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The National Pharmacy Association (NPA) has reiterated its plea to Labour for long term investment in community pharmacy after publication of a report by the Policy Exchange which called for services to be commissioned from dispensing doctors in areas where patients’ access to pharmacies is limited.

The report, published yesterday, claimed the NHS 10-year plan and neighbourhood health blueprint risks neglecting people in rural and coastal areas because funding to support health services in those locations, including pharmacies, will fall behind larger towns and cities in England under current Government policy.

The report said closures of pharmacies in rural areas had left patients struggling to access care and suggested Pharmacy First and other pharmacy services benefit “healthcare provision in towns and cities where community pharmacies have larger populations to serve and greater opportunities to achieve economies of scale”.

“Health policy in the UK often gives the impression of being designed for a country in which all patients live in cities, within easy reach of multiple medical facilities and with a range of public transport options to get them there,” the report said. “The picture across the 116 constituencies of rural England is far removed from this.”

It warned “funding formulas, workforce policy and assumptions in the NHS 10-year plan around neighbourhood health” have “neglected” the “reality” faced by rural England. 

The report made 15 recommendations, including commissioning dispensing GP practices to deliver services that have also been commissioned through community pharmacies which “may not be viable or accessible”, so long as practices have “the skills and capacity to do so”.

“This should be built into national programmes, particularly vaccinations and public health services, with the funding, training and support needed,” the report said, warning neighbourhood health will “result in centralisation in disguise if designed incorrectly”.

Other recommendations included ensuring continuity of care is “an explicit and measured part of how NHS services are designed and commissioned” and increasing the proportion of medical and healthcare training placements in rural and coastal areas.

The report also said integrated care boards should assess how hospitals and GP premises can provide more care close to home, including diagnostics, rehabilitation and specialist clinics.

Dispensing doctors are a “solution” when pharmacies may “not be viable” 

However, the report’s suggestion that dispensing doctors are a “workable solution” when community pharmacies may “not be viable” in “very rural locations with the sparsest populations” will catch the pharmacy sector’s eye.

GP surgeries, the report said, can “dispense medicines to eligible patients where access to a pharmacy is difficult”, claiming recent government policy had “overlooked” rural surgeries.

The report used this year’s meningitis outbreak in Kent to illustrate how pharmacies were commissioned to administer vaccinations for young people but dispensing practices were excluded as providers.

“NHS England acknowledged that it had not specifically considered dispensing doctors when designing the service, although it said it would consider supplementary provision in areas with poor pharmacy coverage,” the report said.

It quoted Dispensing Doctors Association chief executive Matthew Isom as saying: “In remote, rural and coastal communities…the most logical place to go would be their local dispensing practice.”

Isom warned students in remote areas without good transport links would be forced to travel further to get vaccinated.

NPA: Bring an end to pharmacy closures

Responding to the report, NPA chief executive Henry Gregg said the Government must address any gaps in healthcare provision by investing in pharmacies in the long term and “bring an end to pharmacy closures”.

“This report rightly highlights that rural communities are underserved by health services and many have to travel significant distances to access the support they need,” he said.

"Previous NPA research has revealed that rural communities have suffered disproportionate levels of pharmacy closures due to historic underfunding, leading to pharmacy deserts in some of the most isolated communities in the country.

 "This has presented challenges for patients wanting to access medicines, advice or emergency contraception, particularly on a weekend, where pharmacies often provide a lifeline to patients and act as the only accessible health care provider in some areas.”

The report was co-authored by Isle of Wight East MP Joe Robertson and endorsed by former health secretary Jeremy Hunt and Health Select Committee chair Layla Moran.