Is Community Pharmacy part of the NHS?
This is a really interesting question with no clear answer. It is a bit contentious and swings with the mood of people. However, it remains an important question that requires a proper answer.
Surprisingly, many pharmacists working in community pharmacy do believe that they are part of the NHS. The pharmacy that they work in has an NHS logo above the door, will have NHS materials on offer. They may have working relationships with hospitals, GP practices and community units and talk endlessly about integrated services and seamless care. They talk about people who enter their pharmacies as ‘their patients’ and take responsibility for aspects of their health, wellbeing and care.
But they are not allowed to join the NHS Pension Scheme. Pharmacists in hospitals and General Practice are – because they are part of the NHS. This may be established from way back in history when community pharmacies were seen as a business and had a significant private retail element to their business. This is no longer the case and many Community Pharmacies are 90% NHS income.
What about premises. Many community pharmacy premises are used mainly for the delivery of the NHS contract. When a community pharmacy wants to upgrade their premises, either through a refit or extension they have to fund this out of their own pockets. So the community pharmacy that delivers the pharmacy contract and bears the NHS logo is 100% supported by the owner of that business. There may be pharmacies that need a refit and development of clinical space – the NHS offers no help to them. The NHS has limited responsibility for the quality and state of the community pharmacy estate.
On the other hand George Osborne committed £1b to the GP infrastructure plan. GPs are allowed to claim notional rent, cost rent or leasehold cost reimbursements. GPs are financially supported to expand their premises. Many GP principles own their premises. The NHS pays them notional rent, based on a calculation of what they would have to pay to lease their own property from themselves. If the NHS supports capital investment, then the rent would be reassessed and payments increase to reflect the value of the improvement. Should the GPs hand back their contracts, then they may be the owner of valuable premises that have received significant funding from taxpayers through the NHS.
At the moment it is easy to suggest that NHS England does not consider Pharmacies or Community Pharmacists to be part of the NHS. Permission to use a logo is a step in the right direction, but it is hardly a great commitment. NHS England doesn’t really look after their community pharmacists or their pharmacy estates.
The Rt Honourable Steve Brine said at the RPS conference that he was committed to improve the integration of community pharmacy into primary care and public health pathways. He knows that pharmacy professionals are committed to the NHS. Perhaps it is about time to change the basis of that arrangement:
- Please support community pharmacists to be seen as a core part of the NHS and open up the ability for them to join the NHS pension scheme.
- Please support the development of community pharmacy premises, ensuring that we have an estate that is fit for the future demands of the NHS.