The last week of August can often have a sombre air, as happy memories of sun, sea and sand fade and are replaced by that sinking ‘back to school’ feeling. Not so here in the Pharmacy Voice office, as this week has marked the beginning of an exciting new chapter for the organisation and for the sector as a whole. As a result, our pencils are well and truly sharpened (or these days, I suppose, our tablets fully charged) in anticipation of a challenging and important new term.
On Tuesday we published the Community Pharmacy Forward View (CPFV), in partnership with PSNC and with the very welcome support of the English Board of the Royal Pharmaceutical Society. The report sets out the sector’s vision for how a thriving community pharmacy network can best support the high performing, affordable health and care system envisaged in the NHS Five Year Forward View, and invites colleagues to work with us to make this a reality.
After setting the scene the CPFV outlines three domains of activity that constitute the core roles of community pharmacy and what delivery of these could look like in 5 years-time, describing community pharmacy as:
- The facilitator of personalised care and support for people with long-term conditions;
- The trusted, convenient first port of call for episodic healthcare advice and treatment; and
- The neighbourhood health and wellbeing hub
You can read through the details behind each of these scenarios in the full document. When you do, it may well sound familiar, as much of what the Forward View describes is already happening across all or part of the community pharmacy network.
I come across examples every day from my discussions with members and with frontline teams. I also hear them from colleagues in other parts of the NHS and local government who are simply getting on with local integration and already see community pharmacy as central to their plans.
Unfortunately, however, this is far from universal. I also come across people who think of community pharmacy simply as the ‘retail’ sector and, as such, have little insight or interest in how it can drive improvements in healthcare quality, value and outcomes. We are currently researching the extent and nature of community pharmacy involvement in the New Care Models vanguard sites, and to say that this is ‘patchy’ is a pretty charitable assessment.
So, while the ideas and aspirations set out in the CPFV might not all be new to you, consistent delivery and demonstration of their impact across the whole country, enabled by effective planning and commissioning and a rigorous focus on implementation and continual improvement within the sector, would represent a radical step forward.
That sounds great, but haven’t we heard it all before? How is a new ‘vision’ going to help?
So yes, the back-yard of the community pharmacy sector (like every other) is already littered with vaguely remembered roadmaps and strategies, and we all know ‘a vision without action is merely a dream’, etc.… I understand why new attempts to imagine and describe the future can sometimes breed cynicism. But personally, I don’t see the regular review, renewal and restatement of ideas as a sign of failure or frustration. While we may have forgotten their names, there will be much in those previous strategies that has actually been delivered, or where progress is being made. And that is because people set out a direction of travel, and then worked hard to follow it. But there will also be things that have changed. The world tilts a little; the context shifts – and therefore so must our plans. Call it ‘emergent strategy’ or just call it real life. In order to flourish and grow we do need to constantly reinvent, adjust, and update our thinking.
In many ways, this is what the Forward View aims to achieve. It builds on previous work including PSNC’s 2012 vision for the sector, their 2015 Five Point Plan and the service development proposals submitted in 2016 to the Department of Health (DH) as part of the ‘reform’ negotiations; it restates and develops the ideas in Pharmacy Voice’s 2011 Blueprint for Better Health and our series of reports on Dispensing Health, as well as themes emerging from the RPS’s commission and report Now or Never: Shaping Pharmacy for the Future (2013) and a range of other strategies, statements and papers.
But while much of the Forward View develops these existing ideas, it also brings something genuinely new to the table, in a number of important ways. For a start, the CPFV brings these ideas together in a single, common vision of the national pharmacy bodies – something we can all get behind. Secondly, along with that vision comes a commitment to engage with, lead and collectively support the sector through the change that will be required if it is to become a reality.
Perhaps most significantly, while clearly focussed on what can be delivered in or through community pharmacies, our Forward View is not framed simply as a strategy or plan for the sector itself. Rather, it is a description of how community pharmacy could operate in order to contribute most effectively to the aspirations for health care and public health that have been set out by national and local government, by the NHS and, most importantly, by the people and communities we all serve.
As such, I do believe the CPFV is a different kind of vision – one that can help bring us alongside our partners across the wider health and care system. We have set out what we can offer and how we want to help; we have not prescribed how that offer might be taken up by different colleagues in different localities and different parts of Government. We will, of course, be working on this; we do need plans for making the vision a reality. But these have to be developed with others, and must recognise and respond to the different ways in which health improvement and delivery models are evolving across the country.
Ok, a shared vision for the future might be helpful, but don’t we have a few more important things to sort out first?
I appreciate that any excitement about a pharmacy led strategy for the future will be tempered by the Government announcement made back in December 2015. I also understand the anger, anxiety and uncertainty felt by many as we await some kind of resolution to the debacle that has since been masquerading as a Government programme for ‘community pharmacy reform’. I know that, in this context, expecting people to look ahead to the future with energy and optimism is a big ask.
Everyone at Pharmacy Voice believes that the future of community pharmacy should be decided by the sector – and when that doesn’t happen we end up with unhelpful interventions such as these latest proposals from the Department of Health. The Community Pharmacy Forward View is informed by that overriding principle and provides a clear and positive alternative that embraces change, drives improvement and provides clarity and purpose for community pharmacy.
Put simply, we are best placed to determine what our future should look like within an integrated, sustainable, high performing health and care system.
The Community Pharmacy Forward View should mark the beginning of renewed dialogue between the community pharmacy sector, the NHS and Government, and will help provide the basis for working together more effectively in future, with a common purpose. With a new Ministerial team in place, new care models emerging across the country and the cracks in historical ways of working opening ever wider, perhaps there really is an opportunity to re-set some of our relationships. We believe that is the case and hope that the Forward View helps pave the way for different kinds of conversations at both a national and local level.
This might be something I want to get behind, so what happens next?
I believe in the vision we have set out for the future of community pharmacy. We have developed it with our members, partners and colleagues working at the frontline of health care and public health delivery, and have based it on their insight into what is needed and what is possible. We have tried to acknowledge and reflect the ways policy and practice are changing within the NHS and beyond. The sector should be rightly proud of its new vision, and can confidently assert itself when asked, ‘how would you do things differently?’
But I also believe that positive, lasting change can only be secured through a process of listening, learning and collaboration. For that reason, I view the Community Pharmacy Forward View not as a blueprint or template so much as a call to action and a request for help. I want to hear and discuss other people’s ideas on how we turn a shared vision for the sector into a reality, and specifically a reality that will be good for patients, the public, local communities and the NHS, as well as for the community pharmacy network and all those who work in it.
That is why we are asking people to get in touch to:
- Provide feedback on the vision itself
- Share stories and examples that illustrate how community pharmacy teams are already leading the way in improving care, support and health outcomes, as part of integrated local health systems
- Make suggestions on what steps needs to be taken to help ensure this vision becomes a reality
- Find opportunities to discuss the Community Pharmacy Forward View in more detail or to arrange a speaker to attend a local meeting you are organising
We genuinely want to hear from you, so to share your thoughts or find out more you can email firstname.lastname@example.org; follow us on twitter: @PharmacyVoice #futureofpharmacy; or call the office on 020 3405 2810
I hope readers find much in the CPFV that resonates and stimulates thinking, and I also hope they have more to add. That’s why (like all proud policy geeks!) I am actually keen to get ‘back to school’ – to get into these discussions; to start mapping out the next steps; and start delivering the changes needed to make our vision a reality.
If you would like to join me, you can contact me directly via: email@example.com or @ElizabethCWade