Substantial increases in the number of clinical pharmacists in GP practices as well as other new pharmacist roles will be funded by an efficiency drive in NHS reimbursement and wider supply arrangements, the NHS in England has pledged in the NHS Long Term Plan published yesterday.
Among the new pharmacy roles, from 2019, NHS 111 will start direct booking into GP practices across the country, as well as refer on to community pharmacies which support urgent care and promote patient self-care and self-management. CCGs will also be expected to develop pharmacy connection schemes for patients who don’t need primary medical services.
Elsewhere in the plan, the NHS pledges direct funding for GP practices typically covering 30-50,000 people. The funding will cover the development of integrated teams of GPs, community health and social care staff.
The plan also outlines significant changes to the GP Quality and Outcomes Framework (QOF) to include a new Quality Improvement (QI) QOF to support more personalised care. Before the end of this year, there will also be a fundamental review of GP vaccinations and immunisation standards, funding, and procurement. This will support the goal of improving immunisation coverage, using local coordinators to target variation and improve groups and areas with low vaccines uptake.
Among the other measures to affect GPs, patients will be given access to online ‘digital’ GP consultations, promoting ‘digital-first’ care options, and by 2024, all service providers will be expected to implement electronic prescribing systems.
There are also various recruitment and retention initiatives including inter-disciplinary credentialing programmes to enable more workforce flexibility across an individual’s NHS career and between individual staff groups.
The NHS Long Term plan provides no other details on the reimbursement proposals, but the DDA has already opened discussions with the Department of Health on reimbursement, and has signed a joint position paper with English pharmacy and GP representatives seeking fair reimbursement. DDA chief executive Matthew Isom said: “We share PSNC’s ambitions to see a system of reimbursement in England that rewards dispensing practices fairly for the valuable dispensing service they provide.”
The reforms are backed by a new guarantee that over the next five years, investment in primary medical and community services will grow faster than the overall NHS budget. This commitment – an NHS ‘first’ – creates a ring-fenced local fund worth at least an extra £4.5 billion a year in real terms by 2023/24.