Mike Smith puts the world to rights…

By now, I am sure that you will all have recovered from the disruption caused by the Christmas frenzy.

Siege mentality set in, despite the fact we were only closed for one day (or two at the most), and the volume of prescriptions seemed to double.

My own pharmacy was like the windmill - it never closed when my competitors were open. However, not yet behind us are the winter pressures that we have all been reading about over recent weeks. You may recall that I mentioned last month that communications from local surgeries to patients to use their local pharmacy to ease pressure on GPs was met with a level of scepticism by some patients. This was in early December, and since then you will have read of the horrendous stories of difficulties over the Christmas period.

Some GP surgeries were closed for four days and this led to the virtual collapse of the 111 NHS direct numbers in some areas. In the southwest, waiting times of 30 minutes for an answer were not exceptional. Anecdotally, there were many cases of patients who were forced to dial 999 for an emergency ambulance, and all this, of course, places an inordinate strain on the ambulance service and then on to the A & E departments. One press report was of seven ambulances queuing to transfer their patients, although it transpires – and this has been apparent for some time – that many of these patients were not emergencies. They could have been triaged, and in many cases treated, for minor ailments by their local pharmacy, which is open for long hours without appointment.

So what is the problem? Remember, it was almost a year ago that the NHS actually advertised in the national press that pharmacies should be the first port of call for minor ailments.

So, I now turn to the pressures on pharmacy staff. I learn from colleagues that reductions in margins are leading to reductions in staffing levels. This means that remaining staff are under much more pressure. This can lead to sickness, which, of course, becomes a vicious circle, again placing more pressure on work colleagues.

In a survey from last year, community pharmacists reported significantly higher levels of stress than other health care workers for seven out of eight work-related stressors. Long working days, being a pharmacy manager and working for large multiples were associated with higher reported levels of stress, in particular. Other surveys point to a rise in paperwork and increasing pressure to provide services. Recent conversations with pharmacists and their staff have confirmed that many can identify with this difficulty and that morale is low. Further frustrations from supply and IT issues are all beyond the control of pharmacy staff.

On top of this, pharmacists will now be required to validate prescription exemptions, but the savings will not accrue to pharmacy. The increasing workload is unacceptable – and quite frankly dangerous. 

I know of many staff and some pharmacists who have left the profession (my own daughter  among them) in favour of less stressful work with more security.

We are an honourable and learned profession and we deserve better. The fact is we have been undervalued for many years by a Department of Health that is happy to sing our praises – but is slow to reward us.

There is a general election in three months and there will never be a better opportunity to influence politicians to recognise the importance of our profession. What happens in that time will determine the future for pharmacy. It will either take its rightful place as a properly rewarded gatekeeper to the NHS, or face inexorable decline as we are expected to do more and more for less. I hope we do not miss the opportunity.

Mike Smith is chairman of Alliance Healthcare, mike.h.smith@alliance-healthcare.co.uk 

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