Opinion: Time to take integration seriously

Integration has become one of those words used so often that we sometimes fail to register its significance when we hear it, says Michael Lennox, NPA local integration lead.

Integration is an established part of the NHS’s strategy for community pharmacy and it is something our whole sector needs to think very seriously about.

By successfully integrating community pharmacy with NHS planning and care pathways, the sector’s future becomes more secure and patients benefit from a more seamless experience.

July’s NPA conference heard from NHS England’s Lisa Simpson on this theme. The Community Pharmacist Consultation Service and the Discharge Medicines Service (DMS) show the way, she said, but people across the system will have to work differently to realise their potential. It is “undoubtedly an opportunity with associated challenges”, she admitted.

DMS ticks all the boxes from an integration perspective – community pharmacy linking with acute trusts, supporting patients in the community and getting information across to general practice for ongoing care. Early data shows about a fifth of pharmacies in England have received DMS referrals from hospitals and the service is successfully preventing medicines-related hospital readmissions and consequent bed days.

The NPA recently launched its ‘How We Can Help’ plan to unleash the potential of community pharmacy, protect the population from Covid-19, improve access to primary care and prevent ill health. In it we acknowledge that integrating community pharmacy with the rest of health and social care will be key to delivering improvements. 

Meanwhile, the Health and Care Bill is now before Parliament and aims to achieve closer collaboration between the NHS, local authorities and care providers to provide more joined-up working. Here once again we find the language and intention of integration. 

While a duty to collaborate will be compulsory for all partners within the system, we know from long experience that community pharmacy cannot take it for granted that genuine, heartfelt engagement necessarily follows from the legal obligations.

That is one of many reasons why the current national review on the roles of LPCs and PSNC as representative structures must deliver strengthened, not depleted, local leadership, optimising local structures to leverage the emerging ICS opportunities and build connections within primary care and beyond. 

"Early data shows about a fifth of pharmacies in England have received DMS referrals from hospitals"