Community Pharmacy services - how they could develop to support patients and the NHS

Overview Service developments and the 17th Dec letter PwC report on the value of community pharmacy Community Pharmacy Forward View

17th December 2015 letter Open letter to PSNC - announced funding for community pharmacy in 2016/17 will be cut by £170m (from £2.8bn to no higher than £2.63bn) Greater efficiencies expected - 40% of pharmacies are in a cluster where there are three or more pharmacies within 10 mins walk Pharmacy Access Scheme large-scale automated dispensing introduce a new terms of service for distance-selling pharmacies and differentiated payment Hub and spoke consultation

Pharmacy at the heart of the NHS There is real potential for far greater use of community pharmacy and pharmacists Aim - a clinically focussed community pharmacy service that is better integrated with primary care But where are their proposals?

Pharmacy Integration Fund (PhIF) Year one proposal - focused on key enablers to achieve integration of community pharmacy supporting the deployment of clinical pharmacists in a range of primary care settings, including GP practices, multi-speciality community providers, urgent care hubs, care homes and NHS 111 Care home group Urgent care group

PSNC’s proposed service developments PSNC’s proposals set out how the CPCF could develop in order to meet DH and NHS England’s stated aims They were presented to DH and NHS England as outline proposals to prompt further discussions with PSNC Set out in three phases – focussed on a care plan service

PSNC’s counterproposals Focus was on creating cash releasing cost savings for the NHS Short term focus; service development proposals still valid Not dispensed scheme, therapeutic and generic substitution, care homes, unwanted medicines campaign But also included proposals on service development Emergency supply service And a proposal for a Quality Payment/Framework

Quality payment Having a consultation room that meets MUR/NMS requirements; Provision of Advanced Services (MUR, NMS and flu vaccination); Maintenance of an up to date NHS Choices profile and NHS 111 Directory of Services listing; Having a programme for the provision of public health interventions to meet local population needs Training staff as health champions; Making interventions on prescriptions as part of the therapeutic substitution and not-dispensed services (described above); Participation in available locally commissioned services; Access to the Summary Care Record; and Participation in an annual medicines waste campaign and audit

Where have we got to in discussions? DH and NHS England are interested in Emergency supply (low fat version) Quality payments Pharmacy First/MAS – no national service – push locally… Clinical services review (chair - Richard Murray) Post-Brexit - David Mowat – announcement of non-implementation in October Further discussions with DH and NHS England now underway DH aim to announce the package in mid-October, to be implemented from 1st December

PwC report Assesses the value of community pharmacy Published 7th September 2016 psnc.org.uk/valueofpharmacy #valueofpharmacy

The estimated value of different community pharmacy services in England in 2015 varies considerably

Community Pharmacy FORWARD VIEW Supported by the Royal Pharmaceutical Society English Pharmacy Board

Context Health and care system facing major challenges and significant change People living longer Science and technology Health spending Community pharmacy’s potential Maximising efficiency across the wider NHS

United approach building on existing work Ongoing development of a long-term, sector and profession-led strategy

Thinking things through Joint workshop in April Key conclusions Sector needs to become master of its own destiny ….but does not need to reinvent the wheel Needs something that works with the NHS 5 Year Forward View Needs something that realises the ambition of the sector and profession Needs something that meets the needs of the public and the Government Something that realises community pharmacy’s potential

Forward View Outline The Forward View establishes a clear ambition for the future of the community pharmacy network This future is already here – everything described is being delivered or developed today Now need consistency across the country

Core functions of community pharmacy The facilitator of personalised care for people with long-term conditions Building on current services – MUR, NMS, eRD Based around principles of medicines optimisation Personalised care and support plans Aim - better health outcomes, controlled costs and reduced demand New approach to funding needed

Expanded services: illustrated pathway Illustrative care pathway for a person with multiple morbidities

Core functions of community pharmacy The trusted, convenient first port of call for episodic healthcare advice and treatment Seamless triage to and referral from community pharmacy ‘Pharmacy First’ ingrained in people’s behaviour Ability to add to an individual’s shared care record Diagnostics, point of care testing and prescribing all within community pharmacy setting

Core functions of community pharmacy The neighbourhood health and wellbeing hub ‘Go-to’ location for support, advice and resources on staying well Build on Healthy Living Pharmacy model Work with community leaders to understand local needs and develop services Great connections with other local organisations

Get involved contact@cpfv.info Get in touch and give us your feedback This is our starter-for-ten – now we want to work with colleagues to turn this shared vision into a reality Get in touch and give us your feedback Make suggestions on what steps need to be taken to help ensure this vision becomes a reality Share stories that illustrate how teams are already leading the way in improving outcomes as part of integrated local health systems Discuss the Community Pharmacy Forward View in more detail contact@cpfv.info

Conclusions Collective vision established Hope that partners in NHS, national and local government recognise and share this ambition Hope the vision resonates with people who lie behind it – pharmacists and their teams Hope it reflects the needs and ambitions of service users Now need to work with others to turn it into reality at both local and national levels

Read the Forward View or its executive summary in full at psnc. org Read the Forward View or its executive summary in full at psnc.org.uk/forwardview