And so another NHS reorganisation will come and go without making any of the necessary changes to community pharmacy contracting, funding, structure or integration.
Why community pharmacy isn’t recognised as ‘part of the NHS’ is beyond me.
Central commissioning which is at odds to local strategy and integration means it will continue to be ‘managed’ centrally and prevents it being a core part of locally directed integration, resulting inevitably in exacerbating health inequalities.
If you see community pharmacy as a business pure and simple, then the ‘shops’ in areas with a higher deprivation index will be adversely affected. When will the NHS recognise these are core services and need to be supported and protected?
By the way, I don’t mean just paying them more money.
I mean encouraging or requiring them to be part of local healthcare planning and strategy.
Primary Care Networks (PCNs) are a good start, but there is still no formal or financial arrangement so the success of PCNs working with community pharmacy will always depend solely on relationships.
Which isn’t equitable.
And it also doesn’t remove the semi-competitive relationship which can exist between GPs and community pharmacy. The flu vaccine service is an example and it looks like the Covid vaccine is heading that way.
If you did a proper stakeholder mapping of the healthcare system from a patient perspective (rather than from a commissioner or provider one) community pharmacy would be a lot closer to the top right than many other ‘true’ NHS services.
Essentially we need to decide, is community pharmacy a private or public provider.
If private then good luck to them, but the NHS needs to change the way it interacts with them. If public, then they need to be brought in properly, and take everything that goes along with it.
Either way, continually ignoring it isn’t the right answer.
Ewan Maule is a pharmacist.
