In many pharmacies the first pharmacist is not affordable, so the question of a second pharmacist is a bit academic to them. But there are three issues for me. First, locum fees have gone down. Second, the cost of iatrogenic diseases is more than employing a second pharmacist – one in six hospital admissions is due to GP and pharmacist errors and this is compounded by carer and patient errors. Third, no one is going to pay for a second pharmacist to shift boxes. So what will both pharmacists do to reduce costs elsewhere, improve health and reduce inequalities?
Hemant Patel, North-East London LPC
Pharmacy contract and the responsible pharmacist regulations stipulate ‘safe and effective running of the pharmacy’. This is only possible if a second pharmacist is present. However, this is not cost-effective and there should be a practice allowance to help pay for the second pharmacist.
Nitin Shah, Fulham Pharmacy, London
Historically, the second pharmacist in the large multiples was usually the store manager. They did the paperwork and covered the dispensary pharmacist when s/he went for lunch/breaks. But the current payment structure no longer makes this feasible. Now the same role would only serve useful in a busy production-line health centre pharmacy. Although CCGs want us to provide extra services such as health checks, they do not cover us for second pharmacist payment. GPs’ staff are partly covered by funds from NHS... Why does this not apply to us, who also provide NHS services?
Al Patel, Lee Pharmacy, London
A second pharmacist funded by the government would be cost-effective to the NHS as it ensures patient safety, increases uptake of services and improves quality. But it would not be cost-effective for a pharmacy to pay, as the bottom line is constantly being eroded away. Currently, there’s no real promise of jam at the end of it, because the commissioners aren’t doing their job.
Sid Dajani, Wainwrights Chemists, Andover
On the current modelling this is not cost-effective, as it would require the commissioning of a minimum of £40k of enhanced services. Even then it is probably more cost-effective to employ qualified technicians to take on the mechanics of dispensing, releasing the existing pharmacist to deliver more enhanced care services. Second pharmacists become of greater value if a number of new services are delivered at the patient’s home or alternate settings. The costings and volume required to justify this are still significant and would require new contracts to be issued for a minimum of three years to justify development and spend.
Ash Soni, English Pharmacy Board (RPS)