The COVID pandemic has exposed the fragility of our health systems in the UK, says Steve Anderson, CEO of the PHOENIX group. General practitioners are now being asked to postpone or cancel routine exams and instead focus on COVID vaccinations. While this can lead to fewer COVID-related hospitalizations, there is a risk of hospitalizations due to heart attacks, strokes, and cancer that might otherwise have been prevented with early detection.

If general practitioners, naturally, cannot provide such early detection, then rather than abandon them for risk groups, why not turn to other professional health care providers – such as the community pharmacy – to take on this role? These checks are vital and fall within the professional competence of community pharmacy.

Clearly our “GP first for every condition you may have” approach simply cannot cope with the volume, depth and breadth of patient demand. It has been tested to destruction. We have too few GPs per capita, many existing GPs are reaching retirement age and others are leaving due to the stress of an incredible and relentless workload.

We need to radically rethink how we provide people with the right care at the right time in the right setting with the most appropriate healthcare professional. This means harnessing the full potential of community pharmacy and, as Health Secretary Sajid Javid recently said, taking a ‘pharmacy first’ approach.

These are welcome words, but they must be backed by fair and sustainable funding and investment to alleviate current workforce capacity issues. The community pharmacy wants to provide more services to patients and is ideally placed to do so – trusted by the public and accessible in all localities – but it faces an acute shortage of pharmacists and pharmacy technicians: a situation that will never do. That getting worse as NCPs / health boards step up their efforts to recruit these skilled professionals into paid NHS roles. Stealing Peter to pay Paul is a zero-sum game in terms of improving patient care.

In England, the hope is that integrated health care systems run by general practitioners will become the means to reinvent the local health care delivery. In some parts of the country, onboarding councils are embracing community pharmacy, but not in others, so we end up with a continuation of the lottery making available by zip code with Joe Public confused as to when to should see their local pharmacist rather than their GP.

The current pharmacy contract lacks imagination, no longer meets the needs of today’s patients and is economically illiterate. For example, CPCS references are a welcome, but poorly thought out, development. The pharmacy will be paid for a referral, but not for a walk-in visit for the same condition. Therefore, if the pharmacy provides exceptional service and the patient’s condition surely returns, he will go directly to the pharmacist rather than his GP: if he does, then no cost to the pharmacy. As it stands, the contract does not reward pharmacies for exceptional performance.

COVID is expected to be a game-changer for the delivery of health care. Phone and video triage by GPs is here to stay, like it or not, and the pharmacy must embrace virtual triage as well, but its USP must act as the necessary physical intervention gateway that can then lead to additional support for health care.


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