Jeroen van de Pol

192 Appendices curricula of schools of pharmacy and therefore pharmacy students are currently already being better educated to provide CPS. However, community pharmacists that received more traditional education, should gain these skills and knowledge via postgraduate training and education. Also, more focus should be put on the joint education of pharmacy- and medical students. This will also most likely increase future collaboration between the two professions. The knowledge level of pharmacy technicians should be complementary to the ambitions of the community pharmacy profession, where current pharmacy technicians are predominantly focused on the dispensing process. Therefore, pharmacy technicians should be more capable in offering CPS, but also on activities that can alleviate the community pharmacist such as managerial activities. By doing so, pharmacy technicians will be capable of supporting community pharmacists fully in implementing CPS in daily practice. In daily practice, it will be shear impossible to spend all available time on activities that are considered CPS. However, community pharmacists spend more time on activities that do not include direct patient contact compared to GPs. Especially activity groups like the dispensing process and pharmacy management consume a large amount of time. The amount of time being spent on the dispensing process could be an indicator that community pharmacists are faced with personnel shortages. Next to this, each activity performed by community pharmacists should be evaluated if the amount of spent time by the community pharmacists is necessary. The current reimbursement model is volume driven, based on the amount of medicines being dispensed to patients. This reimbursement model is therefore considered not to facilitate community pharmacists in focusing on CPS. This calls for a revision of the reimbursement system. A reimbursement model with elements of a capitation system and a fee per performed CPS seems to be most obvious. Next to this, adding an element rewarding community pharmacists for health outcome can be considered to add. The current business model of community pharmacies has been unchanged for the past years. To enable the community pharmacist to better delegate and divide tasks, partnerships between different community pharmacies offers possibilities. By doing so, community pharmacists are capable of upscaling activities and divide among participating community pharmacists. It is expected that community pharmacists will subsequently be able to manage the available time more efficiently and focus more on certain activities, also increasing the quality of the work performed. Community pharmacists can also consider the hub-and-spoke model in which the dispensing process and activities related to distribution are being centralized at the hub . At the same time, the provision of CPS can be performed at the spokes that can be positioned in a wide variety of places including a GPs practice. Another possibility is the separation of CPS and dispensing (including related distributary activities), where CPS is being provided by pharmacists employed by GPs within the