Interview: Sector is changing fast, says AIMp chief executive

AIMp member companies are on a growth path, says chief executive Leyla Hannbeck. She speaks to Arthur Walsh about a rapidly changing sector

This July, Leyla Hannbeck will mark her fourth year as chief executive of the Association of Independent Multiple Pharmacies (AIMp), during which time she has become an increasingly well-known figure on the national stage. This is surely an interesting time to be at the head of an organisation whose members range in size from the tens of branches to the hundreds, and just might be charting their own course through difficult waters.

While they are not immune from the challenges facing the sector as a whole, it appears some AIMp members have their sights set on growth, if a recent market analysis by Christie & Co is anything to go by. Several are now larger than some of their Company Chemists’ Association (CCA) counterparts. Is it a case of right business model, right time?

“We’ve always had members who were bigger than some of the CCA companies – that’s not new. But the business model is different; our members are independently or family owned as opposed to being in corporate ownership.

“The sector landscape is changing and that is going to continue over the coming years. The supermarkets are closing more and more branches,” Ms Hannbeck says, adding that these closures are having a “big impact” on the make-up of the sector. “The people buying these branches are independents, both companies like our members and smaller operators who then become independent multiples.

“So our members are growing, and on the other side we see people like Lloyds and Well selling branches. This is the way the sector is shaping up… we’ve seen a massive shift, with AIMp membership growing significantly.”

How many pharmacies are part of AIMp member companies? “Around 4,000,” she replies, adding that she will soon have a clearer picture as “we are going to be doing declaration of our members – so many have bought Lloyds branches or other pharmacies… things have moved on quite a lot since last year”.

Ms Hannbeck argues that growth in the independent multiple sector should have direct consequences with regard to the level of influence her members have in national negotiating bodies. “Again, it goes back to the logical thing of how many branches you represent. That is definitely a discussion that needs to happen.”

Will it be a sensitive discussion for some? “I imagine it will be difficult – but it comes back to common sense. If you have one part of the sector that has grown and another that has shrunk, there has to be democracy.”

Independent ethos

Given the footprint of her larger members, some may not immediately think of them as independents in a traditional sense. Ms Hannbeck is keen to dispel such notions: “I have issues with anyone who tries to say my members are not independent. My members are independently owned, they may have several branches, but they still have that ethos.

“If you ask someone like Paydens or Weldricks, they have loads of branches, but would describe themselves as independent. The language that some people use is just wrong.” This was a point of conflict at times during discussions around the Wright Review Steering Group (RSG).

But are the challenges quite the same for someone with two branches and someone with 200? Surely the latter has greater buying power, for example? “That’s logical, isn’t it? If you have scale, you have scale – that doesn’t mean they’re not independent. ‘Independent’ means they don’t have to respond to another owner.

“What all independents have in common is that over 90 per cent of what we do is NHS-related. We’re not like a supermarket or Boots, who have other things like health and beauty. Yes, it’s logical that if you have more branches you get a bigger discount, but that’s the way it works.”

When it comes to issues like running costs, workforce and medicines shortages, businesses of any size are exposed. On the ongoing recruitment challenges, Ms Hannbeck says: “We know that recruiting pharmacists has been challenging for community pharmacy; the service is not being particularly well funded, so contractors are in a very difficult position, particularly with wages going up [with the coming National Living Wage increase].

“I’ve been very loud and clear since the beginning of this whole issue that community pharmacy was not given a level playing field – we’re not compensated financially for recruiting pharmacists the way GPs are.”

Many cite the recruitment of pharmacists to primary care roles as the principal culprit behind community pharmacies’ staffing problems, while organisations like the Pharmacists’ Defence Association say there needs to be greater focus on working conditions. What is Ms Hannbeck’s view? “I can only talk about it from independents’ perspective. My members have worked very hard to make sure their branches are optimal places to work; they invest in recruitment and keeping people safe from abuse. They put a lot of effort into training and keeping people, and they seek feedback when a pharmacist leaves to go elsewhere.”

