Preparing for 2018 – NHS priorities and pharmacy service development Sue Sharpe Chief Executive PSNC

Context: NHS Financial pressures Funding growth double that in last Parliament leaves £22bn demand + efficiency pressure by Action Zones 1. Within provider organisations 2. Better whole system working between different parts of health + social care 3. Wider action on public health + prevention to moderate the rate of demand increase

Context: The NHS – 5 Year Forward View Merging Health + Social Care 4 dynamics: personalisation, standardisation, anticipatory care, co-production “The Commission on the Future of Health and Social Care in England showed that the case for a single health and social care budget is compelling but only if sufficient funding is provided. Merging two leaky buckets does not create a watertight solution, as Simon Stevens has observed. ” (Kings Fund March 2015)

Context – Hunt’s 25 year vision Political 7 day NHS – implications and opportunities for pharmacy Attack on BMA: ‘a roadblock to reform’

Innovation Challenge for Pharmacy The NHS needs radical change in the systems for delivery of care. For pharmacy this can be Disruptive or Sustaining innovation Threatening or protecting the network Developing its role, use and value or major rationalisation

What Community Pharmacy can offer the NHS Must be credible Manageable Verifiable Above all – cost saving

The Third Pillar – supporting future NHS provision Community Pharmacy GP led primary care Hospitals Optimising the use of medicines Supporting people to self-care Supporting people to live healthier lives/public health Supporting people to live independently

Where does CP fit in? Help deliver better, cheaper care Relieve burdens on General Practice (LTCs) Relieve pressures on A+E and urgent care (Have we trained people not to use pharmacies for advice + retail?) Older people and reducing hospital admissions + costs Prevent avoidable disease Support self-care: MAAS and non-NHS Wellness

Some figures – Diabetes + Obesity 2013: 3.2m patients with diabetes; increase of 163,000 on 2012; 5m obese 80% type 2 diabetes - preventable Costs ‘more than police, prisons and courts combined’ Pharmacy can identify those with high diabetes risk

Some figures – GP visits for minor ailments >50m per annum minor ailments alone Opportunity to save GP time and costs C90% MAS patients say they would have gone to GP GP support – c90% in W Mids and Bradford MAS service areas Community Pharmacy can take on responsibility as 1 st contact point

Some figures – Urgent care A+E total attendances = 17.84m; = 22.36m Increase 25% % attendances discharged: GP follow-up (1/3), no follow-up (2/3) Urgent supply of repeat medication: <30% of all Saturday calls: high cost for OOH GP consultations Pharmacies can take on much consultation + most urgent supply

Some figures – ageing population Doubling of numbers of over 80s by ,000 patients with dementia 95% older people, cost £26bn pa 670,000 dementia carers Kings Fund 2012: >2m unplanned admissions of elderly people; 68% of all emergency bed use Pharmacies – Reablement + domiciliary support services reduce admissions. Social care a great opportunity

Some figures – the disease burden 3.3m asthma 0.9m COPD 7.5m hypertension 1.8m hyperthyroidism Pharmacies – LTC support and management

The challenges for community pharmacy How do we ensure we have: Ambition and commitment Credibility and Quality Investment and Return IT- supported service integration Support from General Practice

The next few years Community pharmacy has its greatest opportunity since 1948 Local authorities can be pivotal as sponsors and allies Passivity is toxic: action must support ambition Vision and investment now to grasp the opportunity: teams, skills, outcomes