COMMUNITY PHARMACIES ARE ‘SHOCK ABSORBERS’

As PM Rishi Sunak tries to mitigate the ongoing NHS crisis, Asian Voice speaks to health leaders and community pharmacists to understand what they can do to help clear the backlog.

Shefali Saxena Thursday 12th January 2023 00:16 EST
 

Last Saturday, health leaders met with Prime Minister Rishi Sunak at the No 10 summit to discuss the “overwhelmed” NHS during crisis talks. While there is little clarity about who these health leaders were, according to iNews, Consultant physician James Dunbar, who took part in the NHS recovery forum in Downing Street, said that the primary problem facing the healthcare service was that the fronts of hospitals are “overwhelmed”, and that “a lot of” senior clinical leaders taking part in the meeting were “saying the same thing”. The Prime Minister reportedly said during his talk at Downing Street that a “business-as-usual mindset won’t fix the challenges we face”.

“During the pandemic we had to bring boldness and radicalism to how we did things in order to get through,” he said, according to Downing Street.

“I think we need that same bold and radical approach now because a business-as-usual mindset won’t fix the challenges we face.”

 

Jay Patel, executive director of Day Lewis pharmacy group, reportedly raised the role that community pharmacies can play in easing the pressure on the NHS, suggesting it carry out Strep A testing and ease pressure on GPs by prescribing repeat prescriptions. Speaking to reporters prior to the meeting, he said: “I’m hoping that we can look for high impact and quick interventions so that community pharmacy can play a role in alleviating the current pressures. At the moment there is a massive surge in Strep A. With the right protocols, we could test and treat Strep A.” He added: “These aren’t difficult things to do. It is a case of training a professional for a few hours and having access to the relevant test kits. If we have better control of our repeat prescriptions, we could take the pressure off GPs.”

 

Dr Leyla Hannbeck, Chief Executive, Association of Independent Multiple Pharmacies told the newsweekly, “Our member and board member Jay Patel, director of Day Lewis Pharmacy group attended the pan-healthcare meeting led by the Prime Minister and Secretary of State for Health and Social Care representing community pharmacy at the meeting. He articulated our key messages on behalf of the sector clearly and concisely. Pharmacy has so much to offer the healthcare system, but years of underfunding has led to the sector being under immense pressure. We can be a big solution to the NHS, but we cannot be asked to do more for less. We now hope that decision makers take forward these packages of measures which are frankly long overdue.” 

 

Listing some solutions to lessen the burden on the NHS, Dr Leyla Hannbeck said that we need to reduce demand on GP services by using a pharmacy-first scheme (appropriate funding) by utilising the network and its ubiquitous distribution to assist the prevention agenda — this could involve screening, ill health detection and behavioural support for lifestyle choices. The UK needs a national vaccination programme which makes pharmacies the ‘go to place’ for public health vaccinations - reducing the burden on GP surgeries and reducing hospital admissions and a bigger role for pharmacies in the management of long-term conditions. She stated that there have to be more substantive measures to improve the culture and the leadership that drives the culture in regard to community pharmacy This can only happen with enablers like investment in service provision and adequate funding for example increase in the current global sum to get the sector out of this cash flow crisis, support for our workforce and headroom to train, support and deliver the services outlined above and change is needed in the current culture within NHS leadership to allow a pharmacy to be viewed as a solution to the NHS.

 

Gareth Jones, Director Corporate Affairs, National Pharmacy Association believes that pharmacies already play a big role in taking pressure off GPs and hospitals, by providing convenient access to healthcare services in the community. Speaking to Asian Voice, he said, “A fully funded NHS ‘pharmacy first’ service that gives people easy access to advice and treatment for minor illnesses, like cough and colds and tummy ache, would divert millions more unnecessary appointments with hospitals and GPs. This can be set up relatively quickly in community pharmacies across the country and at a fractional cost in relation to the overall budget for NHS England. Many more pharmacists will soon be prescribers, allowing them to provide a wide range of treatments without the patient needing to wait to see a GP. It could be transformative in terms of access to NHS primary care. The starting point, however, needs to be a reversal of the huge funding cuts endured by the community pharmacy sector in recent years; the sector can’t help the NHS get off its knees when pharmacies themselves are at breaking point.”

 

Pharmacies are the ‘shock absorbers’

 

While further talks between the Royal College of Nursing and the Government are due to take place next week, we also spoke to community pharmacists who gave a promising perspective on how they can help in reducing the burden on NHS GPs, not just with ease of accessibility but also by using the power of interpersonal communication with the locals on a day to day basis, which is otherwise not possible for patients in the current healthcare system which is running on backlogs, staff shortage and ambulance strikes.

 

Sanaa Shah, a Clinical Pharmacist from Greater Manchester spoke to the newsweekly about the importance of the interpersonal connection that community pharmacists nurture with the members of the community that helps in ease of treatment for many suffering from lifestyle diseases. Sanaa said, “Pharmacists can help patients to navigate the NHS, they can differentiate between a minor illness and when a referral is required, signposting to appropriate services. Community Pharmacists are at the heart of local communities. The accessibility and familiarity of their community pharmacy teams can be incredibly reassuring for patients.”

“Pharmacists are experts in medication - this includes prescription medication as well as over-the-counter remedies. Being experts in medications means pharmacists are best placed to advise on drug side effects, interactions and general medicines management. Community pharmacies can also offer consultations and remedies for minor ailments such as coughs, colds, and sore throats. Some pharmacies also offer services such as weight loss, smoking cessation, blood pressure checks, cholesterol checks, and vaccinations,” she added. 

 

Reena Barai, Community Pharmacist at S G Barai Pharmacy told us that pharmacies like hers have been easing the pressure on the NHS for years. She said, “We are an unrecognised ‘shock absorber’. Especially in this current crisis, we’ve seen so many people who have been ill over the festive season, so many children with suspected Strep A infections and yet frustratingly, we have not been able to use our skills to the maximum benefit of our patients.  I’ve had so many instances where despite me having the ‘ability’ to physically examine a patient and prescribe a suitable medication because the NHS hasn’t bestowed the ‘power’ for me to do so, I have had to refer patients back to already stretched GPs or 111.  There is so much more Community Pharmacy teams can do to be a solution to the crisis, yet we need the government to invest in the sector and empower us to do so.”

 

AI can assist in this quest 

 

From a frontline doctor’s perspective, NHS Physician and Chair, BAPIO Institute for Health Research Dr Indranil Chakravorty MBE writes in his column (See P6), “The UK has a singular professional regulation authority which has overarching control over the nine different regulators. This is where pharmacists working within community hubs can utilise their skills in deciding which pharmaceutical agents are suitable for different conditions, taking into account individual characteristics, interactions and tolerability. The doctors can focus on what they are trained for, which is synthesising a myriad of conditions to decide what the differential diagnosis should include, and which set of investigations should lead to the answer. AI can assist in this quest and is superior to a single doctor with limited experience in making a wide-enough diagnostic list. But all these are ideas for a long-term transformative look at the future of publicly funded health services.” 


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