Martin McShane, medical director at Optum UK, describes the key findings from an HSJ roundtable discussion on how pharmacy can support efforts to address health inequalities

From delivering major elements of the Core20PLUS5 programme, to supporting the Major Conditions Strategy, to taking on new prescribing duties under the Pharmacy First initiative, pharmacists are central to improving access, addressing inequalities and supporting better preventive care.

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Yet, if we want our pharmacy colleagues to play such an extensive role across our health and care system, we need to do something the NHS hasn’t always been terribly good at – and that is, to listen to them, act on their concerns, and make them a genuine partner in change.

At the recent HSJ ICS Medicines Forum, Optum UK chaired a roundtable discussion with around 30 pharmacists spanning integrated care board, primary care and community pharmacy roles. We built the session around a simple question: “How can pharmacy best support efforts to address health inequalities?”

The results were illuminating. What came through, first and foremost, was their considerable, collective appetite to tackle variation and unmet needs. Yet, this was combined with a growing sense of frustration that the means to do so is not consistently available.

Access to data was a big issue: we know pharmacists can add tremendous value within a patient pathway, but they can only do this effectively if we give them the ability to identify, act, measure and improve through high quality data and intelligence.

One of the difficulties is that data sources differ across the various sectors of pharmacy, creating fragmentation. As a result, data linkage – how we link the different datasets, so we identify those falling between the gaps – is vital, but it remains an unresolved issue for many parts of the country.

A second issue involves building up pharmacy’s voice and influence within systems. To many delegates, it seemed perverse that a profession expected to deliver so much in support of core integrated care system goals too often finds itself in the margins when key decisions are being made.

More needs to be done to give pharmacists “a place at the table”, including rapidly increasing the number of ICSs that have chief pharmacists operating at board level to ensure greater parity of esteem with other professionals.

There was recognition too that pharmacy needed to “bring its own house” in order by reducing professional siloes and speaking with one voice. As one participant suggested, the development of so-called “pharmacy collaboratives” could be a helpful mechanism.

Finally, we heard a note of caution around managing expectations. Pharmacists already shoulder a huge workload, and we need, somehow, to help them find the capacity and head space necessary to implement new ways of working.

Our delegates felt a helpful starting point would be ensuring the strategic value pharmacy can bring is well-understood – and measured not in terms of cash released by paring back medicines budgets, but in the contributions that pharmacy-led interventions can make to securing better long-term outcomes for patients and populations.

As I’ve seen throughout my career, pharmacists have ideas and inspiration that can make all the difference to our communities. We hope our roundtable conclusions will give many ICS leaders food for thought as they look to the future.

Martin McShane is medical director at Optum UK. A full briefing paper describing the findings from the HSJ ICS Medicine Forum roundtable can be downloaded here.

This article was prepared by Martin McShane in a personal capacity. The views, thoughts and opinions expressed by the author of this piece belong to the author and do not purport to represent the views, thoughts and opinions of Optum.

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