Community pharmacy leaders shared their vision for the future of community pharmacy at the Pharmacy Show in Birmingham yesterday.

Several leaders spoke about the need for adequate funding for the sector, the importance of upskilling, and the potential for pharmacies to do much more in terms of long-terms conditions management and prevention.

Meeting local community needs

On behalf of the Independent Pharmacies Association (IPA), contractor Ian Strachan suggested that by analysing the economic value of pharmacy services, the sector could demonstrate that an investment in community pharmacy would be a saving overall.

Mr Strachan also suggested that integrated care systems (ICSs) needed 'the flexibility to address local needs'.

'I think that's something that's going to require quite a cultural shift,' he said.

And he highlighted that community pharmacy could help tackle poverty and health inequalities.

'When you've got a strong economy the NHS does well, and when you've got a strong NHS, then the economy does well,' he said.

With many pharmacies situated in deprived areas, Mr Strachan said: 'I think we could do a lot more in terms of access to ensure that people living in deprivation and poverty can access services more readily, because there is a direct equation of poverty and healthcare.'

SMRs should be 'at the heart of community pharmacy'

Paul Rees, chief executive of the National Pharmacy Association (NPA), told Pharmacy Show delegates that there was 'massive scope' for community pharmacies to do more in terms of medicines optimisation.

'We should be moving to SMRs [Structured Medication Reviews] being at the heart of community pharmacy,' he said.

He suggested that money allocated to general practice for the Additional Roles Reimbursement Scheme (ARRS) could be used to fund this work in community pharmacy and help to alleviate medicines-related problems in the population more generally.

He also said community pharmacies could do more in terms of long-term conditions management.

'If the government are as good as their word, and they do want to shift care to primary care, I think if that happens - and it's a massive if - there is a bright future and an expanded future for community pharmacy,' Mr Rees said.

The success of pharmacies in delivering private services was also highlighted by Mr Rees.

'I think clinical services is the future, and I think IP [independent prescribing] is very much a fundamental part of that,' he said.

Pharmacy funding must be stable in the future

Janet Morrison, chief executive of Community Pharmacy England (CPE), said that any expansion of pharmacy services was 'predicated' on 'a stable and sustainable sector', in which 'everyone can plan for the future and invest in their businesses for the future, for the good of their communities and for their patients'.

Funding must give pharmacies 'clear capacity' to 'run all of the things that they do', including dispensing and spending time with patients.

'I think we're all aware that the dispensing function is undervalued and not being fully paid for, and I think that has to be stabilised in the sense that that's the core on which every other service can be built,' Ms Morrison said during the panel session.

Contractors should also have the ability to be able to invest in the community pharmacy estate, to have the space to provide face-to-face services, she added.

And IT systems should be interoperable with other NHS systems as well as with patient-facing services like the NHS App.

'I'd like to see us delivering an expanded Pharmacy First service that's extended to more conditions, that provides really important opportunities for independent prescribers and flexibility to be able to carry out prescribing, deprescribing, medicine use reviews and all of that,' Ms Morrison said.

She noted there was lots that could be done to 'fully optimise' the services currently in the community pharmacy contractual framework (CPCF).

In the longer term, Ms Morrison said she wanted to see community pharmacy become 'a recognised player in prevention and long-term conditions management'.

Pharmacy should be 'seen as and recognised and valued as a key part in the primary care system... as the neighbourhood and the community centres for care', with a collaborative contract 'as part of the same system' as GPs, Ms Morrison added.

Support pharmacy teams to learn

Also on the panel, Nicola Stockmann, president of the Association of Pharmacy Technicians UK (APTUK), highlighted that as the scope of practice for pharmacists expands with independent prescribing, 'the scope of practice for pharmacy technicians is expanding'.

'We just need to make sure we've got the right person in the right role to deliver the care for the patients,' she said.

In addition to the registered professions, support staff should also be invested in and developed - something which Ms Stockmann said was 'within our gift to give now'.

'Let's make sure that our environment is conducive to learning, then invest in the people, and then we can look at the things that we want to deliver,' Ms Stockmann urged Pharmacy Show delegates ahead of Pharmacy Technician Day today.

Involve pharmacy workforce in designing future services

From the audience, chair of the Pharmacists' Defence Association (PDA), Mark Koziol, called for employed and locum pharmacists to be represented, including within the CPE board.

To which, Ms Morrison of CPE responded: 'We are recognised by the secretary of state as being the representative body for community pharmacy contractors, and that's what we need to do, and that's what our main focus of our work is.'

But she said she understood what Mr Koziol was saying.

'I think one of the challenges we face is that when we come to the table to negotiate, actually, quite a lot of the thinking and planning for the services that have been commissioned has already been done,' she said.

'I would like to change the way that we work with the government and with NHS England, that we can work together to scope: what kind of services do we need, what kind of patient outcomes that we want to achieve? What does that mean for the workplace, for the workforce, what does that mean to operationalise it?' Ms Morrison said.

She said commissioning should be driven by patient outcomes, not purely for the financial wellbeing of business owners or for staff. 'It has to be a more holistic view,' she added.

'Singing in harmony'

Malcolm Harrison, chief executive of the Company Chemists' Association (CCA), said that 'for the first time' in his career as a pharmacist, 'we have something the NHS really wants – some value [and] we have some leverage'.

He asked how the sector could ensure it gets behind Pharmacy First, and 'help it to evolve [and] help it to grow'.

In doing so, Mr Harrison said 'our importance will grow, and our ability to meet on equal terms as we move forward into the new world of pharmacy will grow.'

And he said while different parts of the sector and profession might not be 'singing the same tune', they could 'sing the same songs' and 'sing harmoniously together as we engage externally'.