Community Pharmacies

Kevin Barron Excerpts

Wednesday 2nd October 2019 Westminster Hall

[Sir Kevin Barron (Rother Valley) (Lab)]

It is a pleasure to serve under your chairmanship, Sir David. I thank my hon. Friend the Member for Halifax (Holly Lynch) for securing the debate. I have a non-financial interest to declare: I chair the all-party group on pharmacy.

Community pharmacies play a major role in supporting the prevention agenda, which is a key development in the NHS long-term plan. As an integral part of the NHS, they are also a valued community facility with a positive track record of improving access to healthcare services. Compared with GP surgeries, there are more than 11,600 community pharmacies across England, and 89% of the population are estimated to have access to one within a 20-minute walk. That percentage rises to 99% in the most deprived areas of our country. We should recognise that community pharmacies are crucial.

There is still much more that could be done to unlock the huge potential of pharmacies and to further integrate them with emerging local healthcare networks. For example, service commissioning is patchy across the country, meaning that not all patients can access the same services from their local community pharmacies. More than 95% of community pharmacies now have a private consultation room from which they can offer advice to patients and a range of nationally commissioned services, such as the flu vaccination service. In 2018-19, 1.4 million flu vaccinations took place in community pharmacies. Two years ago, when the service was first introduced, other parts of the medical profession did not like the idea of pharmacies moving into that area, but the figures show that it was a good idea.

The new medicine service allows pharmacies to provide support for people with long-term conditions who have been newly prescribed a medicine to help improve medicine adherence. My hon. Friend mentioned it in relation to the elderly. I am sure we all know that more than 70% of NHS expenditure in the UK is on people with long-term conditions in the acute or primary sector. It is important to recognise that. Many pharmacies are commissioned to offer public health services by local authorities and the NHS.

On the new national services in 2019-20, my hon. Friend mentioned the community pharmacist consultation service, which is something we should look forward to, with the community pharmacists as the first port of call for minor illness or for the urgent supply of medicines. Pharmacies will offer patients a consultation to help manage their minor illnesses or provide an emergency supply of medicine. The service will take referrals from NHS 111, but in years to come such referrals could come from other settings such as GP practices and the NHS online. That is a progressive move so that we can access services far better than we can at the moment. We will see how it goes.

The other national service is hepatitis C testing. Pharmacies will offer testing for people using pharmacy needle and syringe programmes to support the national hepatitis C elimination programme. There will, however, be an extension of the reach of the six mandated public health campaigns that community pharmacies have to take part in, and many community pharmacies will also choose to take part in the pharmacy quality scheme. This year, that might involve preparing for engagement with primary care networks, which is crucial. When I first talked to my local primary care network about where the pharmacy fits in with this, they were not at all sure. We also have: carrying out audits on prescribing safety for lithium, on pregnancy prevention for women taking valproate, and on the use of non-steroidal anti-inflammatory drugs; checking with patients with diabetes whether they have had annual foot and eye checks; reducing the volume of sugar-sweetened beverages; complete training and assessment on look-alike, sound-alike errors, which is crucial for us all; updating risk reviews; completing sepsis online training and assessment, along with risk mitigation; and completing the dementia-friendly environment standards.

From April 2020, all pharmacies will be required to be able to process electronic prescriptions and to have attained healthy living pharmacy level 1 status. Accreditation will mean the pharmacies are local hubs for promoting health, wellbeing and self-care, and providing services to prevent ill health. That is the real move we should be seeing in community pharmacy now, to promote population health and reduce health inequalities. Pharmacies have a major role to play in that.

With regard to other future pharmacy service developments, as part of the five-year deal community pharmacies may also be able to support the appropriate use of medicines through the expansion of the new medicine service to other conditions. In addition, the NHS will use the national pharmacy integration fund to pilot services for potential roll-out. These include a model for detecting undiagnosed cardiovascular diseases and smoking cessation referrals from secondary care. That is crucial—this is a matter for another day—when we see the reduction in smoking cessation services here in the UK, yet still more than 85,000 of our fellow citizens are dying prematurely each year from smoking-related disease.

Further services include: the use of point-of-care testing around minor illnesses to support efforts to tackle antimicrobial resistance; routine monitoring of patients, such as those taking oral contraception, under an electronic repeat dispensing arrangement; activity to support primary care network priorities, such as early cancer diagnosis and tackling health inequalities; and a service to improve access to palliative care. These are the ideas that the community pharmacy has got and where it is going to move in the next five years. That is crucial.

Once again, I thank my hon. Friend the Member for Halifax for securing the debate and providing this opportunity. The issue of expenditure has been mentioned, although I will not go into the history of it now. The Minister will be acutely aware that when we had the pharmacy integration fund, it was set aside after the cut. In fact, it was not used very well and lots of money was left in there. We are now moving into areas where that money should have been used. It is crucial that we get the money now on the table into frontline pharmacy services.