The NHS is in a “critical condition” but can be healed “by hardwiring financial flows” that lock in a “shift of care closer to home”, according to Lord Darzi’s independent investigation of the NHS in England, published today (September 12).

Darzi said that the NHS has been “degraded by disastrous management reforms” and “chronically weakened” by poor funding, leading to a deterioration in “the health of the nation”.

Read more: CPE suggests ‘wide range of further services’ in Lord Darzi submission

He called for the government to “rebalance the system towards care in the community” as he hailed the contributions of healthcare workers including community pharmacists. 

CPE last month told the government's NHS review that some 13 new or expanded pharmacy services and eight new Pharmacy First conditions could “relieve pressure on frontline”. 

 

Pharmacy: “Too few resources”

 

Darzi’s report, commissioned by the new government to inform its NHS policies, described the community pharmacy sector as “one of the great strengths of the health service” with a contract that has “historically…promoted a highly efficient distribution of pharmacies”.

But he recognised that the total level of funding for the sector has dropped and “significant numbers” of pharmacies have closed, even as community pharmacy has “expanded the range of clinical services” it provides in recent years.

Read more: ‘Prepared to protest’: CPE and NPA considering GP-style collective action

He said that community pharmacy has “too few resources”, meaning “a very real risk” of decline in access to services on its “current trajectory”. 

Darzi hailed the “huge potential” of the sector and suggested that it could provide “even more value-added services for the NHS”, noting in particular expanded common conditions treatment and the “active management of hypertension”.

“There is huge potential for a step change in the clinical role of pharmacists within the NHS”, he said.

 

PM’s plans

 

Responding to the report, Prime Minister Sir Keir Starmer said that the government would commit to the “biggest reimagining of our NHS since its birth”.

Starmer added that the “scorched earth” approach of the previous government had produced a “lost decade for our NHS”.

He said that the government will have the “courage to deliver long-term reform”, adding that it is developing a ten-year plan for the NHS that will have “the fingerprints of NHS staff and patients all over it”.

Read more: Political Pills: Crunch time for community pharmacy

This plan will focus on “three big shifts”: creating a “digital” NHS, moving the locus of treatment “from hospitals to communities” and prioritising the prevention of illness, he revealed.

Health secretary Wes Streeting said that Darzi’s report shares “hard truths about the state of the NHS” and suggested that the government faces “a long road ahead” to repair the “damage done” to it. 

“While the NHS is broken, it’s not beaten,” he added. 

 

“Stop the rot”

 

Company Chemists’ Association (CCA) chief executive Malcolm Harrison welcomed the report that “has laid bare the perilous position that the NHS and community pharmacy finds itself in”, adding that the sector needs “immediate action to stop the rot”. 

“An expanded role for community pharmacy is only possible if there is action to protect the existing community pharmacy network through additional investment,” he said.

“We hope that the report’s findings spur action before it is too late and patients lose access to the local pharmacies that they have come to rely on,” he added.

Read more: ‘Not your money’: CPE admits £645m Pharmacy First cash ‘unlikely to be spent’

National Pharmacy Association (NPA) chief executive Paul Rees called on ministers to take “action now” to “end the scandal of pharmacy closures caused by chronic underfunding over many years that is eating away at frontline patient care”.

“There’s a huge prize here – modest investment to ensure adequate pharmacy funding could transform frontline care, end the scramble for doctors’ appointments and help fix the NHS fast,” Rees added.

Rees warned that without "immediate action" from the government, the public's "access to medication and care" will be placed in jeopardy.

Read more: Revealed: NHS to claw back over a million in Pharmacy First cash

Independent Pharmacies Association (IPA) chief executive Dr Leyla Hannbeck said that Darzi's report showed the "devastating impact" that the NHS's "critical challenges" have had on "the nation's health".

Hannbeck added that the community pharmacy sector should be "at the very heart" of the government's proposed "shift to care in the community".

She called on the government to commit to "properly fund our local pharmacies" so that the sector can save public money and "relieve pressure on other parts of the health service".

Read more: CPE ‘expecting’ delayed pharmacy contract negotiations to ‘resume soon’

And Community Pharmacy England (CPE) chief executive Janet Morrison said that it is “absolutely essential to refocus healthcare towards community and primary care services”.

“The government, patients and the NHS desperately need to make better use of the wealth of skills and expertise in community pharmacies,” she added.

CPE will “continue to brief” the government and the NHS, “recommending putting community pharmacies at the centre of delivery of…primary care priorities, focussing on provision of public health services, reducing pressure on GP practices and other measures to position pharmacies as local health and wellbeing hubs,” Morrison said.

“We look forward to discussing these in more detail very soon and hope that we can work at pace to develop a shared ambition for pharmacies, coupled with the right investment and sustainable contractual framework,” she added.

It comes as CPE and the NPA have revealed that GP-style “work to rule” collective action is on the cards for pharmacy if the sector doesn’t get the “right answer” on government funding.