Abstract
Muir Gray’s article 1 presents an interesting but only partial view of levels of care, bureaucracies and populations in need. The ‘bureaucracies’ dimension in particular is over-simplified – referring only to NHS England, CCGs, Hospital Trusts, Mental Health Trusts and General Practices.
What about pharmacy? Given the acknowledged importance of self-care, including its role in preventing transition to more interventionist and much more expensive levels of care, community pharmacy has a critical role to play in supporting populations defined by need.
Pharmacies are the most accessible of all healthcare providers, and they work both within and outside the NHS bureaucracy. Therefore, over-the-counter medication, other supplies and specialist advice can be provided, in a regulated environment, to support self-care and informal care, with the investment in those services adding to stretched NHS resources. The expanding role for the sector was recognised very clearly in the 2008 White Paper ‘Pharmacy in England’ and has most recently been championed in the ‘Community Pharmacy Forward View’ produced by the leading sector bodies – (http://pharmacyvoice.com/wp-content/uploads/2016/08/Community-Pharmacy-Forward-View-FINAL.pdf).
There is now a welcome move to have more pharmacists in GP practices because they are good at managing long-term conditions and spotting when things aren’t right. They can also provide a means to alleviate workforce and capacity issues in the NHS, whilst improving patient safety.
I agree with Muir Gray’s argument that resources should be ‘used for all the people in need not just those who happen to be referred’, but we need to recognise the unexploited potential of pharmacy to respond to that challenge.