Sandra Melville: How to save money in NHS without hitting front-line services

Even if the Scottish Government were to index-link health expenditure with inflation, the demands arising from Scotland's rapidly ageing population, increasing ill-health and extra costs associated with technological innovation would mean the health budget would still fail to meet demand.

In that context, it's easy to become despondent. But at times of difficulty, the challenge is for our public policy-makers to think creatively, to do more for less and to find ways of partnership working that protects front-line services. The health secretary, Nicola Sturgeon, said recently the tightened financial circumstances would "force a pace on reforms and efficiencies … that perhaps in times of plenty, there's not the same appetite or momentum around".

My profession is well-placed to make an increased contribution to the Scottish NHS that would help to maintain and increase existing services.

The Scottish Community Pharmacy Contract enables pharmacists to take on more patient-focused services and offers genuine opportunities to promote partnership working between pharmacists, patients and the rest of the health-care team. So, for example, the Minor Ailment Service, which enables people who are exempt from prescription charges to register with and use their community pharmacy for the treatment of common conditions, is having a positive impact on managing demand on GP services.

Local pharmacies also have extensive experience in playing a proactive role in improving public health. Pharmacy-based smoking-cessation services are a proven success. Ease of access to a network of highly trained practitioners and a non-threatening environment has helped many thousands of Scots to stop smoking. And in countering substance abuse, pharmacists support not only drug misusers, but wider public health strategies. Currently, pharmacists offer both medicines-based and non-medicines-based support as part of a package of care. Methadone supply is only one aspect of that package.

Recent research by the Health Foundation – an independent charity working to improve the quality of health-care across the UK– has validated the extension of the pharmacist's role. Published only last month, the research found the revision of patient roles can raise the quality of care and that a greater role for pharmacists has the potential to create cost savings.

Our success in Scotland has been followed with some envy by our colleagues south of the Border. In the General Election campaign, all the major parties are now extolling the virtues of public health and prevention services. Indeed, Conservative health spokesman Mark Simmonds has recently argued that public health budgets need to be ring-fenced and that England should have adopted additional services from pharmacists faster than it has done.

So what should be the next steps to developing a truly integrated NHS geared to generate efficiency savings without reducing services?

The Scottish Pharmacy Board recognises it's vital to continue the strong partnership between pharmaceutical and medical services, but a necessary prerequisite is appropriate access by pharmacists to patients' healthcare records. While some pharmacists have access to Emergency Care Summaries, I am disappointed the Scottish Government has not yet enabled the information exchange necessary for pharmacists to deliver their expanded contribution.

Sandra Melville chairs the Scottish Pharmacy Board of the Royal Pharmaceutical Society.