Dr Bruce Warner, Deputy Chief Pharmaceutical Officer for England
As pharmacy and medicines professionals we have so much to be proud of in the way we have responded to the COVID-19 pandemic - how we have supported patients, local NHS teams and our local communities.
We have played a key part in delivering the COVID vaccine to millions of people and consolidated our clinical role as part of NHS teams providing integrated clinical services to patients.
Since the Community Pharmacy Contractual Framework (CPCF) five-year deal was agreed in 2019, the expansion of clinical services in community pharmacy has included minor illness and urgent medicines referrals from general practice and NHS 111 into the NHS Community Pharmacist Consultation Service.
And community pharmacy teams are working clinically with their professional colleagues in hospitals and primary care networks to prevent harm to patients when they leave hospital with new medicines through the Discharge Medicines Service.
New clinical services being introduced as part of the Year 3 CPCF agreement include hypertension case finding and referral of patients from hospital to continue receiving support with stopping smoking.
Community pharmacies are also supporting referral to a new weight management scheme as part of the Pharmacy Quality Scheme (PQS).
In addition we have introduced a significant expansion of the New Medicine Service (NMS) into new therapeutic areas including epilepsy, Parkinson’s Disease, heart failure, stroke/transient ischemic attack and coronary heart disease, allowing many more to benefit from expert advice and support.
I see the expansion to the NMS, now covering sixteen therapeutic areas in total, as an important endorsement of the clinical skills of community pharmacists and the role you and your teams have to play in supporting patients to get the best from their medicines.
This takes the service into new, and potentially more clinically challenging areas which demonstrates the trust and confidence that commissioners, other healthcare professions and, critically, patients have in community pharmacists.
"This is what being a community pharmacist is all about. I and many others have worked all our professional lives to see clinical services extended into community pharmacies at this scale."
Community pharmacy has a vital role to play in supporting people with their mental health and wellbeing. Pilots starting in early 2022 to include people who are starting to take a new antidepressant, in NMS, is further evidence of this trust and confidence.
As we move into this potentially more challenging area, it is really important that we get it right.
Piloting potential areas for expansion through the Pharmacy Integration Programme is incredibly important in helping us think through any potential pitfalls, any training support that may be required and making sure the service is safe and effective, allowing us to test models before rolling them out at scale.
The size of the ‘prize’ is huge, particularly for patients. By having these initial and follow up conversations with a highly qualified health professional they trust, in a confidential setting, research has shown that more patients will take their medicines in the correct way and will benefit more in terms of their outcomes.
Imagine the difference it can make to somebody’s quality of life if we help them to take newly prescribed antiepileptic medication in a way that means they remain free from seizures.
Living with heart failure, and then suddenly being able to walk to the local shops again because somebody has understood your needs, and helped you make sure your newly prescribed medicine is taken in a way that works effectively.
Playing a part in restoring dignity can be incredibly rewarding.
Other parts of the CPCF can also encourage the delivery of NMS. Personalised asthma plans, inhaler technique checks and the anticoagulation audit – included in the PQS - can both prompt an additional NMS.
The rewards professionally can be profound. Conversations with patients that genuinely use shared decision making can provide both the patient and the pharmacist with a sense of achievement. The follow up element of the service allows an opportunity for the pharmacist and patient to get the best from shared decision making and really make a difference.
This is what being a community pharmacist is all about. I and many others have worked all our professional lives to see clinical services extended into community pharmacies at this scale.
Alongside the hypertension case finding service, the smoking cessation service, vaccination services and a whole range of clinical services, being delivered day in day out in our community pharmacies, and with new clinical pilots due to commence over the coming months, the expanded NMS signals a very clear direction of travel.