I doubt if we were re-imagining the NHS from scratch today in this cash-strapped, technology driven, 24/7 world, we would start from where we are now. We certainly wouldn’t want hospitals sited where they are, GPs would be distributed more evenly and community pharmacies would be placed where people need them most rather than (as now) often clustered around GP practices, which is inevitable because local pharmacies rely on the NHS (and therefore prescriptions) for more than 90% of their income. But we all know that changing the NHS is a slow and frustrating evolutionary process because ’we are where we are’.
The last thing we community pharmacists want is to be forced to compete against our GP colleagues
Pulse editor Nigel Praities argues that we need pharmacists but we don’t need pharmacies ’where their skills are based in a building a few streets away, tucked behind shelves of corn plasters and toothpaste’.
He displays an ignorance of the social capital value of the pharmacy network, the billions of pounds we save the NHS in supported self-care and the sheer scale of the logistic challenge of safely and accurately dispensing well over one billion prescriptions per year
Nearly two million people a day visit England’s 11,674 community pharmacies which is roughly twice the number who visit their GP. When asked what they would do if pharmacies close, 29% of people would book an appointment with a GP, rising to four in five in deprived areas. Could GPs really cope with these extra visits? Could the NHS fund them at £45 a throw?
In fact Pulse recently described the prospect of community pharmacy closures as ’a disaster for GPs’ due to the knock-on effects.
The community pharmacy network is already 24/7. It does far more than distribute medicines. In fact it is a highly-accessible public-health network. There are already 2,000 Healthy Living Pharmacies nationwide – and that has been achieved with no additional NHS funding. Pharmacies are the most highly-valued service on the high street and community pharmacists are held in the highest trust of any profession.
When given a choice, people overwhelmingly chose community pharmacy – for example, 66% of women get emergency contraception from the pharmacy network, but we could do so much more. For example, a nationally-commissioned, pharmacy-led common aliments service would save over £1bn and free up 57 million GP appointments per year. This is just scratching the surface: we already promote early diagnosis of long-term conditions from cancer to diabetes, hypertension to dementia. Secure (NHS) emails and imminent access to electronic health records unlocks massive potential and renders the fact that we are ’a few streets away’ irrelevant.
All of that said, I agree with Nigel’s point about the commissioning of flu jabs. I have argued for years that local community pharmacists and GPs are natural allies, caring for the same primary care populations. Our complementary skills should be aligned in such a way as to best benefit those whom we all serve.
Please be assured that the last thing we community pharmacists want is to be forced to compete against our GP colleagues. So, Nigel please let’s not exacerbate the differences between us in a polarised debate. Instead let’s seize the opportunity to come together and create a joint vision of how community pharmacies and general practices can work together for the future, for our patients, and to save the NHS.
