The solution to the woes of the NHS may seem simple. Once you appreciate that we have a growing, aging population with more long term conditions and you have stripped out some of the bureaucracy and inefficiency, controlled agency/consultancy spend, reorganised and introduced new models of care you are back to the same issue.
We need to either reduce demand or increase capacity. And we have little money to pay for either. That might be the end of the blog, but we do need to think outside of the box, push the envelope or dip into blue sky – whatever the current buzzword of the day.
Housing Associations have entered the discussion big time. They want tenants that are regular payers of rent – they need their tenants to be mentally and physically well. The NHS needs their tenants to be mentally and physically well. Again we could end here, but housing plays an important role in the success of communities and the associations will support enablement, recovery and health creation.
The Police and fire services understand that health communities have less crime and they play an increasing role to improve troubled communities.
But what of Community Pharmacy? The sceptics might say they are a tricky bunch to manage and are variable in their delivery – there are fantastic examples of service provision, but that is not consistent. However the government needs to think of community pharmacy firstly as an owner and secondly as a member of the pharmacy team. The pharmacy owner needs to see a sustainable business proposal that would encourage them to invest their money in training and development to provide expanded and additional services. The Pharmacy team needs space to deliver proactive clinical community pharmacy services, with the feedback and support included.
So can community pharmacy reduce demand – yes – pharmacy first (minor ailment schemes) and basic responding to symptoms help people to manage their own care. It reduces demand and saves the NHS money. I could easy add that a minor ailment scheme consultation cost is about £3 and the equivalent GP consultation about £30, but the reality is that there are not enough GPs around and practices are too busy.
CCGs are trying to push the supply of OTC medicines from GPs to Community Pharmacy – where they should really be establishing community pharmacy as the gatekeeper to General Practice to facilitate the process.
So can community pharmacy increase capacity – yes. Community pharmacy represents the unique retail arm of the NHS. Gaps in NHS provision can be plugged by community pharmacy. And in some situations there are no funding requirements – how about that – increasing capacity for no additional cost to the NHS.
It is time for a better discussion with community pharmacy – bring them centre stage and see what they could do.