patients to self-refer for support with their medicines and argued that the Discharge Medicines Service, which relies on hospitals referring patients onwards to pharmacies and therefore creates extra work.

“Community pharmacists want to become more involved,” said Connect Care. “But you won’t find these professionals at the decision making table for someone’s care beyond a hospital discharge, nor are they currently someone a care coordinator would know to refer you to for further support.”

The start-up also called for a more nuanced approach to medication adherence, arguing that health professionals tacitly assume “that there is an agreement between the prescriber and patient about the prescriber’s recommendations”.

“Yet studies show that the majority of non-adherent behaviour is a conscious deviation from a treatment plan – the reasons for which go unnoticed.”

And it cautioned against a ‘one-size-fits-all’ approach to self-management aids: “Dosette boxes are becoming harder to acquire at the same time that pharmacies are beginning to turn away new patients who are currently using them.

“Too often, dosette boxes are being employed when a simpler approach might achieve the same or better results, promoting independence and confidence in a way that is practical and sustainable.”