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Deal done, work starts

By Rob Darracott

The last time the Pharmaceutical Services Negotiating Committee had something very positive to announce, it was May 2011. After a delay caused by the 2010 election and the introduction of the new coalition Government, health minister Freddie Howe gave the green light to the New Medicine Service. 

The great and the good were gathered together, around the board table at the Royal College of Physicians. All the national pharmacy organisations, the professional press, no fewer than three senior civil servants, in addition to the NHS Employers negotiators who struck the deal. 

I should declare two separate interests. I was a member of the original research team that developed the evidence base for what was to become the NMS. And I was in the room that day, representing the Company Chemists’ Association and Pharmacy Voice. 

It was an exciting day. The first new service since 2005. The first to be based on a detailed evidence base, including a full randomised control trial, and a business case that persuaded the chief pharmacist to write it into a Government White Paper, and a new health minister to accept a previous Government’s policy, and back it. The whole room was positive. Everyone wished the new service well.

The dealmakers were urged by the civil servants, separately, to plan for implementation carefully. To do it properly. The same advice was proffered in response to a question asked at last Monday’s press conference announcing the new five year deal. In 2011, the goodwill represented by the coalition of bodies was not called on. The NMS got up and running in fits and starts, thanks to the tireless work of some individuals, notably  Alastair Buxton, to explain and promote the new service.  

In 1999-2000, when the scoping work for the original research was done, we found that community pharmacies could expect to identify between three and five new prescription service opportunities per week. Today, eight years on, as we report on page 47, community pharmacies deliver around half of the NMS interventions they are allowed under the current contractual framework. That’s one or two. 

I’m not surprised that community pharmacy hasn’t got completely behind a service of known value to patients. Changing behaviour is hard work. Implementing a new service starts with winning hearts and minds. That’s hard work too. It requires leadership; you might need to build trust and work with other stakeholders. As an inspiring example, you can read how one community pharmacist/GP partnership evolved on page 14. 

The bodies in the room in 2011 could, and should, have been co-opted in a proper, programmed implementation to build the NMS. To ensure those being asked to deliver it understood why they were doing it. To show them how to do it well. To develop it in the light of real world experience. To create the dataset that would measure its worth. And to use the implementation of one service as a platform to agree what should come next.

We can, we must, do better in 2019-20. 

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