Hospital to community – putting power in patients’ hands

Pharmacies have a crucial role to play in the Government’s 10 Year Health Plan. With ambitions to deliver more easily accessible care closer to home and a focus on addressing health inequalities, expanding the role of pharmacies will be vital to improving confidence to self-care across all demographics.

According to Lord Darzi’s 2024 independent investigation of the NHS in England, more than 85% of the English population has access to a community pharmacy within a mile of where they live. Being able to visit pharmacies, which often have longer hours than GP surgeries and are open weekends, means more people can access medication and advice without putting yet more strain on the NHS. As highly trained healthcare professionals, community pharmacists are well-placed to be the first port-of-call for many self-treatable conditions, providing access to over-the-counter medicines and advising on suitable treatments or self-care options.

Over the next five years, the Government wants to move the focus of community pharmacy away from predominantly dispensing medicines and further towards being seen and understood to be a key part of the neighbourhood health agenda, offering more clinical services by making better use of digital tools and available technologies. This includes plans for pharmacies to become securely joined up to the Single Patient Record, modernise the approach to dispensing medicines and support the emergency hormonal contraception service.

All of this is geared towards ensuring people can take more control and responsibility for their healthcare choices and strengthening their confidence to self-care.

How has Pharmacy First paved the way?

Pharmacy First, which launched in February 2024 enables patients across England to get prescription-only treatment for seven common conditions at their local community pharmacy without needing to see a GP. This initiative has showcased how expanding pharmacy services can support GPs to reduce the number of appointments they see for self-treatable illnesses, including common conditions like ear infections, sinusitis, sore throats, and uncomplicated urinary tract infections (UTIs) in 16-64 year-old women.

According to PAGB’s most recent Self-Care Census, we’ve seen a promising trend with a significantly reduced number of patients with uncomplicated UTIs seeing a GP from last year. In fact, the census found that on average, 38% of adults have been referred to consultation with a pharmacist by their GP surgery or NHS 111 services in the last year for their self-treatable condition. The Company Chemists’ Association has also reported this year that potentially over 9 million GP consultations a year could be transferred to community pharmacies under the current Pharmacy First service, for those currently eligible. Not only this, with targeted expansion, up to 40 million GP appointments could also be safely transferred to pharmacies.

The launch of Pharmacy First hasn’t come without some hiccups. PAGB’s Self-Care Census found that only 50% of people are aware of Pharmacy First services and that they can receive prescription treatment from community pharmacists following defined clinical pathways. In addition, the digital integration of Pharmacy First hasn’t been smooth – more needs to be done to join up the pathways for patients, pharmacists and GPs. There’s a real opportunity here to not only raise the visibility of pharmacy services to improve the public’s understanding of and confidence to self-care, but also to expand the eligibility criteria of the Pharmacy First service to reach more patients. Awareness and understanding really are key to improving the use of these services.

As the Government look to reform the current healthcare system, it will be important to focus on empowering people to utilise access points at pharmacy whilst also recognising in some circumstances that it may be appropriate to see a GP. The 10 Year Health Plan aims to integrate pharmacy services into a new Neighbourhood Health Service. In the implementation of this it will be important to ensure pharmacists play a more significant role in influencing the health choices people make to help them move from choosing GPs and A&E for self-treatable conditions to self-care.

Equip pharmacists to play a stronger digital role in self-care

Pharmacists already play a vital role in enabling self-care, as we have seen through the rollout of Pharmacy First. However, there is still further to go to fully integrate pharmacies into NHS digital pathways.

This is where future plans for the NHS App could create real change. Using the App to support digital triage will mean that patients could quickly and easily understand what kind of support is necessary for their condition, how swiftly this should take place, and who is best placed to manage the patient or request. PAGB’s latest report on digital self-care joins calls recommending that the NHS App allow individuals to select pharmacy as their preferred first point of contact where appropriate, based on minor symptom presentation. This would not only ease the burden on NHS services, but coupled with a nationwide awareness campaign, could see more people educated about the pathways to self-care.

Community pharmacists are ready to take on a bigger role in prevention through their interactions with patients. Plans to join up the Single Patient Record should include allowing pharmacists to document consultations, interventions and outcomes digitally in a way that links to wider NHS data systems. This will both strengthen evidence for the value of pharmacy in prevention and early intervention, informing commissioning and resourcing decisions, and help patients to feel more knowledgeable and in control of their healthcare, with their own health records available at their fingertips through the NHS App.

Ensuring that patients feel empowered and assured in managing self-treatable conditions with the support of pharmacy services is an actionable and transformative strategy for the future of healthcare that will also deliver both financial and efficiency benefits across the NHS by accelerating access to self-care.