Expanding pharmacy services: From dispensing to comprehensive care

Around one in 20 patients in the UK waits an average of four weeks to see a GP from the date an appointment is booked.

GPs are under huge pressure to deal with growing patient lists and older populations with more complex health needs.

However, part of the pressure is created by the number of patients requesting a GP appointment for what would be considered a “minor ailment”.

In fact, around 13% of all “in hours” GP consultations were assessed to be for minor ailments that could have been handled by a community pharmacy, in one study.

This highlights the changing role of community pharmacies in the UK. Far from just dispensing medication, pharmacies play a much bigger role in community health care, providing a more consultative service for products and medications, while also becoming the first port of call for managing some long-term conditions.

Here we look at the role expanding pharmacy services plays not only in improving patient care, but in providing new revenue opportunities for community pharmacies.

Before you get into the blog, watch episode one of our new docuseries "The Game Changers of Community Pharmacy" by clicking the image below

Taking an interventionist approach to community care

Community pharmacies provide an easily accessible and affordable platform for improved community health care, and as they continue to take on more services, pharmacies are playing a much bigger role on the “front line” of community healthcare, relieving strain on other parts of the NHS.

Far from just dispensing medications to treat symptoms, pharmacies now play a leading role in interventionist consultations, providing help and guidance on wider health matters such as stopping smoking, contraception, healthy eating and wellbeing, as well as health monitoring (like blood pressure monitoring) and vaccinations.

For patients it means they have a much easier time booking appointments for a wider range of conditions, while GPs can focus more on complex cases.

For pharmacies, these changes present a huge opportunity, both to play a bigger part in healthcare and increase additional revenue streams, but also potentially rethink how their business operates, and what skills they need to improve or introduce to take advantage of the opportunities.

This is something highlighted in our new docuseries, The Game Changers of Community Pharmacy.

In episode one - The Visionary - second generation pharmacist Gurminder Singh says reskilling and upskilling has become a key focus for him:

“I’ve probably put more education into myself in the sense of doing more clinical training,” says Gurminder.

“As well as taking things to a more broader level, it probably also opened up my father’s eyes in proving what can be done and taking ourselves to the next level.”

He also highlights how these changes can help open up more services for patients and give them more control over their own health and lifestyle changes.

“If patients want to take their health into their own hands at their own costs then it needs to be affordable for them, but also accessible for them as well.

“From there they can have a gauge on their own body’s level of what they need to change in their diet, health and lifestyle [while pharmacists can offer] those preventative measures that the NHS currently do like blood pressure checks.

“By making it accessible for people, and then having more advanced treatments people can change their health.”

Taking the strain off GPs for some health conditions

The idea of pharmacies taking a bigger role in healthcare isn’t new.

The “Healthy Living Pharmacy” concept has been around since 2010, when HLPs started up in Portsmouth to deliver a wider range of additional services such as alcohol advice, weight management, stop smoking advice and NHS Health Checks.

As the scheme was rolled out further the results highlighted the critical role that pharmacies can play in the community when given the opportunity.

An evaluation of the services found that one in five people getting advice or services from their local pharmacy would not have received any support at all, while 60% said they would have gone to their local GP for support.

It is this last statistic that shows the wider benefits of pharmacies becoming more immersed in community healthcare.

By diverting patients away from their GP and towards community pharmacy services, patients were able to access services quicker (or that they wouldn’t have had access to at all) while GPs weren’t inundated with appointments for preventative advice and support.

And these additional services are only increasing, with pharmacies now able to prescribe medicines for some common conditions like sinusitis, sore throat, shingles and earaches without requiring a GP consultation first.

Pharmacists can also take a leading role in helping patients manage long-term conditions like asthma, arthritis, diabetes and high blood pressure.

Again, in order to take advantage of these opportunities, a rethink is needed about pharmacy operations, particularly when it comes to the role technology will play in helping manage additional services and patient data.

But as well as rethinking operations, Gurminder highlights how a mindset change is needed across the NHS, including within GP offices themselves and understanding which services can be diverted to a pharmacy.

