Pressures on health funding mean the future shape of the National Health Service is under scrutiny like never before. As they face stark choices in the weeks ahead the government would be well-advised to remember that, whether they are located in urban high streets or village squares, pharmacists have long been patients’ chosen first source of healthcare help or advice. They are local, they are on the doorstep, easily accessible with long hours, open on Saturdays and often Sundays.
In any walk of life, open-minded decision-makers adapt practice to the ways people live their lives. Dropping in to speak to a pharmacist for advice about a problem is simple: much easier and more convenient than trying to get to see a GP. No need to remember to phone on the dot, the moment that day’s appointments are released. No need to face the stigma or inconvenience, or overcome the reluctance of actually going to see the doctor.
So when access to a GP, waiting times and accident and emergency pressures are such a problem then a good pharmacist offers people a good quality service and, often at times of great distress and anxiety, peace of mind.
In that context, the government’s plans to cut £170m from community pharmacy, threatening the viability of 3,000 local pharmacies, were always an illogical false economy which, aside from making it hard for people to get their prescription, were bound to increase pressure on GP surgeries and hospitals.
It was not surprising, then, that a petition opposing the cut attracted nearly two million signatures. And not surprising, either, that the government sought to appease dissent in early September by announcing what they painted as a reprieve.
That announcement was welcome, even though it raised questions in the context of the NHS’s current financial challenges. Did the partial U-turn mean money had been magicked from elsewhere? Would it lead to cuts in other parts of the NHS? We still do not know and we are told we must await further government announcements on pharmacy funding.
On the face of it, the reflection and reconsideration is welcome, and now it is incumbent on the government to use the time wisely to consider the true potential that modern pharmacies hold in addressing the country’s healthcare needs.
Over 1.5 million people visit pharmacies every day, seeking advice, medication and treatment. They are an accessible resource for people with a huge range of needs: a true first port-of-call. Health ministers should build on this, helping pharmacies fulfill their potential to creatively address the challenges the NHS faces. And they should remember their community role often extends beyond their healthcare one.
For example, in my Bristol South constituency, the Bedminster community pharmacy links to five local GP surgeries, they have strong relationships with all the doctors, picking up prescriptions; they know the community well and, like any good business, tailor their offer to changing need and demand. It provides a pleasant environment and a range of services and goods, all in area that is struggling to attract footfall and other businesses. And they offer products for sale in an area where hardly any other business will invest.
Elsewhere in my constituency is another pharmacy, one of the few remaining shops in a ward with one of the highest levels of deprivation in the country. It offers vital help to many people with drug and alcohol problems; a methadone service, for example. I spent a morning there in 2015 and found staff to be hugely respectful of – and knowledgeable about – the community and the individuals that rely on them.
Like other pharmacies it plays a crucial role knowing the patients it serves, which is particularly important for people with a long-term condition, and following the patient’s needs – for example into and out of hospital. It offers help with the transfer of care both ways. We know that this is both a distressing time for patients and their families or carers, and also one of high cost. The hospital passes information to the pharmacist, with technology playing a part along the way. For example, where a patient goes in to hospital with two types of medication and comes out with lots more, the local pharmacist has time to chat and explain the meds, and offer vital support afterwards.
Investment in pharmacies saves the NHS money in the long run. YouGov research indicates around a third of people who look for initial advice from a pharmacy would, if it closed, make a GP appointment instead. NHS research suggests in areas of high deprivation this rises to as high as 80 per cent.
Ministers should take a progressive view – understanding and embracing the role pharmacies can play on the front line in a changing healthcare system.
At a time of rising demand and financial pressures – and a desire for more local responsive services to sustain our NHS – pharmacies should be at the forefront of the government’s thinking, not first in line for cuts.
Karin Smyth is member of parliament for Bristol South. She tweets @karinsmyth
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