With hundreds of thousands of patients receiving same-day consultations with their local pharmacist after calling NHS 111 or their local GP - for minor illnesses that would have otherwise required a GP appointment for treatment - it’s fair to say community pharmacists are playing a much bigger role in clinical care.
Advanced Pharmacy Services have changed the game for pharmacists, moving them away from transaction based medicine dispensing, to a consultative offering that can provide treatments like flu vaccinations or advisory services like smoking cessation.
This shift, which is speeding up with the emergence of Pharmacy First, creates a massive opportunity for pharmacists to diversify revenue streams and relieve the strains that come with dispensing medications like price fluctuations and funding pressures.
But it’s not just a profit haul for pharmacists.
Advanced Pharmacy Services create the scope to improve the entire healthcare system.
By removing the need for GP interventions for common, minor conditions and giving pharmacists more clinical responsibilities, Advanced Services are also freeing up much needed resources across the NHS, leading to better patient care allround.
In this blog we look at the role Advanced Pharmacy Services play in the future of community healthcare.
Before you get into the blog, watch episode one of our new docuseries "The Game Changers of Community Pharmacy" by clicking the image below
As of April 2024, there were around 2,294 patients for every full-time GP in England.
So it’s maybe not surprising that this is putting huge pressure on local health providers, with around one in 20 patients waiting at least four weeks to see a GP.
What makes the situation worse, is that many of these patients don't actually need a GP appointment, with NHS figures estimating that around 6% of all GP appointments (about 25 million) could actually be delivered by pharmacists.
Advanced Pharmacy Services can dramatically improve the speed at which patients can book appointments to be seen for minor ailments and some long-term conditions, not only speeding up access to treatment, but giving GPs more time to focus on complex patient cases and referrals.
By expanding the number of services patients can access without a GP, it’s making the health system far more convenient and is improving care for minor illnesses and even the management of some long-term health conditions like asthma.
NHS England is already predicting that the Pharmacy First advanced service will save up to 10 million GP appointments a year.
By allowing patients to bypass their GP and seek Advanced Services at their local pharmacy, it will greatly reduce the strain and waiting times for patients in need of a GP appointment for more complex or urgent conditions.
For patients too, it allows them to seek treatment for more conditions without extended waiting times, as pharmacists have more capacity to carry out these treatments sooner (often on the same day).
The rollout of additional services is being welcomed by those within the wider NHS also.
In a letter announcing the launch of Pharmacy First advanced service three senior NHS officials (Dr Amanda Doyle, Dr Claire Fuller and David Webb) noted the rollout as being “a significant moment for pharmacy, primary care and the wider NHS” claiming advanced services play a key role in the primary care access recovery plan.
By allowing community pharmacists to play a bigger role in community healthcare, it creates opportunities for pharmacists to become more profitable and engaged in patient care, and offers respite to other parts of the wider health service.
While Advanced Pharmacy Services have tremendous upside for pharmacists and the NHS as a whole, they will require a more joined up, collaborative, approach by all parties in order to make them effective.
While much of this will come in the form of technology and data sharing, it starts with a more human element, and that’s within the awareness of other healthcare professionals that these pharmacy services are available.
This is a point touched on by Gurminder Singh, a second generation pharmacist who recently featured in our new docuseries, The Game Changers.
In the first Game Changers episode - The Visionary - Gurminder said collaboration and understanding was needed in order for patients, pharmacists and the NHS as a whole to benefit from the roll out of advanced services:
“What’s everyone’s first thought when you wake up and your ear is hurting or you’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 and most peoples’ thought straight away is to call the doctor at that 8am window [to try and book an appointment].
“Receptionists play a role [when they answer the phone] in recognising the seven new minor ailments and referring the patient onto the pharmacy [rather than booking a GP appointment].”
This connected and collaborative approach to community care is going to be essential for Advanced Services to work.
Community pharmacists are under constant pressure with regulations and fluctuating market prices that often end with them dispensing medication at cost - or even at a loss.
This, coupled with the rise of online pharmacies means community pharmacists need new avenues for revenue in order to secure their future.
Gurminder highlights this point specifically in our Game Changer series, explaining these pressures were one of the key motivations for bringing Advanced Services into his family’s business:
“We thought if we could support the pharmacy and our overheads like staff wages, your own wages, and our general overheads with the advanced services you can provide [that would help us].
“Because how it was working out more recently is that the amount we were getting for the drugs was the amount we were spending on drugs, and there wasn’t any leeway like there used to be to pay to run the business.
“They want you to prevail on doing more services, doing more clinical exercises in the pharmacy and changing the role, so if you’re left behind in the old pharmacy, you won’t survive.”
Gurminder also explained how technology was helping his pharmacy to identify patients who could benefit from additional services so he could promote them:
“There’s a big help at the moment with New Medicine Service (NMS) in that it identifies the patients who may be eligible for the service, then it can target those patients, because the label automatically comes out from the dispenser, then you can stick it on the bags and identify that patient when they come in and ask them if they’d like us to do the New Medicine Service with them and start that process.”
Along with NMS and advanced services like flu jabs, Gurminder has found success in other services, particularly in introducing a new IV clinic, which has proved a big success and is hugely popular with patients.
While advanced services definitely provide benefits and opportunities for community pharmacies, they also come with challenges.
Particularly when it comes to managing the services along with the traditional dispensing that pharmacists will always do.
As Gurminder explains:
“It’s a balancing act in that you could have a couple of new minor ailment patients coming in, plus have some travel vaccinations, smoking cessation patients and so forth, and your day can be filled up very quickly.
“And within that and those services, imagine having to check numerous amounts of items [for dispensing] in between.”
Pharmacy management software, like that we provide at Cegedim, help community pharmacies by removing much of the manual side of dispensing, so they have the time they need to focus on patient care and services.
Pharmacists can view clinical services in one system, get easy access to patient information (including verifying patient records through the NHS and GP systems) and deal with referrals directly with the PMR.
Integrated NHS MYS also ensures pharmacists have easy visibility of the services they have and haven’t yet claimed for, ensuring no payments are missed.
It’s clear that a new attitude is needed in order for community pharmacies to thrive, whether that’s embracing new services to build new revenue streams and improve patient care, or innovating with technology that removes many of the manual tasks associated with pharmacy dispensing in order to free up time for new services.