A call for community pharmacy to be viewed as 'the front door to the NHS' has been made ahead of Integrated Care Systems (ICSs) becoming statutory bodies from July.

Pharmacy representatives called for a ‘pharmacy first approach’ and parity across the healthcare system,  in a National Pharmacy Association (NPA) roundtable with Gina Naguib-Roberts, director of the Fuller Stocktake/Integrated Primary Care in Systems.

The NPA published findings from the roundtable today (13 June), after the event on 14 March, and called wider representation at strategic level and encouraged ICS leaders to 'ensure inclusion and representation of primary care at all levels in the ICS.' 

The report also called for at-scale primary care, where services are delivered to a larger population; tackling health inequalities; and dating sharing, saying 'easily accessible unified care records' are 'as much about referring people out of community pharmacy as into it’.

Participants argued that ‘it's really important for ICS leaders to understand the breadth and scope of what [community pharmacy] can offer them,’ and urged them to 'challenge their bias as to what a community pharmacy actually does,’ the NPA said.

Leaders should also 'better utilise the facilities available within community pharmacy’ and offer enhanced services to local communities, particularly considering 'limited primary care estates remains a problem for PCNs,’ the attendees said.

Community pharmacists should be empowered to work in a ‘concerted effort for whatever the patient needs in the here and now’, because they form part of patient pathways ‘from the outset’ and do not just signpost patients to appropriate help, they argued.

In addition, the report suggested that participants thought ICS leaders should recognise ‘the community pharmacy building’ as an ‘asset’, which is open 24 hours a day, seven days a week and could offer services such as preoperative survey and diagnostic testing.

It also called for 'visibility and recognition' of community pharmacy as a 'unique business,' saying 'the values of community pharmacy are within the NHS, but often some of the value that comes from them being businesses is not adopted as much as it could be.'

Imploring ICS leaders to 'appreciate the scale offered by community pharmacy', one participant said: 'My ICS has 587 community pharmacies doing about 2.6 million prescriptions and 20,000 advanced services every single month, and that doesn't even count all the self-care stuff, the general walk-in and the local services. I'd be looking at my ICS and saying how do you want to make these wealth of contacts count?'

Summing up the roundtable at the end of the session, Ms Naguib-Roberts acknowledged 'the power of community pharmacy' and the 'really clear message about the scale and the reach that cannot be replicated.'

She said: 'We will absolutely be seeking to set out to the ICSs some different models, but some clear models, about how community pharmacy along with the other pillars of primary care should be involved in decision-making.

'We don't want to leave it to chance that community pharmacy is in the right conversations. If that was the case, then I would consider the [Fuller] work to have failed.'

Michael Lennox, NPA integration lead, said 'community pharmacy voices were heard in the stocktake process, and now that conversation needs to be amplified locally.'

Broad recommendations to ICSs, emerging from the roundtable, include:

  • Work at scale to best target and serve patients and make every contact count
  • Ensure true parity between the pharmacy sector, wider primary care and across the system
  • Support and remunerate the training and development of community pharmacists/pharmacy leaders
  • Recognise the critical enablers of data, digital, training and education, and leadership opportunities
  • Keep community pharmacy involved in future decisions and planning at system level.

Last month, the ‘Next Steps for Integrating Primary Care: Fuller Stocktake report’ outlined a ‘more active role’ for community pharmacy in urgent care and prevention, and the Association of Independent Multiple pharmacies said more trust is needed in the pharmacy sector to make ICSs efficient.

The recruitment of 42 community pharmacy clinical leads – one for each integrated care system – was announced in February.

In March, Sajid Javid said pharmacists and other providers in primary care will be expected to play a large role in preventive care under new health reforms set out by the Government.

A report by NHS Confederation's PCN Network, Primary Care Federation Network, National Pharmacy Association and Primary Care Pharmacy Association calls for community pharmacy and general practice towards work towards changing their relationship as competitors to a more collaborative ‘single voice for primary care’ if pharmacies are going to be fully utilised in ICSs.

In November last year, NHS leaders urged the government that the pharmacy sector should be better integrated into the healthcare system in England.