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

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

3. 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

4. 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?

5. 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

6. 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

7. 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

8. 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

9. 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

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

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

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

14. 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

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

16. 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

17. 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

18. 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

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

20. 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

21. 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

22. 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

23. 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

24. 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