Community Pharmacy England (CPE) has highlighted issues with the ‘variable’ quality of consultation spaces within community pharmacy.
The negotiator has therefore called for improved funding to allow pharmacies to invest in their premises to support the roll out of new services – including Pharmacy First, which requires a consultation room to advise and treat patients.
Speaking to a parliamentary inquiry into pharmacy this week, Janet Morrison, CPE chief executive, said: ‘The vast majority of pharmacies and those who will have registered [for Pharmacy First] will have a consultation room, but it's very variable and let's be honest about that.
‘Some are amazing, the pharmacies and the consultation rooms they've built – some less so.’
She added: ‘The problem is with our underlying funding. We get paid nothing towards our premises and our facilities.
‘And at the moment given the huge squeeze on finances, I think any business would be hard pressed to be refurbishing their premises, [to be] able to build even better facilities.’
CPE representatives giving evidence to the committee proposed the return of the establishment payment to support investment in community pharmacy premises.
Developing infrastructure should go ‘hand in hand’ with developing new services, added Ms Morrison.
‘Ideally, pharmacy should not be viewed in isolation from other parts of the primary care system,’ she told the committee.
Ms Morrison suggested that Pharmacy First could also include free over-the-counter medications for those on low incomes.
She also thought chest infections would be the ‘next obvious’ condition to add to Pharmacy First – ‘where it's a one-off minor ailment that you could deal with, but if you need referring onwards, you'd be referred onwards’.
In the longer term, Ms Morrison suggested that community pharmacies could host multidisciplinary teams, including allied health professionals in community healthcare hubs.
The recently expanded oral contraception and blood pressure services could be ‘built into wider services’ provided by the community pharmacy sector, she added.
For instance, the blood pressure service could expand into hypertension management, cholesterol management, atrial fibrillation, and help patients with diabetes too.
‘It would also make sense to be building on oral contraception to actually look at other forms of contraception [and] HRT,’ said Ms Morrison.
In the longer term, clinical services must be commissioned in community pharmacy in order to make the most of independent prescribing when it is possible on a more widespread scale, she added.
‘The use of patient group directions [in Pharmacy First] is helpful but the direction of travel should be towards more independent prescribing,’ she said.
Ms Morrison warned there would still be issues of bringing ‘the rest of the workforce up to speed’ on prescribing even when every new pharmacist will graduate as an independent prescriber from 2026.
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