The three reasons why the push to increase the role of pharmacies is being undermined
It is an exciting time for community pharmacy. The end of this month will mark three months of Pharmacy First in England, the scheme to expand pharmacy services that NHS England hopes will save 10 million GP appointments a year.
Official data on the number of Pharmacy First consultations is yet to be published, though the early signs appear positive. National pharmacy bodies and the government were quick to highlight in February that there had been around 3,000 consultations nationally in the first three days. Figures show that over 95% of pharmacies in England have signed up to the scheme.
Our research
Our research, published this week, also outlines that, even before the scheme launched, most of the public was already more likely to go to a pharmacy than a GP for five of the seven new conditions.
However, alongside some promising indications for Pharmacy First, our research reveals the barriers people face in using pharmacy services. Let us focus on the three most pressing obstacles and what healthcare leaders should do to address them.
Access barriers
Cost of living
First, cost-of-living pressures continue to dissuade or prevent members of the public from using healthcare services. Pharmacy is no exception, and, though the picture has improved since last year, our data shows around one in 20 people are avoiding either getting an NHS prescription or the over-the-counter medication due to cost.
Let’s make it easier for pharmacy users to afford treatment, particularly those who use services the most. One way to do so is through prescription prepayment certificates (PPCs), which allow people to save money on multiple prescriptions. FOI data from 2021 showed that over a million people could have saved money through PPCs, yet many are unaware. NHS Business Services Authority, which has data on prescriptions, should proactively promote PPCs to those who would benefit, while physical versions of the certificates must be available through pharmacies for those unable to order online.
Closures
Second, closures are causing significant frustration among patients and discouraging engagement with pharmacies. Permanent closures have caused the most disruption, with the overall number of pharmacies at its lowest level since 2016 and the poorest areas most affected by closures. However, temporary closures are also common, particularly over busy periods like lunchtime. We hear from people that this is due to the absence of a qualified pharmacist on site and the lack of available locums.
The success of initiatives such as Pharmacy First will rely on patients feeling confident they can get ‘walk-in’ treatment for common health conditions at their local pharmacy instead of their GP. Until addressed, closures may continue to affect that confidence. Workforce training must be targeted towards the areas with the most significant shortages of pharmacists, while patients should have access to better ‘real-time’ information on closures through the NHS website and NHS App.
Medicine shortages
Third, Healthwatch England continues to hear how medicine shortages wreak havoc on patients. Our polling at the end of last year showed that one in four members of the public in England had experienced medicine shortages in the preceding 12 months.
Shortages of painkillers, hormone replacement therapy, and ADHD medication, among many others, have led to rationing and desperate instances of ‘pharmacy bingo’, where patients must travel from pharmacy to pharmacy looking for stock.
We are calling on the government to review the medicine supply chain to ensure medicine safety and resilience. And, where safe to do so, pharmacy teams should be given flexibility to make changes to medicines they dispense in collaboration with patients.
The future for community pharmacy looks bright. The public has welcomed the option of being seen for more conditions in their pharmacy rather than through their GP. Indeed, in the long term, our research shows they want to see further expansion of services offered by pharmacies in future, particularly in areas like vaccinations and dermatology services.
However, the sector mustn’t run before it can walk. National decision-makers and local commissioners should work closely with pharmacies and patients to address the core barriers people face to using pharmacy services, starting with the three outlined above.
The blog was originally published on Health Service Journal, hsj.co.uk, on 1 May 2024.
