Providing patient care through community pharmacies in the UK: policy, practice, and research.

OBJECTIVE

To describe the provision of patient services through community pharmacies in the UK, with particular reference to England, and to explore the research evidence and policy developments for enhancing the contribution of community pharmacy to primary care and public health.

FINDINGS

In the UK, National Health Service (NHS) pharmaceutical services are delivered under contract by privately owned community pharmacies. In England, a new 3 tier structure for pharmaceutical services was introduced in 2005 comprising essential, advanced, and enhanced-level services. All NHS pharmacies must deliver 7 essential pharmaceutical services and provide evidence that they meet the requirements of a comprehensive quality assurance framework. In the first year of the contract, around 40% of pharmacies were accredited to undertake medicine use reviews, the first advanced-level service to be implemented. Meanwhile, up to 25% of pharmacies provide a variety of enhanced-level services; the most common of these is supervised administration of methadone as well as support programs for patients quitting smoking. New legislation is being introduced that will accomplish the following: allow pharmacists to acquire independent prescribing rights, require pharmacy technicians to be licensed, necessitate that both pharmacists and pharmacy technicians periodically demonstrate their continuing qualification to practice, and introduce the concept of the "responsible pharmacist" to the operation of community pharmacies.

DISCUSSION

Community pharmacy is now being recognized by the government as a mainstream contributor to primary care and public health. The current priority is to integrate services provided through community pharmacies into programs provided by other primary care professionals, through strengthening information technology and contractual arrangements. While major changes to the regulation of the pharmacy workforce are occurring, the quality management of community pharmacy services merits further attention.

CONCLUSIONS

The new NHS pharmacy contract and current legislative changes provide a basis for community pharmacy to become fully integrated into NHS long-term care and public health programs.