Clinical Services Review sets direction for community pharmacy

Clinical Services Review sets direction for community pharmacy

December 14, 2016

NHS England has today published the report of the Community Pharmacy Clinical Services Review that has been carried out by Richard Murray, Director of Policy at the Kings Fund.

The review was informed by a steering group, but was carried out independently.

The report concludes that there needs to be “renewed efforts to make the most of the existing clinical services that community pharmacy can provide and to do so at pace”.

It sets out how the skills of community pharmacists and their teams can be used to help people to manage long-term conditions and to embed medicines optimisation within care pathways. This may require national action through the Community Pharmacy Contractual Framework, as well as local progress on integrating pharmacies into evolving models of care, the report states.

The report sets out a number of recommendations for the future development of community pharmacy services including:

  • Incentivising use of electronic repeat dispensing so that this becomes the default for repeat prescribing;
  • A redesign of MURs to develop them into full clinical reviews including ongoing monitoring and follow-up of patients, consideration of prescription duration, and utilising independent prescribing as part of the care pathway;
  • Consideration of making smoking cessation services an element of the national contractual framework;
  • Use of the Vanguard programmes to develop the evidence base for community pharmacists, including integrating community pharmacists into long term condition management pathways, involving them in case finding programmes, and using new ways of contracting that mitigate any perceived conflicts of interest;
  • Support from NHS England and national partners to help STP leads to integrate community pharmacy into their plans and local commissioners to contract for services; and
  • Joint work by PSNC, the Royal Pharmaceutical Society and national GP representatives to explore what practical steps can be taken to unravel professional boundary issues and ensure closer working between community pharmacists and GPs.

The report also called for NHS England to set out how it intends to deliver on its commitment to ensure that minor ailments services are commissioned across England by April 2018. It stressed the need for community pharmacists and their teams to share information with clinical records held by other healthcare professionals, and said pharmacy technicians should be able to work under Patient Group Directions to improve better use of the skill mix within pharmacies.

The report recommends that a formal group be established, including representatives of community pharmacy, to have oversight of progress and recommend further action where needed.

Read the report in full.

The independent review was commissioned by the Chief Pharmaceutical Officer of NHS England earlier this year. NHS England has set out its intention to use the recommendations of the review to inform its approach to the commissioning of NHS community pharmacy services.

A rapid review of the evidence for community pharmacy services, carried out by Professor David Wright, was published alongside the report.

Additionally, PSNC has issued a briefing summarising the main elements of the report: PSNC Briefing 072/16: A summary of the Murray Review of Community Pharmacy Clinical Services.

PSNC Chief Executive Sue Sharpe said:

“This review includes some positive and welcome proposals for developing the community pharmacy service. We are ready and keen to work to implement these as soon as possible. The events of the last year have badly dented the confidence of pharmacy contractors, but energy in moving forwards will do a lot to restore it.”

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