Scotland’s model for pharmacy offers lessons for England’s future
As pharmacies in Scotland receive renewed government backing, Steve Anderson takes a look at the future of English pharmacy against the backdrop of a damning new report
In a welcome development for community pharmacy in Scotland, Community Pharmacy Scotland (CPS) and the Scottish government have reached an agreement on future funding for 2023/2024.
The investment will help secure essential primary care for Scottish patients, setting a benchmark for other regions to follow.
Read more: Community Pharmacy Scotland agrees ‘adequate’ new funding offer for 2023/24
English ministers need to take heed of the Scottish example and learn valuable lessons in sustaining and advancing community pharmacy services.
While Scotland is looking to the future, an expert panel set up by the parliamentary health and social care committee (HSCC) issued a report last month (July 26) that gave a damning indictment of government policy. Neglect, indifference and ineptitude best describe the English government’s approach to community pharmacy.
Read more: HSCC gives scathing review of DH progress on pharmacy pledges
The health secretary in England now says he wants a Pharmacy First model to make greater use of pharmacy on the frontline, delivering improved patient access and outcomes. Of course, we welcome that – it is the direction of travel for primary healthcare reform. But the stark reality is that the pharmacy contract must be fixed first because that is the foundation on which service innovation can be built.
I must commend Scotland's Pharmacy First model, which has set the standard for the delivery of patient services through pharmacies. With PHOENIX's presence in 29 European countries, I can see that Scotland's approach stands out for its reach and ambition. The key, however, to its success has been borne out of years of government investment and commitment to maintain a financially viable network based upon sustainable long-term funding.
Read more: 'Our funding is rotten': Sector needs £1.1bn now, warns AIMp chief
Unlike in England, where community pharmacies have faced cumulative funding cuts of more than £750 million per year, Scotland’s investment has allowed pharmacies to focus on patient care without the constant financial pressures. Community pharmacies should not be viewed as disposable figures on a spreadsheet. Our pharmacy teams provide vital care in our communities, improving healthcare outcomes and helping to manage long-term conditions.
If England wishes to develop its own Pharmacy First approach, that is a key lesson it must learn. If Scotland had failed to offer a fair funding commitment to pharmacy, politicians in England would have been forgiven for thinking they could get away with a cut-price Pharmacy First model from a steadily shrinking number of pharmacies.
Read more: ‘Far short of what is needed’: CPS rejects government's 2023/24 funding offer
In Scotland, the outlook on community pharmacy is that it plays a crucial role in enhancing healthcare outcomes and increasing patient access to essential care. Community pharmacies are an important part of the overall system, but one that clearly differs from that of a GP or hospital.
Community pharmacies do have the potential to reduce pressures on the NHS, particularly as healthcare demands increase, but further action is essential to enable community pharmacy to play an enhanced role delivering more patient care services. While funding is vital, the issue is not exclusively based on money.
We need a radical reform of legislation, policy and regulation that currently prevents our sector from meeting its true potential. The HSCC rightly points out that primary care network (PCN) recruitment of pharmacists in recent years has created workforce shortages in community pharmacy, which in turn leads to temporary pharmacy closures and drives up the cost of employing locums at a time when most pharmacies are facing a financial crisis.
Read more: NHSE to ‘extend success’ of ARRS under workforce plans
The lesson from Scotland could not be clearer: invest in a robust and sustainable pharmacy network that increases patient access to essential NHS care. This in turn will reduce cost and demand pressures on other parts of the NHS, improving patient satisfaction and health outcomes.
Saving our pharmacy network is not a big ask. It will not bankrupt the Treasury, but it will lead to improved outcomes for patients across the country. There can no longer be any excuse for neglect, indifference and ineptitude when it comes to much needed investment in our sector.
The CPS agreement is not only an excellent outcome for patients in Scotland, but offers a ray of hope for the patients across the UK who need care and support in the community.
It can be done right, and community pharmacy can be saved.
Steve Anderson is group managing director of PHOENIX UK