Pharmacy is facing unprecedented challenges, which means it’s more important than ever that everyone’s skills are used effectively

Community pharmacy doesn’t exist in a bubble; it is subject to the considerable fiscal pressures emanating from the NHS, its main source of income, as well as those experienced by other retailers who are competing intensively for their share of customer spend.

It is clear that the NHS is going through the biggest financial squeeze in its history. Since 2010, its budget has effectively been frozen, increasing by just enough to cover inflation. While this is generous compared to other areas of public spending, increasing demand for care means that services are under huge pressure.

While the NHS has responded well to these challenges, financial pressures are growing, with large numbers of hospitals now in deficit and additional funding of £8 billion having to be found. Pharmacy funding has been challenging for longer than most of us can remember. Looking further ahead, pressure to spend more will grow as the costs of treatment rise, public expectations increase, a seven-day NHS becomes a reality, and the population continues to age.

A number of overarching policy documents and publications refer to the need for the NHS to develop and make best use of its full workforce. Helpfully, there has been much reference to the greater use of pharmacists in supporting GP practices and working more collaboratively with GPs, particularly in relation to medicines optimisation. There has also been talk about furthering the self-care agenda, supporting patients through pharmacy and signposting them to pharmacy through, for example, formalised pathways in NHS 111.

All of this provides clear opportunity for pharmacy and pharmacists. However, the challenge is one of time.

Where is the time and capacity to engage in a meaningful way? Part of the answer may come from increased funding, wider use of second pharmacists, but arguably a greater part of the solution will come from making better use of pharmacy staff already there, releasing time and capacity for the pharmacist.

The pharmacy context

The phrase ‘more for less’ is often used when referring to the need for the state to deliver efficiencies in all areas of government spending. It could also be usefully applied to making the best use of resources, specifically those relating to the skills and knowledge of our people. The day-to-day reality of many pharmacies is that pharmacists find themselves getting bogged down in routine dispensary and front-of-shop tasks, which leaves them precious little time for the vital managerial functions such as long-term planning, service development and relationship building with GPs.

How might situation evolve, and how will pharmacies need to adapt in the future? How will the wider spread of dispensing automation, large or small scale, drive the need to think very differently about who does what in a pharmacy? As community pharmacists become more involved in the delivery of medicines-related professional services under new national contracts and locally commissioned service contracts, then maximising the value of the skills mix within pharmacy support teams will become increasingly essential.