Pharmacy in a changing NHS

Use pharmacists’ expertise to help design NHS services for the future and improve patient care.

 

Pharmacy and the Long-Term Plan

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Pharmacists' clinical expertise will be crucial in delivering NHS England's Long-Term Plan over the next decade.

With £20 billion of funding allocated over five years, NHS England want organisations to work in partnership, to coordinate healthcare.

To get the most health benefit and the best value from medicines the NHS needs to support a system-wide approach to medicines optimisation.

This will be a challenge. Governance frameworks need to be established and local pharmacy leaders supported.

Some frameworks are already in place, such as Sustainability and Transformation Partnerships (STPs), Integrated Care Systems (ICS), Integrated Care Alliances (ICA), Primary Care Homes (PCH) and Primary Care Networks (PCN).

But, whatever terminology is used, local health and care leaders working together will ultimately decide how the NHS works in future, and pharmacists must be at the heart of these discussions.

Find out more in our new resource on pharmacy system leadership.

What's happening in Scotland and in Wales? To find out visit Working With Government.

About the NHS Long-Term Plan About the NHS Long-Term Plan

About the NHS Long-Term Plan

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The NHS Long-Term Plan, published in January 2019, sets out NHS England’s ambitions for improvement over the next decade, and its plans to meet them over a £20 billion five-year funding settlement.

It recognises that pharmacists’ skills and expertise are needed to achieve better health outcomes, improve patient safety and reduce medication errors. 

Proposed changes. as part of the new GP contract, include:

  • £4.5 billion investment in primary and community care, to help people stay healthier and out of hospital
  • Recruiting pharmacists as part of up to 20,000 staff to support Primary Care Networks.
  • Supporting clinical roles of pharmacists across primary care, such as community pharmacy, general practice and care homes
  • New ideas on how community pharmacists can support NHS Health Checks
  • Referring into community pharmacy from NHS 111 for minor illness (DMIRS)
  • Supporting prevention and detection of high-risk conditions, such as cardiovascular disease
  • A new workforce plan to be developed in 2019
  • Local health and care organisations working more closely together within ‘Integrated Care Systems’ by 2021.

The NHS Long-Term Plan stated that NHS England and the Government “will explore further efficiencies through reform of reimbursement and wider supply arrangements”. 

The PSNC, which negotiates with Government and the NHS on the community pharmacy contract, has published an animation about how community pharmacies are likely to fit into the NHS of the future.

RPS Director for England Ravi Sharma has been appointed to the new NHS Assembly, a national forum of health and care stakeholders to support the delivery of the NHS Long-Term Plan.

Primary Care Networks (PCN) Primary Care Networks (PCN)

Primary Care Networks

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NHS England’s Next Step On The NHS Five year Forward View (2017) included proposals for more GP practices to work together in ‘hubs’ or networks. 

Based on the premise that a combined patient population of at least 30-50,000 allows practices to share workforce, it builds on the Primary Care Home approach championed by the National Association for Primary Care.

The new workforce would include pharmacy teams and expand diagnostic facilities, sharing responsibility for urgent care and extended access.

Primary Care Networks would be linked to the proposed Integrated Care Systems – working across organisational boundaries with community, primary, secondary care, mental health and social care services.

From 1 July 2019, GP practices in Primary Care Networks will be able to receive funding for up to 20,000 additional staff, including:

  • Pharmacists
  • Physician associates
  • Physiotherapists
  • Community paramedics
  • Social prescribing link workers

as part of the new Network Contract Directed Enhanced Service.

In the longer term, an additional six full-time equivalent pharmacists could support every typical network of 50,000 patients - that's over 5,000 new pharmacist roles across England.

Each Primary Care Network is recruiting an accountable Clinical Director to oversee delivery. A clinical director ‘development support syllabus’ is expected to be produced to support these new leadership roles.

Pharmacists are already being appointed to these roles, which is very encouraging.

The RPS is continuing to work alongside pharmacy and other organisations on the evolving role of pharmacists and how different professions can work together to support patient care. 

Read our joint statements with the BMA and RCGP on Primary Care Networks and Clinical Pharmacists and Primary Care Networks and Community Pharmacists.

Community Pharmacist Consultation Service Community Pharmacist Consultation Service

Community Pharmacist Consultation Service

The NHS Community Pharmacist Consultation Service (CPCS) is a new national Advanced Service as part of the Community Pharmacy Contractual Framework. It will refer patients requiring low acuity advice, treatment and urgent repeat prescriptions for a consultation with a community pharmacist. This will see referrals from NHS 111 initially, with the potential for referrals from the other parts of the NHS in future, such as general practice.

It aims to reduce pressure on GPs and the urgent care system and is a step towards community pharmacy delivering more clinical services for patients. This service was developed following two successful pilots to integrate community pharmacy into local NHS urgent care pathways – the Digital Minor Illness Referral Service (DMIRS) and the NHS Urgent Medicines Supply Advanced service (NUMSAS).

More information, tools and FAQs are available on the PSNC website.

Integrated Care Systems (ICS) Integrated Care Systems (ICS)

Integrated Care Systems

The Long-Term Plan set out the ambition for local health and care organisations to become part of the new ‘Integrated Care Systems’ by 2021.

The Plan builds on the 44 Sustainability and Transformation Partnerships (STPs) developed since 2016. It will promote more integrated working, including between primary care, hospital trusts, local authorities, and the voluntary sector. Commissioners will make shared decisions with providers on how to use resources, design services and improve population health.

Read more about Integrated Care Systems

The Workforce Implementation Plan The Workforce Implementation Plan

The Workforce Implementation Plan
(also known as the ‘People Plan’)

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Having the right workforce in place will be vital to realising the ambitions of the Long-Term Plan. However, education and training currently falls outside of the NHS England budget and so was not included in the additional funding set aside by Government.

NHS Improvement has been leading on the development of a Workforce Implementation Plan, which will set out a vision for how the NHS workforce will transform over the next ten years.

The Interim Workforce Implementation Plan covers five main themes:

  1. Supporting staff recruitment and retention by making the NHS a better place to work
  2. Improving the NHS leadership culture
  3. Increasing the numbers of nurses and midwives
  4. Developing the skill mix and new role types as part of the multidisciplinary team
  5. Reviewing national, regional and local responsibilities for workforce planning.

Read our response to the Plan here.

This will require more Government funding, so a full implementation plan is expected following the Comprehensive Spending Review.

We are engaging with NHS England and NHS Improvement on workforce issues, including the need for investment in foundation training and professional development for pharmacists.