Pharmacy employers have two tasks in “massively important” efforts to retain and upskill the existing workforce of pharmacists and pharmacy technicians, according to NHS England’s chief pharmaceutical officer David Webb.

“Working with employers, we are aiming to deliver fulfilling roles across all sectors for new and existing registrants,” he said. “To support these developments, employers need to make sure they are training enough pharmacists to meet their own needs, which means providing undergraduate placements and providing foundation trainee pharmacist places. Secondly, at a time of challenging workforce preferences, [employers need] to listen to employees, understand their preferences and, as a result, offer attractive careers.”

Mr Webb said that the pharmacy integration programme is investing £15.9m in training and development of community pharmacy professionals. Some 3,000 independent prescribing training places for the existing workforce have already been provided, while HEE is asking people to register their interest in the next phase of funded clinical examination skills training for community pharmacy professionals, including in specialist areas such as cardiology, paediatrics, ENT and dermatology.  

In a pre-recorded video for the Sigma Conference, Mr Webb thanked the sector for its “brilliant work” in a tough landscape. He said he fully recognised the pressures pharmacy teams and contractors are under. “Everywhere I’ve been, I’ve been impressed with the work taking place, and the positive local relationships that have been developed between pharmacy colleagues with other healthcare professionals and across local systems.”

The pandemic changed the landscape, but the NHS was still working to achieve the ambitions set out in its Long Term Plan, due to be updated shortly by a primary care recovery plan as well as the NHS long-term workforce plan. “Community pharmacists are already playing a larger role in prevention and access to clinical services. This will continue with the prospect of a greater role in long term condition management.”

Mr Webb said the delegation of commissioning of pharmaceutical services to integrated care boards/organisations (ICBs), due from April, will allow local providers to form partnerships to deliver integrated services at place and neighbourhood level. “To make the most of ICB commissioning, community pharmacy teams will need to be collaborators with each other and with primary care networks (PCNs) and social care teams to deliver joined up services as part of formalised pathways of care,” he said. Community pharmacies would need to understand the population health needs in their local area and propose solutions. “New community pharmacy clinical leads in ICBs, funded by NHS England, are there to advise and support.”

A key priority for ICBs will be addressing health inequalities across populations, he said. “They will start in the most challenging areas, using population health management in line with the national CORE20+5 policy. Community pharmacy teams can make a real difference, with work on health inequalities included in year five of the Pharmacy Quality Scheme, where the ask is to collaborate with the ICB, local PCN or local GP practice to develop and action plan to tackle a health inequality, for instance with hypertension case finding.”

Mr Webb said his team is working with 15 pharmacy organisations to develop and embed inclusive pharmacy professional practice into everyday care for patients and the public, to support the prevention of ill health and to address health inqualities in diverse local communities. “Addressing health inequalities is fundamental to our success and I hope you will join in and support the inclusive pharmacy practice initiative,” he said.  

The future direction for community pharmacy was becoming clear, Mr Webb said. “Nationally a lot of the building blocks are in place, although there is more work to be done. The developments in clinical services over the last few years and their delivery by community pharmacy professionals and teams are very positive. These are helping to change people’s perceptions about what services they can receive in pharmacies and provide evidence to policy makers for the commissioning of new services. We now need the sector as a whole to support and provide leadership.”

With responses to consultations due, Mr Webb said: “There will be synergistic efficiencies gained by using hub and spoke dispensing and OPD. Later this year the Government will also consult on allowing pharmacy technicians to use PGDs and better use of skill mix within pharmacies.

“We’re developing the role of pharmacy technicians as professionals in their own right,” he said. “This will help enable community pharmacists to be independent prescribers and deliver clinical services and the future we are all seeking and help us to meet some of our workforce challenges. The vision is for the unique role of pharmacy technicians to become the norm in all sectors. Their skills as competent, trusted, registered health care professionals used in a way that makes them essential to every team in every sector.

“Community pharmacy independent prescribing pathfinders in every region will inform the future commissioning of NHS community pharmacy clinical services from 2024. These pathfinders will be supported by ICBs testing different models, allowing for local variation in creative design and delivery, responding to local need and the availability of pharmacist prescribers. Patient safety, governance, digital and reimbursement processes will be tested and evaluated. With our expertise in the use of medicines, I believe pharmacists will excel as prescribers, working as part of the integrated team.”

Mr Webb ended by reflecting on the recent report of the UK Commission on Pharmacy Professional Leadership. “In light of these developments, it’s clear how important their report is to us as a profession,” he said. “Pharmacy is at a time of great opportunity. Pharmacy professional leadership as a whole need to reset and re-establish a strong and a united voice to enable it to meet the challenges of rapid technological advances, expanding professional roles, fundamental changes to initial education and training, multiple healthcare pressures and changing public expectations. The public, patients, the NHS and other employers, regulators and Government all depend on the healthcare professions to provide authoritative leadership, scientific insight and a co-ordinated voice.

“The next few years are pivotal,” Mr Webb said. “NHS England will continue to work collaboratively with all our partners across the sectors. I believe pharmacy professionals at all levels have an enormous contribution to make and that the highest standards of professional practice will be fundamental to our success. There is no doubt in my mind that community pharmacy teams are central to the future of the NHS.”