A review into how the system of primary care in England might be transformed under the new integrated care systems (ICSs) which come into being in July has struck an optimistic tone. The National Pharmacy Association, which took on the role of co-ordinating community pharmacy input to the review, has welcomed the outcome.

The Next steps for integrating primary care: Fuller Stocktake report, describes the forthcoming changes to the NHS landscape as “a moment of real opportunity”.

In her introduction, Dr Claire Fuller, the chief executive (designate) of the Surrey Heartlands ICS, who was commissioned by NHS England & Improvement to conduct the review, said: “There is real optimism that the new reforms to health and social care landscape – if properly supported to embed and success – can provide the backdrop for transforming how primary care is delivered in every community in the country.

“Primary care must be at the heart of each of our new systems – all of which face different challenges and will require the freedom and support to find different solutions.”

Significantly, all the CEOs of the 42 new systems have added their signatures to the report.

“Health visitors, community and district nurses, GPs, dentists, pharmacists, opticians and social care workers are among the most recognisable of a multitude of dedicated staff delivering care around the clock in every neighbourhood in the country,” it says. The role community pharmacy played during Covid, in particular how it kept its doors open, is noted upfront.

The new vision for integrating primary care, improving access, experience and outcomes for communities, centres around three things: streamlining access to care and advice, providing more proactive personalised care with support from a multidisciplinary team of professionals, and helping people to stay healthy for longer through a more joined up approach to prevention.

The report envisages closer working between primary care providers, and the building of integrated teams in every neighbourhood.

Community pharmacy is specifically highlighted in the chapter on improving same day access for urgent care, with the suggestion that the sector is one key element that needs to be organised into “a single integrated urgent care pathway in the community that is reliable, streamlined and easier for patients to navigate”.

The role community pharmacy plays in prevention is also highlighted. “We heard very clearly that the wider primary care team could also be much more effectively harness, specifically the potential to increase the role of community pharmacy, dentistry, optometry and audiology in prevention, working together to hardwire the principles of ‘making every contact count’,” it says.

The report recognises the responsibilities for commissioning NHS community pharmacy services that will be taken on by ICSs from April 2023, and advises that building relationships with local pharmaceutical committees is a key element of “ensuring primary care leadership across all four pillars is embedded into systems”.

The NPA welcomed “NHS England’s commitment to break through primary care silos and engage community pharmacy,” adding that the review provides a “clear signal” that integrated care systems must break through silos in primary care.

It convened a sector-wide meeting with the team leading the stocktake, to explore community pharmacy’s place in the landscape of ICSs and NPA representatives sat on each of the review’s working groups.

The NPA highlights the reviews call for integrated neighbourhood ‘teams of teams’ to evolve from primary care networks, and notes the pick up on roles for community pharmacy in urgent care and prevention including early diagnosis of cancers. “This adds up to a significant opportunity for pharmacies to engage with the NHS at a local level.”

NPA chief executive, Mark Lyonette, said: “So often in the past community pharmacy has been barely recognised in key reviews. This document is a clear signal to ICSs to engage community pharmacy in a multidisciplinary push on prevention, urgent care and long term conditions.

“This is an invitation to be active partners in integrated care and that means investing time and energy in building relationships to improve local services.”

NPA board member Reena Barai served on two of the Fuller working groups and spoke at the launch event for the report. She said: “As a community pharmacist I am part of ‘team primary care’, which is bigger than general practice alone. This report will form the blueprint for partnership working as a ‘must do’ rather than a ‘nice-to-do’.

“In the last two years I’ve seen a growing desire for collaborative working, driven by the pandemic, but there’s a way to go yet.”