We must develop a mental health support role

Let’s be honest: community pharmacy has never been short of reports on vision, leadership and “the future”.  

It is telling that I can play, with remarkable success, a game that I call ‘Match the Report^©’.I can link the name of each report to a lead author, organisation or think tank. One thing they all have in common is the claim of a “new brighter dawn for pharmacy” – or something similar. This dawn has never actually broken, sadly. Could this be about to change?

The recently published Vision for Community Pharmacy by the Nuffield Trust and King’s Fund could not have been better timed. The findings sound similar to previous strategies but, as Bob Dylan says: “Times they are a-Changin’...”.

Community pharmacy, the report says:

• Will play a key role in supporting people and communities to stay healthy and well, focusing on reducing health inequalities
• Will have a much more clinically focused role, with members of the public consistently able to access care from community pharmacy teams for common conditions in a way that suits them and supports their health and wellbeing
• Will support people to access and live well with their medicines and treatments, including new and advanced therapies, whenever they emerge
• Has a skilled workforce providing high-quality services. It will continuously develop and improve how patients, the public and healthcare professionals are supported.

Add in the changes to the training of pharmacists – graduating with prescribing competence from 2026 – and the launch of the NHS England prescribing pathfinder programme, and I find myself wondering whether, taken together, all this could finally herald an exciting, new dawn for pharmacy.

I know I am allowing myself, dangerously so, to have unbridled hope and optimism that we can – and will – get it right. So let me explain what I think we need to do.

My plea to you

As change happens to us, pharmacy has to respond. As the profession transforms, let’s take a leaf from Columbus and Gide: “Crossing the ocean of opportunity by having the courage to lose sight of the shores that have defined us”. 

I come to make a case – a plea, if you like. Looking at the possible areas to be explored by the pathfinder sites, I am worried that the opportunity to ‘own’ an evidence-backed, much appreciated, maybe even uncontestable role in delivering population health and wellbeing may be missed as we continue to focus on medicines optimisation. After all, pharmacy and medicines go hand in hand. Don’t they?

Yet for community pharmacy, population health management and tackling health inequalities are equally core tenets of our practice.  

Take the area of mental health. The Royal College of General Practitioners’ policy paper on mental health published in 2017 affirms the evidence that people prefer to receive their mental healthcare in a primary care setting. The paper emphasises providing care as close to the patient’s home as possible, in a less stigmatising environment. It also underscores the importance of communication skills and relational continuity in the bio-psycho-social care model.