NPA Response To Delivering The New NHS For Wales (Consultation Paper II), UK

Main Category: Pharmacy / Pharmacist
Article Date: 01 Mar 2009 - 1:00 PDT

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The National Pharmacy Association (NPA) is the trade association for community pharmacy in the UK and has virtually 100% of community pharmacies in membership. The NPA has over 600 member pharmacies, two board members and a member of staff working in Wales. The NPA endorses the response to this consultation made by Community Pharmacy Wales, and makes some additional comments in this document.

Leadership on the National Delivery Group

The NPA believes that the opportunity to enhance the services delivered from community pharmacy, as set out in the three tiers of the 2005 community pharmacy contract, has not yet been fully realised. There are over 700 community pharmacies in Wales that can play a vital role delivering services in the heart of communities.

If community pharmacy is fully supported, with national leadership and strategic direction, if can deliver so much more to the population.

Pharmacies are visited by a wide range of people, including those who are well and those who are ill. All community pharmacies are contracted to provide advice and information on healthy lifestyles, participate in health promotion campaigns and provide signposting services as part of their essential services. Enhanced services which can be, although are often not commissioned from pharmacies by LHBs, include stop smoking, weight management, sexual health, vaccination (e.g. influenza), point of care testing and minor ailment services.

Community pharmacies already support people with long term conditions through the Medicines Use Review service, lifestyle support and advice, point of care testing and prescribing. The use of pharmacist independent prescribers provides opportunities to further enhance the care of people with long term conditions. Enhanced services in this area might include medicines assessment and compliance, full medication review and support for care homes.

Repeat dispensing is available from pharmacies for patients with long term conditions whose treatment is stabilised. Their repeats are managed by their nominated community pharmacy for a period of up to 12 months. This saves time for GP surgeries, is convenient for patients and has the potential to improve medicines management and reduce wastage of medicines. Again, this service is not being used as widely as it could be.

The National Delivery Group will provide strategic leadership and management to the NHS in Wales. We believe that the National Delivery Group should be responsible for the strategic development and delivery of the community pharmacy contract, with a member of the group having specific responsibility for pharmacy. This would ensure that all people in Wales would be able to benefit from the full range of services that community pharmacy can provide.

It is not clear how the National Delivery Group will receive advice on commumity pharmacy issues. We suggest that a stakeholder advisory group is established to ensure that full consideration is given to community pharmacy, and its potential to support patients and help prevent illness.

Ensuring the best service providers

As the new LHBs will be able to act as both a service planner and provider, there is the potential for conflicts of interest. These will exist when the LHB is called upon to decide whether to seek service delivery from an in-house team or an external contractor (eg, GP or community pharmacist). The LHB's ability to make an impartial decision, in the best interests of patients and the taxpayer, may be compromised.

To ensure probity and effective decision making when both in-house provision and using external contractors is an option, we recommend:

- Involving the Professional Forum when designing patient pathways. - Decision making should be completely transparent. This can be facilitated by publicly advertising opportunities and providing potential providers with all the relevant information they would need to consider delivering the service.

- Judge applications and make decisions on particular providers against set published criteria.

Engaging local pharmacy

The NPA believes that having a local practising community pharmacist on the board of the LHB has been an important feature for engaging local pharmacists and promoting developments within services. If this is not to happen on the newly formulated LHB, we believe that it is important that sufficient focus is given to developing pharmacy at a local level. This could be achieved by having a director or direct-report to a director with responsibility for pharmacy issues.

National Pharmacy Association

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