Pharmacies and Integrated Healthcare: England

Debate between David Mowat and Anne Main

Wednesday 11th January 2017 Westminster Hall

[David Mowat]

I completely agree. Pharmacists have a big role to play in saving money, and medicines optimisation is very important in that. NHS England has established an integration fund, which will provide £42 million—a significant amount, even in the context of the rebalancing that has occurred—of seed money between now and the end of the next financial year to address just those sorts of things and take that work further.

The Murray review, which was commissioned by Dr Ridge, the chief pharmaceutical officer at NHS England, and published in December, sets out in some detail what we believe the direction of travel should be. Someone asked earlier when the Government will respond to that review. I expect NHS England to respond this month—if I may put that on the record in that way. NHS England will respond, not me, but there is not a lot in the review that is controversial. There are a lot of very good points, many of them about IT integration and the care record. I agree completely that some of the progress we need to make with services involves the ability to both read and write to the summary care record. That will be part of where we have to get to. Frankly, technology is an area in which the NHS could improve. That is true in Scotland—it is true everywhere. I will not spend a lot of time talking about what we need to do, but we could facilitate an awful lot of progress on integration between pharmacy and primary care, and primary care and secondary care, if we had stronger technological and IT solutions.

Colleagues have talked about the need to have more pharmacy involvement in medicines optimisation, and care homes are part of that. Pharmacists could do an awful lot with a more structured approach to care homes. One strand of work that has come out of the integration fund is a care homes taskforce, which is chaired jointly by the Royal Pharmaceutical Society and NHS England and is setting out a direction of travel for doing the sorts of things we have talked about, such as medicines optimisation, in a more structured way in care homes right across the country. There are more than 50,000 qualified pharmacists across our country. There are also 23,000 qualified pharmacy technicians, who are part of this too. The pharmacist profession is not as short as some, and it can and needs to do more to make progress in this area.

One part of the Government’s approach to this whole area that has been mentioned and I do not think enough is made of is the GP forward view. Everyone understands how much pressure GPs are under. There are something like 400 clinical pharmacists working in GP practices. We have committed and budgeted £112 million to increase that to 2,000 clinical pharmacists, many of them dispensing pharmacists. Parts of the community pharmacy network, which we have heard a little about, regard that as potentially in conflict with what they do. I think that is wrong. It is not in conflict; it is a way of breaking down the barriers that I accept there have occasionally been between CCGs and GPs and the pharmacy profession. Those are not in anyone’s interests, and we need to get over them.

[Mrs Main]

The only concern I have about too much of a drift towards putting pharmacists in GP surgeries is that GP surgeries have limited opening hours. Many pharmacies have a drop-in service. My hon. Friend the Member for St Austell and Newquay (Steve Double) mentioned the average waiting time of eight minutes. Having a link between booking a GP appointment and going to the pharmacy would start to bring people back into GP services rather than keeping them outside those services. That is the only concern I have about that matter.

[David Mowat]

That is of course a valid concern. We are trying to make progress on having GP services open for much longer than they have been historically, including weekend opening. Several colleagues have made the point—the Murray review also addressed this—that there is occasionally a barrier between the attitudes of some GPs and what can be done by pharmacists. That is true. We must be conscious that it behoves us to try to encourage the breaking down of that barrier, and misplaced professional pride must not prevent us from doing things to the best extent. Putting some pharmacists in GP practices—particularly with new models of working in which more disciplines tend to work together and a GP does not just work on his own—is an important part of that.