Community Pharmacies

Maria Caulfield Excerpts

Tuesday 21st June 2022 Westminster Hall

[The Parliamentary Under-Secretary of State for Health and Social Care (Maria Caulfield)]

It is a pleasure to serve under your chairmanship, Sir Gary. I thank the hon. Member for Bootle (Peter Dowd) for securing this debate. He is pushing at an open door, as I am a huge supporter of community pharmacists.

The evangelising of my right hon. Friend the Member for South Holland and The Deepings (Sir John Hayes) is definitely working. Community pharmacies are front and centre of the changes we want when developing primary care. Of course, they are already a central part of the NHS, delivering vital primary care services at the heart of every community throughout the country and ensuring that patients have timely access to medicine. That is one of the lesser elements of the services we have talked about, but it is an important element that keeps patients well and out of hospital, enables them to get discharged safely and prevents readmission.

Community pharmacies are offering more services and they are accessible to all. They are key in providing self-care support, thereby allowing individuals to manage their own healthcare needs and, in turn, increasing capacity for the NHS overall. Community pharmacists are an easily accessible and trusted part of the NHS: a team of highly skilled, qualified, experienced healthcare professionals. There are more than 11,000 community pharmacies across England, 80% of which are around a 20-minute walk from most people’s homes. I am committed to making the best possible use of their resources and talent.

As many Members said, we saw the clear difference that community pharmacies made during the covid pandemic. They stepped up to implement a medicines delivery service for shielding and isolating patients. They implemented Pharmacy Collect, making lateral flow tests widely available to the public. At the height of the vaccination programme there were more than 1,500 community pharmacy-led covid vaccination centres. There is no doubt that they stepped up to the mark and showcased what they could offer.

We have a clear vision for community pharmacy. In 2019, we agreed the landmark five-year deal, the community pharmacy contractual framework, which commits to £2.592 billion of funding for the sector. It also sets out a joint vision for the Government, NHS England and the Pharmaceutical Services Negotiating Committee for how pharmacy services will support the delivery of the NHS long-term plan. We are in negotiations for year 4 of that deal, so I am limited in what I can say about the funding, but I can reassure Members that the PSNC is negotiating hard and we want to work with it to expand services. Obviously, it is keen for funding to be attached.

[Sir John Hayes]

It is vital that, as the Minister described, the service is integrated. GPs must continue to offer out-of-hours services, weekend services and, most salient of all, face-to-face encounters with their patients. Services do a great job but that does not mean that GPs should not do all those things.

[Maria Caulfield]

Absolutely—it is not an either/or situation. We have enough capacity and patients to expand community pharmacy services, but that does not mean that we do not also need to support GPs and other primary care providers.

I thank the team at the Department of Health and Social Care; often, their work is not recognised, but they are working hard to develop some of the services that we have talked about. The community pharmacy consultation service went live in November. Patients can dial 111 and be directed to a community pharmacist for help with minor ailments or medication. We have extended that to GP surgeries, so now a receptionist can make an appointment at the local pharmacist for minor illness consultations.

It has been estimated that 20 million appointments in general practice alone do not require a GP—that does not mean we do not need GPs—and pharmacists can look after those conditions. The introduction of the scheme has been slightly slower than we would have liked, so there is work being done to help to overcome some of the barriers to referrals, because once they see their community pharmacists, patients have a positive experience.

In addition, the discharge medicines service enables hospitals to refer discharge patients to community pharmacists for support with their medicine. The evaluation of this service indicates that for every 23 consultations, one readmission is prevented. Where patients are readmitted, their stays are reduced by six days on average, which I think we can all agree is of huge value. We also have the blood pressure check service, which enables people with high blood pressure to be managed by their local community pharmacist, offering blood pressure checks.

We also have the stop smoking service to enable patients who started their stop smoking journey in hospital to continue with a community pharmacist, and we are looking at developing the role of community pharmacy teams, because it is not just the pharmacist who has clinical knowledge and skills. We are working in a number of areas to upskill the whole community pharmacy team so that they can deliver more and use their skills in a better way.

As has been mentioned, we now have NHS Direct cancer referrals, which community pharmacists will be able to take. Just to reassure the hon. Member for Bootle, we have 160 community diagnostic centres, which will be increasing the capacity to do some of those diagnostic tests, and we have already had 1 million visits to those centres. We are not just expecting pharmacists to refer into existing services; we are expanding the routes for diagnosis as well.

My hon. Friend the Member for Southend West (Anna Firth) beautifully told the story of Ask for ANI. It is so vital that a woman can go into a pharmacist, just say those few words and get help—they might not be able to go to a GP practice, because sometimes the help they are asking for might be more obvious.

We also have the minor ailments service, which is being rolled out throughout the country, so pharmacies are delivering more and more. The hon. Member for Coatbridge, Chryston and Bellshill (Steven Bonnar) knows that I am a pharmacy first supporter. I hate to admit it, but Scotland has taken the lead in that, although we are not afraid to learn lessons if that means learning from what Scotland has done.

On the Fuller stocktake and the future of primary care, just to reassure colleagues, we are not just looking at how general practice looks in the future; community pharmacy will also play a key part in that model. With the integrated care system set to go live on 1 July, we are working with those who will be making commissioning decisions in local communities to set out how that future will look.

We are considering all options for community pharmacy and how we build on the progress we have already made. It is important to say that although we have made progress, there is a lot more that can be done. We are developing new standards for the initial education and training of pharmacists, which are set to be implemented shortly, so that from 2026 all newly qualified pharmacists will be able to be independent prescribers—an essential skill that will help to deliver and develop the service further. For those who are not currently prescribers but would like to be, Health Education England is supporting the existing pharmacy workforce to undertake the required training and upskilling, and £15.9 million of funding support has been made available.

We are also looking at the use of patient group directions, because pharmacists have specifically asked for that, so there are a number of measures in place. We are listening to the community pharmacy community, and where we can make changes quickly and easily, we will.

Just to touch on the issue of violence, I want to be really clear that there is zero tolerance for abuse and violence against community pharmacists—and, indeed, against all primary care staff, whether receptionists, GPs or community pharmacists themselves. I also want to put on the record our thanks to the hon. Member for Coventry North West (Taiwo Owatemi) for her work in the NHS as a pharmacist and the experience she has brought to this debate. I reassure hon. Members that we are on a clear journey and we will be supporting community pharmacy going forward.