The Future of Community Pharmacy
20 years ago, if a pharmacist setup an automated system to dispense centrally then go to pharmacies for dispensing to patients, they would have been stopped by the RPSGB as well as stand before the Fitness to Practice Committee. Thankfully times change and the idea of centralised dispensing through the ‘Hub and Spoke’ Model are on the agenda as proposed by Keith Ridge, Chief Pharmaceutical Officer.
Reason for interest is, quite simply to save money as the Government is cutting NHS funding, causing a 6% cut in pharmacy funding. It is estimated this will result in the closure of 3000 pharmacies. This article is not going to be about focusing on this issue (there’s already plenty on this), but more on the impact the Hub and Spoke Model will have to pharmacists from the point of view of services.
Traditionally, pharmacies have made their money through dispensing, as that was what they used to be paid for. However over the last decade, the dispensing fee and medicine reimbursement fee (through category M) has consistently been cut and now margins are so tight, many pharmacies are barely keeping themselves afloat. However with ever increasing pharmacy prescription numbers, and the difficulty in obtaining an accuracy checking technician, pharmacists and their dispensary assistants are struggling to keep up as pharmacists must check every item to ensure it is correct to the prescription. The Hub and Spoke model will in theory end this allowing pharmacists to have more time to do what they really want - focus on improving patient care by delivering more services to patients. But currently there are few services around. Services such as MURs, NMS, smoking cessation are the main few. The pharmacy degree is also becoming more clinically focussed which can means we now have (in theory) greater knowledge when entering the workplace than the current experienced generation of Pharmacists did. However in the future, I see the Government reducing the dispensing fee further until its only sustainable if you have a centralised warehouse with a robot dispenser.
Furthermore the interoperability of information (Summary Care Records) being shared between healthcare professionals, mean community pharmacy is now better integrated that ever before into the wider healthcare system. This, will improve the quality of patient care. Access to this information allows Pharmacists to have deeper conversations with patients which means an improvement in the quality of service offered. As a result we have seen a paradigm shift of Pharmacists entering new roles within hospitals, sports and now GP surgeries (mentioned below). It is important with this growing integration pharmacists, which are meant to be the face of the NHS come out and work more clinically using our true potential for greater patient care.
To help solve the trap of pharmacists and improve the quality of patient care, we have entered into an era of ‘SuperPharmacists’. SuperPharmacist’s such as Ravi Sharma are striving to innovate and create a whole new career path for pharmacists in GP surgeries. The idea is to use our clinical skills in medicine management and conditions to improve patient care and reduce overprescribing. The tiring work behind the scenes include countless hours of business plans, hours of refinement, travelling, education, master classes and the list goes on. The normal 8–12 hour shift becomes a forgotten concept and as days turn to nights, and days blur together. This is unsustainable for those SuperPharmacists and we need more people, if we are to change this bleak future of community pharmacy.
For this reason, I am currently working on developing a healthathon (health hackathon). A hackathon, where community healthcare problems presented on by experts and solved collaboratively by professionals and students through a technology enabled solution. The idea is to increase networking between the introverted profession, and build a collaborative environment to solve problems, where those with new radical ideas can come and express their creativity in real life problems to develop real services. The team solutions will then be pitched to a panel of judges who will assess and mark the pitches and a winner will be announced! But it doesn’t have to end there. We would encourage all teams to keep the collaboration going and take their ideas forward to develop services to pitch to their CCGs and improve patient care across the country.
