The Future of Pharmacies: leading new models of community-based care

On the 1st June, Lambeth, Southwark and Lewisham Local Pharmaceutical Committee and Community First Services Pharmacy Federation hosted an event in collaboration with Health Foundry on the opportunities that pharmacy has to take a lead role in developing innovative new models of community-based care with a range of partners from the digital and voluntary and community sectors.
Amit Patel, Chief Officer of Community First Services Pharmacy Federation and Chief Executive Officer of Pharmacy London, kicked off proceedings introducing us to pharmacy and asking the question “how can pharmacy play a lead role in bringing people together to transform community-based care?”. 
The vision is to ensure it becomes a true key player in primary care utilising all its key features. He mentioned the ability of pharmacy to promote self-care through easily accessible services, flexible opening hours, real understanding of local patient populations and the potential for a more cost-effective, efficient operating model. Amit also discussed the ability to work with a diverse set of partners and being able to truly employ family based care.
James Roach, NHS Transformation Lead at the National Pharmacy Association then set out the vision and strategy for pharmacy in the future and the importance of elevating the role of the community pharmacist in a changing NHS. He talked about the need for change and the benefits of redirecting non-essential workload out of general practice. He highlighted how our professionals must be enabled to lead that change and how positioning community pharmacy as a regional system solution could add value. James then discussed community pharmacy interventions and the importance of taking the continuous care brand forward.
We then looked at the innovative work already being done by pharmacy in all sorts of different settings and with different partners across the system. First to the stage were Lelly Oboh, Kat Le Bosquet, Gopal Ladva from Guy’s and St Thomas’ Integrated Care Pharmacy Team and Lambeth CCG Community Med Plus team discussing how focusing community support on those with frailty rather than those with highest risk of hospital admission can improve patient care and reduce hospital bed usage. This was a great example of pharmacy working in conjunction with secondary and community care to improve patient outcomes.
Next up was Clare Thomson from Lambeth and Southwark Integrated Heart Failure Service. She started by highlighting the shocking statistics around heart failure in the UK, showing that 900,000 people are estimated to be living with heart failure in the UK and 30-40% of patients diagnosed with heart failure die within a year.  Clare suggested that with early and accurate diagnosis, access to heart failure specialists, prescription of evidence-based therapies and coordinated care can significantly improve prognosis, and quality of life. She highlighted the important role community and practice-based pharmacists can play in helping reduce unplanned admissions by helping identify and educate patients with heart failure, signpost patients to help, promote self-management and support medicine adherence.
Following Clare was Melanie Dalby, a Darzi Fellow discussing how by integrating the role of community pharmacy with secondary care it can lead to better support and outcomes for patients on oral anticancer medication. 
Next on the agenda was a Q&A on becoming an independent prescriber and the experience of using this and working in General Practice with Atul Patel, Mohammed Mia and Fatai Papoola. Each pharmacist was asked about why they became an independent prescriber and the benefits that it has brought to them as pharmacists as well as to patients and the GP’s that they work with. They all shared the message that, whilst it isn’t an easy course to pass requiring a lot of commitment and effort, independent prescribing represents a real opportunity to change the culture of general practice and have GPs and commissioners see the strengths and assets that pharmacy can bring to the table.
The next part of the event focused on the question: “what pharmacy can do with other partners?”
First we welcomed Rosa Friend from South London Cares and Karman Chung from Hills Pharmacy in Lambeth to discuss their fantastic partnership. Rosa now does outreach work one day a month at Hills Pharmacy talking to older patients about their social needs while they are waiting for their prescription and how South London Cares can support them with their advice and wonderful inter-generational befriending model. 
Rosa described how a community pharmacy is a safe place to meet vulnerable older people and there are real practical benefits as her organisation now has a base in North Lambeth with a room and wi-fi she can use to work remotely. Karman then explained from a pharmacist's perspective that this was a very simple and effective way of supporting his patients to access care they needed that he couldn’t otherwise provide and at no cost to him or his pharmacy. Karman described how this was also extremely rewarding on a personal level to make a difference in this way. 
This partnership is a great example of how community groups working in conjunction with community pharmacy is easy to do, doesn’t cost anything and provides fantastic care and outcomes for patients.
Rich Harris, Health Foundry's Community Manager, then gave an introduction to Health Foundry. Rich highlighted its role in connecting digital health solutions within community based pharmacy interventions. He discussed its vision in creating a more effective health service and how enabling the healthcare system itself to innovate and adapt new technologies can be beneficial to the system. Rich talked through examples of the inspiring work its members contribute at the co-working space and introduced two member’s Adam Oakman (NVOLVE) and Baron Armah-Kwantreng (RemoteHealth Tech) to showcase their work and discuss specifically how it can benefit pharmacy in Lambeth, Southwark and Lewisham.
NVOLVE is a medication adherence helping hand. Adam highlighted how important it is to empower patients to take control and in turn their medication on a regular basis and also provide the necessary support if and when they need it. He discussed how loved ones and caregivers can work together and help increase adherence rates with polypharmacy patients. NVOLVE have several products including a simple SMS reminder and self reporting system which attaches through to a device that monitors how much and when the medication is taken. Adam highlighted how he sees pharmacists as key in helping with adherence rates and is excited to build on the connections with the Lambeth, Southwark and Lewisham Local Pharmaceutical Committee.
RemoteHealth Tech is a digital health software company focused on developing remote data services using wearable technology that can improve the clinical outcomes of people suffering from abnormal heart rhythms. Baron shared their current activities which involve developing a working model of a software platform that can gather clinical grade heart rhythm data from wearables, and share information with health professionals through a secure log in system. They are also working with manufacturers of a wrist band ECG device that can be used gather clinical grade data in medical surgeries and remote locations to integrate data with patient record systems.
Baron highlighted the importance of startups working with pharmacies to help understand what each group can contribute to improving health outcomes in local communities and then working with them to understand how to best to collaborate effectively together. He also highlighted how community pharmacies have a vital role to play as community gateways for in person-centric medicine where the health service needs to pivot around their needs and locality. They are keen to explore opportunities such as developing AF screening services integrated with personal health records using existing and future devices in the pharmacy setting.
The evening ended with a summary from Will Nicholson, Health Foundry Community Connector, who thanked everyone who participated in the group discussion and suggested a follow-up session to build on the energy, great ideas and conversations. Will looked forward to addressing the possible challenges and opportunities that had arisen throughout the evening and welcoming anyone to get in touch to help build on this success and to get practical in finding ways to work together. 
The follow up event is going to be on 28 June 2017 at Health Foundry between 7-9.30pm. If you are interested in attending or would like more information please email Will Nicholson.