More than six in 10 community pharmacists surveyed by The Pharmacist believe they have the capacity to deliver a common conditions service in England this winter.

Those surveyed highlighted public and GP awareness, proper funding for the service and training for pharmacists as key enabling factors for the service.

‘More resources, clarity on payment reconciliation, and hefty promotion by the government and NHS,’ was what one pharmacist said was needed to make the service a success.

Among over 160 community pharmacists surveyed, 65% said they thought they would have the capacity to deliver Pharmacy First from this winter, 20% said they did not, 10% didn’t know and 4% were not based in England.

The data is based on responses to an online survey shared on our social media, website and mailing lists between August and September.

Funding

Several respondents highlighted that appropriate funding would be a key enabler for Pharmacy First, both in terms of payments for the service itself and for the sector at large.

One said that ‘a contract that pays us appropriately for core services so we can afford the staff to support these services’ was needed, while another echoed that ‘better funding for pharmacy so that we may recruit and bolster staffing levels’ would help enable the service.

Another respondent highlighted the need to support the provision of medicines to patients.

‘Patients cannot afford to buy medication over the counter [OTC]. For some, especially in this area, if they buy the medication OTC, they will be unable to eat or pay their bills,’ they said.

‘They are having to choose between health and their essentials which is horrendous! The cost-of-living crisis is proving worse than the government seem to realise.’

Workforce

One respondent to The Pharmacist’s survey said that a ‘fully staffed store’ required ‘double pharmacist cover at each pharmacy where one is focusing on clinical services and one focuses on shop/prescriptions’.

While another suggested that the skill set of other members of the pharmacy team, such as technicians and accuracy checking technicians, could be utilised to support the delivery of services.

Respondents also highlighted the need for ‘basic clinical competence’, as well as ‘supervision, support and evaluation’ for pharmacists.

GP and patient awareness

Respondents also said that it was important to ensure GPs were on board with the common conditions service, and that GP receptionists were trained to ensure appropriate referral of patients.

One respondent said that an ‘extensive awareness campaign’ was needed to increase public awareness and understanding of Pharmacy First.

In September, Dr Kiren Collison, NHS England interim medical director for primary care, told a webinar for GPs that planning for a public-facing campaign to help raise awareness of the pharmacy common conditions service was ‘underway’.

Negotiations taking ‘longer than we would have liked’ but need to ensure payments are fair

Janet Morrison, chief executive of Community Pharmacy England, told The Pharmacist that despite ‘overwhelming support for the introduction of a Pharmacy First service’, ‘struggling community pharmacies’ would only be able to deliver it if it came with ‘the right funding and support’.

And she said that while negotiations on the service had taken ‘longer than we would have liked’, it was ‘vital that what we agree is workable for pharmacies’.

‘We need to understand the relationship of the new proposals with the current contract, ensure the structure of payments is fair, and consider how to manage delivery against potential demand,’ she added.

‘Vital’ to make a success of Pharmacy First

Vice-chair of the National Pharmacy Association, Jay Badenhorst said that while capacity among community pharmacy teams was ‘severely stretched’, it was ‘vital’ that the sector made a success of the ‘strategically significant opportunity’ presented by Pharmacy First.

‘We absolutely must show government and NHS that when they back community pharmacy we deliver,’ he said.

‘For several years now, pharmacies have been asked to do more and more with less and less, but NHS England is putting substantial new investment behind the common conditions service,’ he added.

But he said that it was ‘unfortunate’ that pharmacies were still awaiting information about how and when the £645m in funding would be distributed throughout the sector, and added that ‘the core funding model needs to be sorted out, including concessions’.

At the Pharmacy Show this week, NPA representatives outlined a range of steps that they believe community pharmacy teams could do now to get ready for the new service.

Pharmacy First must be appropriately funded and realistic

Dr Leyla Hannbeck, chief executive of the Association of Independent Multiple Pharmacies (AIMp) told The Pharmacist that in order to make the common conditions service a success ‘it must be appropriately funded and realistic in terms of what pharmacies can deliver.’

While she said that AIMp would get behind the service, she warned that the additional funding for Pharmacy First was not ‘going to save’ the sector.

And she described the sector’s core as ‘rotten’, adding that the £645m was ‘not going to scratch the surface’ or offset the Category M clawbacks faced by the sector.

The sector needs to know what is being asked

Malcolm Harrison, chief executive of the Company Chemists’ Association (CCA), told The Pharmacist in a recent interview that in order to be ready to deliver Pharmacy First, the sector needed to know exactly what it was being asked to deliver. Once the detail of the service was released, ‘businesses can make the choice of gearing up and actually getting there’, he said.

And he stressed that the detail needed to be released in time for the sector to prepare. ‘You can't say on a Friday night, “here we go”, and [expect] on Monday morning, it will all happen.’

But he emphasised that he had not heard of any part of the sector being reluctant to deliver the service.

‘As soon as they know what's needed, I'm sure they will be working as quickly in time as they can to meet that need,’ Mr Harrison said.

Pharmacy teams must be supported

And James Davies, director of the Royal Pharmaceutical Society in England, described the common conditions service as ‘a really positive step to enhance patient access to care and better manage demand across the health service’.

‘The investment is a welcome recognition of the crucial role that pharmacists play in helping the public at the heart of primary care,’ he added.

He said: ‘As we head into a busy winter, how the service is implemented on the ground will be crucial to its success.

‘It is vital the funding flows to the frontline and that pharmacy teams are supported to give patients the quality service they deserve.’

‘The economics of Pharmacy First speak for themselves’

Speaking exclusively to The Pharmacist this week, former pharmacy minister and chair of the Health and Social Care Committee Steve Brine said that despite pressures on the sector: ‘I don’t have concerns about Pharmacy First because ultimately the economics of Pharmacy First speak for themselves and will show themselves more and more as we go forwards.’

‘I love Pharmacy First… I want to see it realise its potential and I think it will,’ he added.

And he said that the scheme would help people realise the clinical skills of pharmacists in primary care, and could lay the groundwork for ‘more and more’ clinical services being delivered by community pharmacists.