He said: “What’s everyone’s first thought when they wake up and their ear is hurting, or they’ve got a sore throat? They’re going to call the doctor because it’s quite an acute thing, but it’s something that comes on quite quickly.

“Most peoples’ through straight away is to call the doctor’s office in that 8am window [to try and get an appointment]. Receptionists play a role then in recognising the minor ailments and referring the patient onto the pharmacy.”

Integrating systems for integrated services

Electronic order systems can make the process easier for patients to order medications and for patients to keep more accurate records.

But when you’re also delivering clinical services, pharmacists need more than their own dispensing records, they need access to patient records, which would normally be stored by the GP.

Integrated systems enable pharmacists to read information on patient records, so they have a full picture of any current conditions or medications, and also write directly to GP records (for example after a blood pressure consultation at the community pharmacy).

This not only allows pharmacists to read accurate information, but allows them to automatically update GP systems, ensuring that information is passed accurately, and securely between healthcare partners.

By enabling more reliable sharing of data electronically, it not only removes the potential for errors during manual duplication, but allows GPs and pharmacies to create more accurate records without requiring any additional work.

Not only that, integrating services allows pharmacists to more easily identify patients who are eligible for additional services so they can begin a dialogue.

Again this is highlighted by Gurminder in his Game Changers episode.

He comments: “There’s a big help at the moment with the New Medicine Service (NMS) in that it identifies the patients who may be eligible for the service, and then it [the Pharmacy Services system] can target those patients because the label comes out automatically from the dispenser so you can stick it on the bag and identify that patient when they come in.

“Then you can ask them if they’d like us to do the New Medicine Service with them and start that process. It’s also easier to follow up with that person afterwards and complete the service.”

What will the future pharmacy look like?

The successful rollout of new services and opportunities - like those presented by Pharmacy First - relies heavily on overcoming operational challenges within community pharmacies, as well as addressing the need for improving technology and IT systems to integrate pharmacies within the wider healthcare system.

Patients are already becoming more reliant on pharmacies and trusting of them when it comes to accessing advice on wider healthcare services, not just picking up prescriptions and over the counter medications.

More than 70% of people in the UK have used a community pharmacy in the last three months, according to one healthwatch report.

Many patients say they value the accessibility of community pharmacies, in terms of getting to a local pharmacy, and also the speed at which they’re seen once there.

Respondents to the health watch report also said they were open to the idea of going to a pharmacy rather than a GP for the services community pharmacies can now offer.

As patients become more accustomed and confident using pharmacy services rather than a GP, there is huge potential for services to expand further, with pharmacies having the time now to integrate additional revenue streams and integrate better technology to allow them to deliver more services while remaining efficient and profitable.

Gurminder predicts a key consideration for pharmacists is to keep a step ahead of changes as they’re introduced, particularly when it comes to pharmacists becoming independent prescribers in the future.

“It’s just predicting the movement of things,” he states. “Everything can change so you need to be flexible and then, as a baseline, keep true to your clinical knowledge, true to your overall ethics of practice and try to do everything to the best of your standard.

“The first cohort of uni students going into pharmacy [this year] will be coming out as independent prescribers. In for to five years every pharmacist is going to be a prescriber, and if you’re not then you’re not going to survive.”

Make the most of new pharmacy opportunities with Cegedim

As the role of community pharmacies continues to grow it’s more important than ever that they rethink how they operate and how they can improve to be able to take advantage of new commercial opportunities as well as provide better patient care.

With 43% of patients saying a pharmacy would be their first choice to access the new services available, compared to 30% who would still use a GP, it is clear how big the opportunity presented to pharmacies is.

Rolling out new technology to enable the delivery, reporting and reimbursement of new services is critical.

Whether it’s automating manual processes and using robotic dispensing to speed up and improve medication management for patients, or using real time data to make better decisions and remove inefficiencies, the tools are there ready for pharmacies to take advantage.

And pharmacies around the UK are already taking advantage of these opportunities.

Watch the full episode of Game Changers: The Visionary and see as Gurminder tries to bring to life a new vision for his family’s already successful pharmacy business with the introduction of new advanced services and technology to create a more profitable future — but always in the name of improving patient care.

Click here to watch the video.