Covid has exposed the fragility of our healthcare systems, says Steve Anderson, group managing director at Phoenix, but the current pharmacy contract in England is no longer relevant and economically illiterate

While the emphasis on vaccines may lead to fewer Covid hospital admissions, it runs the risk of rising admissions due to heart attacks, strokes and cancer that might otherwise have been avoided through early screening.

If GPs, understandably, cannot provide such early screening then, rather than drop them for at-risk groups, why not look to other professional healthcare providers to undertake this role? Such checks are well within the professional competency of community pharmacists.

It is clear that our ‘GP first for every healthcare concern you may have’ approach simply cannot cope with the volume, depth and breadth of patient demand. It has been tested to destruction.

We have too few GPs per head of population, while many existing GPs are reaching retirement age and others are leaving due to the stress of incredible and unrelenting workload pressures.

We need to radically rethink how we provide people with the right care at the right time in the right setting with the most appropriate healthcare professional.

That means embracing fully the potential of community pharmacy and, as the health secretary Sajid Javid said recently, adopting a “pharmacy first” approach.

Welcome words

While such words are welcome, they need to be backed up by fair and sustainable funding and an investment in relieving current workforce capacity problems.

Community pharmacy wants to provide more patient services and is ideally placed to do so – trusted by the public and accessible in every locality – yet it faces an acute shortage of pharmacists and pharmacy technicians, a situation which will only get worse as PCNs/health boards ramp up their efforts to recruit those qualified professionals into paid NHS roles.

Robbing Peter to pay Paul is a zero sum game in terms of improving patient care.

In England, the hope is that GP-led integrated care systems will become the means to reinvent local healthcare provision.

In some parts of the country the integration boards are embracing community pharmacy, but not in others.

So we end up with a continuation of postcode lottery provision and the public confused about when they should see their local pharmacist rather than their GP.

The current pharmacy contract in England is no longer relevant to today’s patient needs and is economically illiterate.

For example, CPCS referrals are a welcome development, but ill thought through. Pharmacy will be paid for a referral, but not for a walk-in for the same condition.

Therefore, if a pharmacy provides an outstanding service but the patient’s condition recurs, the chances are they will go straight to the pharmacist rather than their GP. If they do that, there's no fee for the pharmacy.

Covid should be a game changer for healthcare. GP telephone and video triage is here to stay, like it or not, and pharmacy also needs to adopt virtual triage.

But its USP must be acting as the necessary physical intervention gateway that may then lead to further healthcare support.