Patient services and community pharmacy: April 2013

From Andy Murdock, External Relations & Policy Director, Celesio UK

 In one of his regular blogs Roy Lilly, a healthcare commentator renowned for his controversial, but thought provoking views stated that community pharmacists should forget about providing patient services and should instead focus on making money by selling lipstick.

 Readers will not be surprised when I say I fundamentally disagree with Roy’s rather tongue in cheek suggestion. Let me explain why because it is important that people like Roy understand why providing patient services in community pharmacies is not a “nice to have” in our healthcare system, it is a “must” have for our healthcare system.

 We all know that the NHS is creaking at the seams and frankly providing poor care for far too many patients. That should not surprise anyone because fundamentally the NHS was designed to diagnose and treat those who become ill. That is what it delivers and does so, for the most part, with exceptions such as Mid Staffordshire, exceptionally well, although we know it is creaking at the seams.

 However, the greatest healthcare challenges we face nowadays and will increasingly face in the years ahead are not diagnosing then treating those who become ill, rather they are preventing people becoming ill in the first place and providing an on-going care pathway for those who develop long-term conditions.

 Unfortunately, our healthcare was not designed and is still not structured to meet those particular challenges. If it was we would not have a million or so people with undiagnosed type 2 diabetes or between 30 to 50% of patients not taking their medications as directed if at all or the thousand plus avoidable deaths among asthma sufferers.

 Most of those who live unhealthy lifestyles and who are therefore at risk of developing serious conditions such as type 2 diabetes do not necessarily think of themselves as being ill and therefore do not see the need to visit their local GP surgery. Yet community pharmacies are ideally placed to act as local health hubs.

 Similarly most GP surgeries do not have the capacity to provide the kind of on-going care which those with long-term conditions require, in particular medicines optimisation. In response some people have said surgeries should have a clinical pharmacist to work alongside GPs and nurses, but that fundamentally misses the point: we already have the healthcare assets we need to provide that service – they are called community pharmacies.

 I accept that a diabetic specialist nurse probably knows more about that condition than your average pharmacist, but they cannot in the same way advise on the four, five or more medicines some diabetic patients take for other conditions.

 So why don’t we see those nurses or even GPs undertaking outreach activity based in local community pharmacies working alongside the pharmacist or pharmacy staff to provide better support to those with conditions at high risk of developing avoidable complications? After all, the bricks and mortar, the consultation rooms as well as the professional expertise in medicines already exist.

 I am concerned that too often community pharmacy is portrayed as just another “Any Qualified Provider” of services and not, as I believe we are, one of the foundation stones of a modern healthcare system alongside another contracted service namely GPs.

 That, Roy, is why we need more community pharmacies providing more patient services.