Preparing for 2018 – NHS priorities
and pharmacy service development
Sue Sharpe
Chief Executive
PSNC
Context: NHS Financial pressures
Funding growth double that in last Parliament leaves
£22bn demand + efficiency pressure by 2021
3 Action Zones
1. Within provider organisations
2. Better whole system working between different parts
of health + social care
3. Wider action on public health + prevention to
moderate the rate of demand increase
Context: The NHS – 5 Year
Forward View
Merging Health + Social Care
4 dynamics: personalisation, standardisation, anticipatory
care, co-production
“The Commission on the Future of Health and Social
Care in England showed that the case for a single
health and social care budget is compelling but only if
sufficient funding is provided. Merging two leaky
buckets does not create a watertight solution, as Simon
Stevens has observed. ” (Kings Fund March 2015)
Context – Hunt’s 25 year vision
• Political
• 7 day NHS – implications and opportunities for
pharmacy
• Attack on BMA: ‘a roadblock to reform’
Innovation Challenge for
Pharmacy
The NHS needs radical change in the systems for
delivery of care. For pharmacy this can be
• Disruptive or Sustaining innovation
• Threatening or protecting the network
• Developing its role, use and value or major
rationalisation
What Community Pharmacy can
offer the NHS
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•
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Must be credible
Manageable
Verifiable
Above all – cost saving
The Third Pillar – supporting
future NHS provision
Optimising the use of
medicines
Supporting people
to self-care
Supporting people to
live healthier
lives/public health
Supporting people to
live independently
Community
Pharmacy
GP led
primary care
Hospitals
Where does CP fit in?
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•
•
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Help deliver better, cheaper care
Relieve burdens on General Practice (LTCs)
Relieve pressures on A+E and urgent care
(Have we trained people not to use pharmacies
for advice + retail?)
• Older people and reducing hospital admissions +
costs
• Prevent avoidable disease
• Support self-care: MAAS and non-NHS Wellness
Some figures – Diabetes +
Obesity
• 2013: 3.2m patients with diabetes; increase of
163,000 on 2012; 5m obese
• 80% type 2 diabetes - preventable
• Costs ‘more than police, prisons and courts
combined’
Pharmacy can identify those with high diabetes
risk
Some figures – GP visits
for minor ailments
• >50m per annum minor ailments alone
• Opportunity to save GP time and costs
• C90% MAS patients say they would have gone to
GP
• GP support – c90% in W Mids and Bradford MAS
service areas
Community Pharmacy can take on responsibility as
1st contact point
Some figures – Urgent care
• A+E total attendances 2004-5 = 17.84m; 2014-5 = 22.36m
• Increase 25%
• 2013-14 57.9% attendances discharged: GP follow-up (1/3),
no follow-up (2/3)
• Urgent supply of repeat medication:
• <30% of all Saturday calls: high cost for OOH GP
consultations
Pharmacies can take on much consultation + most urgent
supply
Some figures – ageing
population
• Doubling of numbers of over 80s by 2030
• 850,000 patients with dementia 95% older people, cost
£26bn pa
• 670,000 dementia carers
• Kings Fund 2012: >2m unplanned admissions of elderly
people; 68% of all emergency bed use
Pharmacies – Reablement + domiciliary support services
reduce admissions. Social care a great opportunity
Some figures – the disease
burden
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•
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3.3m asthma
0.9m COPD
7.5m hypertension
1.8m hyperthyroidism
Pharmacies – LTC support and management
The challenges for
community pharmacy
How do we ensure we have:
• Ambition and commitment
• Credibility and Quality
• Investment and Return
• IT- supported service integration
• Support from General Practice
The next few years
Community pharmacy has its greatest opportunity
since 1948
Local authorities can be pivotal as sponsors and
allies
Passivity is toxic: action must support ambition
Vision and investment now to grasp the
opportunity: teams, skills, outcomes