Every day there is a commitment to creating more healthcare professionals. We need thousands of GPs, thousands of nurses and now thousands of mental health workers. There is a pool – and when you pull from one it creates a shortage in another. It takes years to train and nurture healthcare professionals and then we reduce their income and make them work harder – unjustly it is just the way it is. While we fiddle, valuable professionals look towards their retirement, move to agencies and find better paid jobs elsewhere. The spirit only lasts so long before camaraderie and the value of doing a valued job wears thin.
We could always look overseas – try to attract healthcare professionals from other countries to come and work here. This was very successful – it keeps us going for now, but we need to do more.
We could put all of our hopes in technology, supplying services through the internet and connecting services to create efficiency and share expertise. It will help, but it is hardly the replacement for one-to-one contact and a personal experience. I reflect that it was the joy of one-to-one interactions that first brought me into the NHS and for many patients it is the one thing that they value most.
We must understand and use our resources better. The program to put pharmacists into General Practice is not new. I worked with GPs 20 years ago and I hope that they found my help valuable. It took 20 years for the NHS to catch on and launch their program to pump prime pharmacist placement. Fantastic, I say, knowing that my local GP federation are now looking for at least 14 pharmacists. But what we will discover soon is that we have a lot of pharmacists, but not ones with the necessary skills. It does make you wonder what workforce planning is all about. But we will succeed, training and supervision will now happen and after a rocky start this program will fly and we will see an increasing number of patients benefiting from seeing a pharmacist in General Practice.
We also have 10,000 pharmacies in England. As dispensing medicines becomes automated and delivered to your door or popped in a convenient collection locker – what is the plan? Is ‘close them’ the right answer?
As I watch high streets decline, the post office is gone, the banks are going the Pharmacy is the anchor store that remains. Do councils appreciate that when they go the high street dies? Do they want to build healthy communities without a Pharmacy as a central point?
It is about time that we took a second look and a hard think about what we want of a local healthcare provider – often open long hours and still offering one-to-one and face-to-face contact. What might we want / need:
- Full minor illness management with integration in existing out of hours services
- Active delivery of public health services and the creation of health and wellness services
- Point of care diagnostics
- Long term condition management
- Managing medicines for housebound and frail elderly
Then we need to plan for this – engage owners and look at the training and developmental needs of front line pharmacists. Support the redesign and development of pharmacies. And start developing a wider training program that works.
We need a stronger structure that better links NHS England via the LPNs to the LPCs and individual contractors.
It isn’t really difficult- it just needs some vision and the will to do it. While there is no magical GP or practice nurse tree – we could create something special by developing our pharmacy led healthcare on the high street.