NOW OR NEVER : SHAPING PHARMACY FOR THE FUTURE The report of the Commission on future models of care delivered through p

1. Section Title NOW OR NEVER: SHAPING PHARMACY FOR THE FUTURE The report of the Commission on future models of care delivered through pharmacy

2. Why a Commission on pharmacy Unprecedented era of economic, demographic and technological change Significant reforms to the NHS in England Narrative for the pharmacy profession’s role in the reformed NHS in England Royal Pharmaceutical Society (the leadership body for pharmacists) sets up a Commission on future models of care delivered through pharmacy Independent Chair - Dr Judith Smith, Director of Policy, Nuffield Trust

3. Commission timeline Launch event Manchester stakeholder event Literature review 1-2-1 meetings + interviews Commission launch (April 2013) ‘Tell us what you think’ – over 130 submissions Submissions (deadline 14 June 2013) 1-2-1 meetings + interviews Birmingham round table Analysis (June-July 2013) Targeted stakeholder briefings Commission report (November 2013) Report published 5 November Houses of Parliament www.rpharms.com/futuremodels

4. Section Title Structure of the report • Challenges facing the NHS • Challenges facing pharmacy • Examples of models of care identified through the Commission • Why the models of care are not more widespread • What needs to be done • Recommendations

5. Section Title Challenges facing the NHS • Future models of care delivered through pharmacy depend fundamentally on what is happening in the wider NHS • A decade of flat funding • Rising demand – especially for long-term conditions • Stronger focus on quality of care • Pharmacy has a central role to play in assuring safe and consistent medicines management and wider care, in primary, social and acute care. • Pharmacy will have to make its case for delivering new models of care, based on evidence of cost and clinical effectiveness, and the ways in which it can help address the core problems facing the NHS.

6. Section Title Challenges facing pharmacy • Long-debated potential to assume a broader role in patient care • Moving from dispensing and supply of medicines to helping people to make the most of their medicines, and supporting their wider care. • Technology and skill-mix are driving change in pharmacy • Community pharmacy is under pressure: • NHS funding for dispensing and other services is constrained • Reimbursement of drug costs is less • Non-pharmaceutical sales are falling • Over-supply of pharmacies and pharmacists • Pharmacy has a once-in-a-generation opportunity to capitalise on highly trained professional workforce, local and accessible premises, and understanding of local communities

7. Section Title Models of care • Over 100 models of care reported to us • The future is here – but only in some places • Models developed despite the barriers • often reported • Pharmacists are slowly forming new networks and • organisations • Disheartening that examples remain relatively rare • Much more that could be done – is the desire • really there? • Access for advice and minor ailments • Integrated long-term conditions management • Support for older and vulnerable people at home or in care • Helping people to get or stay out of hospital • Providing local public health services

8. Section Title Why are they not widespread? • Pharmacists (especially community) are marginalised within the NHS, nationally and locally • There is a poor level of understanding among the public, and within the NHS, of the potential role of pharmacists • Lack of national and local leadership, exacerbated by multiple groups • Lack of fulfilling career opportunities for new graduates •  Locally, pharmacists are often professionally isolated from the wider primary care team and sometimes peers. • Fragmented and complex commissioning of community pharmacy services. • Little alignment of pharmacy funding with that of general practice and other community services

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10. Section Title In Summary • Widespread consensus that pharmacists are an underutilised resource – 40,000 plus in England and their numbers are increasing • The NHS must adapt to the needs of patients with long-term conditions and preventable illnesses. Pharmacists have a vital role here • Some patients, carers and members of the public already have access to a broader range of care from pharmacists (see www.rpharms.com/futuremodels) • But progress is slow and access is patchy.

11. Section Title In Summary • Pharmacy is marginalised • Lack of public awareness about pharmacy – pressing need to de-mystify • Urgent need for focused, outward-looking local and national leadership of pharmacy • Shift in the balance of funding, contracts and service provision toward the provision of patient care (away from fee per item dispensing) • Explore networks, ‘chambers’, consortia, lead providers as a way of integrating pharmacy into the provision of primary and coordinated care • Window of opportunity is open now, it may not be open for long

12. Section Title • Download a copy of the report at: www.rpharms.com/futuremodels

13. NHS England’s Call to Action on Community Pharmacy Improving health and patient care through Community Pharmacy – a Call to Action published on 10th December 2013 Follows the publication in the summer of The NHS belongs to the people – A call to actionand Improving General Practice – a Call to Action Similar documents on dentistry and eye care are expected to be published soon

14. NHS England’s questions How can we create a culture where the public in England are aware of and utilise fully the range of services available from their local community pharmacy now and in the future? How can the way we commission services from community pharmacy maximise the potential for community pharmacy to support patients to get more from their medicines?

15. NHS England’s questions How can we better integrate community pharmacy services into the patient care pathway? How can the use of a range of technologies increase the safety of dispensing?

16. The Royal Pharmaceutical SocietyThe Royal Pharmaceutical Society is the professional body for pharmacists in Great Britain. The Royal Pharmaceutical Society Future Models of Care Commission brought together expertise from across health and social care to provide a coherent narrative for the pharmacy profession’s role in the reformed NHS in England.You can find out more at:www.rpharms.com/futuremodelsJoin the conversation on Twitter @NoworNever

17. Section Title Exploring in more detail • Questions