Wouldn’t it be great if…
By Reena Barai, Owner of S.G. Barai Pharmacy, PSNC Committee Member, and Vision Steering Group Member
Wouldn’t it be great if… That’s how a vision starts. I’ve recently been interviewed by Nuffield Trust and The King’s Fund as part of PSNC’s Vision Project and it has been quite a cathartic experience to unload some of my thoughts on how pharmacy could operate in the future.
Whilst we are all well aware that community pharmacy teams cannot push themselves further on current budgets, the vision and strategic options we build now will be critical to getting a fairer deal for contractors in future negotiations.
There are so many things I want to do – just simple things like, for example, completing an episode of care. We can only do so much at the moment before we end up sending a patient to their GP. In an ideal world, it would be great to meet the needs of the patient from beginning to end.
If someone comes in with a mole that looks a bit dodgy, why can’t I refer them directly into the secondary care cancer pathway? If a woman complains she has a UTI, why can’t I prescribe an antibiotic and see her on her way? If a young lady comes in asking for EHC, why can’t I help her not only with her immediate need, but move her along by prescribing the pill for 3 months?
At the moment we can only do bits of the care pathway. In too many cases we have to refer patients on to get the episode of care completed. It is such a waste of resources. And we have the ludicrous situation that a pharmacist working in a GP practice can do most of these things – assuming they are a prescriber.
Wouldn’t it be great if people knew that they had to go to a pharmacy if they had a minor illness? Wouldn’t it be great if, in secondary care, instead of waiting hours for a TTO, a script could be sent electronically to the patient’s pharmacy? How much that would help free up beds and get people on their way home quicker.
What if local community pharmacies were more integrated with primary care teams so that they knew more about local health issues and who to target services at…
These sorts of things seem so logical to me. Community pharmacies see people when they are ill and when they are well. They are in the right places geographically to do so. They have, for the most part, good relationships with patients and customers. Many people know their pharmacist better than their GP these days.
These are some of the ‘starters for 10’ in my vision of the future. Have a think: what could pharmacy look like in the future for you? The Vision project currently underway with Nuffield Trust and The King’s Fund would be delighted to hear from you.
Think about every pharmacy having 2-3 pharmacists and a suite of consulting rooms… If I can vaccinate for flu and Covid, and give travel vaccinations, why not childhood vaccinations? Why can’t I have full access to a patient’s care record so others can see the care that I have provided? Wouldn’t that be great, and useful and helpful to everyone in the primary care team?
The nice thing about a vision (although perhaps also a dangerous thing) is that you don’t need to get too bogged down in the practicalities of implementation, of money and funding and NHS politics. That’s where the research and learning element comes in – and Nuffield Trust and The King’s Fund really come into their own with their expertise in the healthcare sector.
Back in the real world, I am worried about the change model that needs to stand alongside my ideas. That is probably the most difficult piece. How can we get the same level of service in every pharmacy in England? How do we get all the IT properly joined up? How will we integrate with local medical services? How will the funding work? But these are challenges that comes after the vision…
Given the current state of community pharmacy, I do recognise that funding and workforce are the big barriers that we will need to overcome to reach pharmacy Utopia. But that should not stop us thinking about how things could be in the future.
About this blog
Reena Barai is a member of the Vision Steering Group, but the views expressed in this blog are her own.
The open consultation on the Vision for Community runs until 11.59pm on Friday 9th December 2022.
In addition to the online survey, PSNC will be hosting some online engagement events next month (January 2023). These will allow any contractors who would prefer not to submit a written consultation response to input into this stage of the vision work. Details of how to register for these events will be published shortly.