Pharmacy White Paper Building on Strengths Delivering the Future Overview

Aims of the White Paper  To set out practical, achievable programmes for the development of NHS pharmaceutical services.  To mesh with the overall strategic direction for a fair, personalised, safe and effective NHS, tackling health inequalities and supporting healthy choices: Showing the opportunities for pharmacy to provide an extended range of services;

Aims of the White Paper Shifting the emphasis from dispensing to clinical services, utilising pharmacy’s skills more fully; and Rewarding quality and better health and service outcomes for those who embrace the new contract.  The focus is on community pharmacy services, but the White Paper also covers hospital pharmacies, dispensing doctors and appliance contractors.

Chapter 1 - Background  Pharmacy’s role to date  Considerable strengths on which this White Paper builds  Identifies further potential for pharmacy to contribute

Chapter 2 - Context  Major health and social challenges  NHS reform programme  Focus on commissioning for health and well- being  Making better use of available resources  Need to harness new technologies  Annex 1 - how and where pharmacy can contribute to the major health challenges ahead

Chapter 3 – Expanding access to medicines with more help  Medicines Use Reviews (MURs) - better targeted health priorities and reward health outcomes  Greater push on repeat dispensing  Improving the use of medicines and reducing waste

Chapter 3 – Expanding access to medicines with more help  Increasing access to medicines, including in an emergency and to OTC medicines in rural areas  Pharmacists’ critical role in promoting safe use of medicines - reducing inappropriate admissions, ensuring integrated care  Local health community clinical pharmacy teams

Chapter 4 - Future service development in pharmacies  As centres promoting healthy living and health literacy, supporting self-care  Exploiting pharmacy’s ready availability in more deprived areas to expand access to healthcare  Offering people more choice with pharmacies being able to prescribe for and deal with minor ailments on the NHS, as first port of call, complementing, not replacing, role of GPs

Chapter 4 - Future service development in pharmacies  Providing support for people with long-term conditions - especially those newly prescribed a medicine  Offering vascular and other screening  Providing immunisation  Two new pharmacist clinical directors to support this

Expanding Services  Weight management  Stop smoking  Sexual health  Alcohol misuse services  Supporting an ageing population  Screening e.g., vascular checks and chlamydia screening  Long term conditions  Mental health  Reducing medicines related harm  Drug misuse  Immunisation & vaccination  Supporting people in work

The longer term vision will see pharmacies  Become ‘healthy living centres’ encompassing a greater emphasis on health promotion and supporting self care.  Become the first port of call for patients with minor ailments with community pharmacies enabled to provide a wider range of medicines (saving up to 57 million GP consultations per year).  Provide support to patients with long term conditions, including supporting patients newly diagnosed and starting new courses of treatment.  Increase their professional involvement in screening, vaccination and sexual health, services.

Community Pharmacy Use - summary of quantitative market research  84% visit pharmacy a least once a year  78% for health related reasons  Adults in England visit on average 14 times a year  Around 1 in 10 get health advice, but few use pharmacy for urgent advice  Mainly used for prescriptions and OTC medicines

Community Pharmacy Use - summary of quantitative market research  Currently very low use of other health related services in pharmacies, eg health screening  Women, those aged over 35 and those with a long term health condition or disability (LTC) are frequent users  Majority use same pharmacy all the time. Those with LTC or disabilities or live in rural areas are more likely to visit same pharmacy

Community Pharmacy Use - summary of qualitative market research  Considerable use already of pharmacists for advice and guidance, OTC medicines and in some cases tests - driven by ease of access and opening times  Much more interest in making greater use of pharmacist for advice, minor ailments and OTC supplies, routine tests.  Repeat dispensing would be widely welcomed

What do PCTs need to do?  Read it!  Understand their “baseline” in relation to current use and commissioning of community pharmacy  Link to NSR work in ALL Clinical Pathways  Review and strengthen their Pharmaceutical Needs Assessments (PNAs) and robustly link them to their Joint Strategic Needs Assessments AND the commissioning process.  Link to WCC and PCT strategic plans for primary care Provide leadership in implementation – who in your PCT

Pharmacy White Paper - Summary  Lead on safer and more effective use of medicines;  Make a significant impact in promoting better health for all and preventing illness (e.g. more screening);  Provide a clear lead for people to help care for themselves as well as supporting those with long-term conditions;  Have a central role in integrated partnerships to address key health inequalities (e.g. access);  Make a significant contribution to achieving wider NHS goals for greater patient control, improved choice and local accountability. Alignment with the primary and community care strategy, setting out a series of structural changes needed including:  reforming contractual and market entry arrangements;  payment systems which reward quality and outcomes;  developing the profession and skills base;  better information on clinical outcomes and cost effectiveness;  closer working with other professionals (e.g. GPs); and  ensuring better public understanding and awareness of the role of pharmacies A blueprint for pharmacy to:How this will be delivered