In business: Despite the cuts

Our case study series, In Business, explores how community pharmacies can survive and thrive in these challenging times.

Mark Burdon, pharmacist and PSNC regional representative for the North East and Cumbria, talks us through some of his ideas for driving his pharmacy business forward

What are the issues facing community pharmacy and how are you tackling them?

We have a massive reliance on the NHS, and the last two years have highlighted the dangers of being over-reliant on one customer. NHS cost-saving measures have been put in place, potentially with even more to come. Government is seeking to make savings on the drugs budget by concentrating on the cost of these medicines. Furthermore, the pharmacy market is at risk of being totally commodified with serious consequences for the network of community pharmacy premises.

I’ve put together a five-year plan for my organisation to put us in the best position to address these challenges. This is based on four key areas: workforce; services and extended scope of practice; premises; and marketing and public awareness.

Thinking about where we would like to be in five years, prescribing and management of long-term conditions is key. I’ve had several trips to Canada and seen the ‘Alberta model’ in action, whereby pharmacists manage long-term conditions such as hypertension, diabetes and asthma. It’s much more developed than the pharmacist prescriber model we have here.

How have the pharmacy funding cuts affected your pharmacies? What has your response been?

We started to plan for reduced funding as soon as the government’s proposals were announced. Like any pharmacy, we’ve always run very efficiently, but we’ve become even stricter with cost containment. The focus was on identifying, and seeking to extricate ourselves from, unprofitable work (such as an anticoagulation clinic that was affected by the shift from warfarin to newer agents) and managing costs appropriately, while releasing capacity to exploit new opportunities.

It’s important to us that staff are involved in every stage of the planning process. As a team, we are not simply hunkering down and hoping for the best; we are remaining positive!

Do contractors and employees need to be thinking differently?

Rather than relying on the NHS to make best use of community pharmacy, pharmacies must seek to expand the customer base. Private services are key to new revenue sources, for example strep throat and travel clinics; they also help relieve the pressure on the NHS. In the short-term, these can be based around PGDs, but the long-term aim is for pharmacists to become prescribers.

Any new services must be properly and adequately funded to be sustainable. For example, when I costed the NUMSAS service spec, I could not make it work financially. Therefore, we have not signed up to it.
While retail business is going to supermarkets and discounters, we can still maximise the benefits of the P medicines category. Things like the POM to P switch for Maloff Protect are helpful for us.

We should engage the public via local printed media (e.g. community newspapers) and social media opportunities, display service offerings prominently in the pharmacy using electronic means rather than posters and leaflets, and communicate directly with patients via SMS wherever possible.

Are there positives as well as the negatives?

Definitely. While there is still a big job to do to make the government recognise the value of the service, there are opportunities to do more. It is regrettable that the government has failed to make the most of community pharmacy, but we have to move on and take matters into our own hands.

What’s your view on where pharmacy is currently?

We are in a difficult position as government doesn’t value the service. The comments made by the CEO of the NHS about “doling out medicines” (indicating that’s all we do) is both frustrating and disappointing. All pharmacists are clinical, not just the new breed of so-called “clinical pharmacists” being promoted as the answer to the NHS. The biggest challenge we face is changing these jaundiced views.

This involves getting to grips with data. It is vital that community pharmacy gathers data, as this is the evidence base that serves as proof of our worth. The PwC Value of Community Pharmacy report, commissioned by PSNC, shows the enormous value (>£5 billion) that we deliver on just 12 services examined. The more data you have, the more you can power up an economic study to look at the value of the service.

We must also value our core service – the dispensing, supply and supervising safe use of medicines. The best way to manage the product is to build the service around it, rather than having the medicine delivered by an automated warehouse. This service is exceptionally valuable to the public, but I don’t think at the moment the government really sees that.

Mark talks through his business ethos

“My wife and I own five pharmacies in the north east of England (Burdon Pharmacy Group), spread across a wide geographical area. We focus on the needs of the local community and integrate ourselves into the community. Excellent relationships with other healthcare professionals are essential to what we do. Our management structure is unusual in that we have a centralised approach. Our operations director looks after the business side, leaving the pharmacists to concentrate on professional matters and the patient-facing role.

We have always been responsive to opportunities for innovative services. These include provision of pharmacy services to prison and prescribing support to GP practices/CCGs.”

 

 

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