Independent Investigation of the National Health Service in England: the Darzi Report’s implications for clinical pharmacy practice

Independent Investigation of the National Health Service in England: the Darzi Report’s implications for clinical pharmacy practice

Over the past few weeks, the healthcare sector, including pharmacy, has been reflecting on the damning outcomes of the independent investigation into the NHS led by Lord Ara Darzi. While the issues highlighted may not be new, the report makes for sobering reading and underscores the pressing need for action and reform, especially in light of rising patient demands and continuous pressure on healthcare services. The report outlines systemic issues within the NHS, notably the over-reliance on hospitals and a lack of investment in community care. But what are the implications for clinical pharmacy?

As Tase Oputu, chair of the RPS in England notes, “medicines are an essential part of NHS care and…pharmacy must be a part of the conversation”. Lord Darzi frequently mentions pharmacy throughout the report, emphasising the huge potential of pharmacy professionals in providing “even more value-added services for the NHS”, particularly in relation to their clinical role. He notes that “there have been positive developments in growing the wider workforce in general practice such as clinical pharmacists”. This correlates with the introduction of the Additional Roles Reimbursement Scheme in 2019, which has increased the number of pharmacists in general practice, which has helped grow their clinical responsibilities.

The report sets out the pressures faced in secondary care, including tackling significant rises in attendance at hospital emergency departments. While much of the report focuses on community pharmacy, there are key lessons that can be applied across community, hospital and GP pharmacy. Closer collaboration between primary, secondary, and community care sectors can support more integrated care strategies. For example, clinical pharmacy professionals in hospitals and general practice can work more closely with GPs, nurses, and community health teams to ensure seamless care transitions, particularly for patients with long-term conditions.

This emphasis on interprofessional collaboration aligns with Lord Darzi’s core argument: to shift spending from secondary care and towards community and primary care and prevention, particularly by enhancing GP and community services to provide more out-of-hospital care.

This diagnosis from the report does present an opportunity for clinical and community pharmacy professionals to contribute towards the solution to “GP waiting times, reducing demand for hospitals, prevent[ing] illness”, as Paul Rees, chief executive of the NPA explains. This involves building “capacity, capability, infrastructure and technology base of care that is delivered in the community, including general practice”, where pharmacists can leverage their prescribing skills to enhance patient care. However, to maximise the efficacy of the potential of pharmacy professionals, there needs to be sufficient prescribing budgets and workforce planning.

The report also highlights the missed opportunities to embrace technology within the NHS. Tase Oputu points out that achieving the goal of providing patients with care closer to home is out of reach without investment in technologies and digital capabilities, such as electronic prescribing in hospital pharmacy. By embracing digitally enabled care with investments in digital automation within laboratories and pharmacies, for example, the NHS can improve efficiency and enhance the quality of patient care.

The Darzi Report presents a call-to-action for pharmacy professionals to expand clinical responsibilities, seamlessly integrate with healthcare teams, embrace digital innovations, and lead in preventive care. The recommendations in the report have been well received by pharmacy leadership bodies where everyone is in alignment that more investment and resources are needed in primary care to improve the health and care of the nation as a whole.

Read the full report here: https://assets.publishing.service.gov.uk/media/66e1b49e3b0c9e88544a0049/Lord-Darzi-Independent-Investigation-of-the-National-Health-Service-in-England.pdf