The feedback can be eye opening, she says. “A lot of the time, people say they have been very happy working for our members but were lured by the nine to five hours in a surgery.”

“You need to be realistic,” she adds, explaining that the average community pharmacy will never be able to offer desk-based work at standard office hours. “We say we’re accessible to the public, so we need to honour that. It’s a busy environment.”

Some of the stresses community pharmacy teams encounter on the primary care frontline are difficult to predict. “Some things are outside our influence,” says Ms Hannbeck. “For example, medicines shortages that lead to abusive customers, prescriptions arriving late from doctors – these are all daily challenges in community pharmacy.”

Funding first

Ms Hannbeck has no doubts as to the starkest challenge confronting UK pharmacies: “The most pressing issue at the moment for us all is the funding challenges our sector has been facing for some time. On top of the 2016 funding cuts, we had the 2019 contract, which didn’t take inflation into account. We are being asked to do all of these services within a global sum that has not increased – it’s basically a nightmare.

“Pharmacies are struggling to survive; they need an additional booster of millions of pounds to keep their heads above the water. Once we have that breathing space, we need to deliver services, but they must be appropriately funded so that pharmacies are not out of pocket. A lot of the time with these national services, the costs borne by pharmacies are not taken into account.”

While it appears some ministers view a Scotland-style Pharmacy First service as a neat solution for England’s woes, Ms Hannbeck calls for realism: “It’s all well and good talking about Pharmacy First, but the sector needs an immediate cash injection as the first step; the second step is Pharmacy First, but it has to come from outside the global sum and it has to be properly funded. There’s been talk about Pharmacy First for months, but we haven’t really moved forward – it’s a waiting game.”

Last September, PSNC announced the outcome of its negotiations with the Department of Health and Social Care for 2022-23 and 2023-24, with Ms Hannbeck describing the agreement as a “devastating blow” to thousands of pharmacies and saying that the five-year contract “has been the biggest disservice ever done to pharmacy”.

PSNC often finds itself having to sell a weak deal to contractors. Should it be prepared to walk away from the table, or does that create too much uncertainty? “From the perspective of our members, if it doesn’t work, it doesn’t work. We shouldn’t just feel obliged to accept little breadcrumbs.”

Talking about undercutting other providers is unhelpful, Ms Hannbeck says. Referring to a PSNC analysis that said pharmacies can manage minor illnesses at a “much lower cost” than GPs, she says: “If you say pharmacists can do everything at the half price of doctors, you’re already lowering expectations in terms of how much funding we want – that is absolutely the wrong language for PSNC to be using.

“We don’t gain respect for ourselves when we go and highlight that we are doctors on the cheap, or the pound shop of primary care. We don’t want that image associated with pharmacy.”

Media strategy

A pivotal part of AIMp’s strategy has involved working with the national press to generate awareness of funding issues, and Ms Hannbeck has become one of the sector’s most recognised spokespeople.

“I’m a pharmacist myself and wanted to boost the profile of the profession,” she says, adding: “I can confidently say the work AIMp and myself have done with the national media was my vision and strategy, and I’m keen to say my board were completely behind it. It starts by gaining the public’s support. This work led to the profile of pharmacy being the highest it’s ever been, and campaigns from the likes of the Daily Mail.

“I’ve done interviews from airports, or at 3 in the morning when I’ve been in a different time zone. It’s their [journalists’] schedule and you have to be flexible around it. I don’t want to say it was all AIMp’s doing; had it not been for the great work pharmacies did during Covid, it would have been difficult to raise the profile as much as I’ve done now.

“It starts by putting our profession on the map and making people see we’ve been there throughout. If the wrong decisions continue to be made then local pharmacies and the accessibility we offer will no longer be there.

“And it’s not just about traditional pharmaceutical care, there is also the social care element of being there for lonely people who don’t have anyone else to talk to. That consistency and continuity cannot be replaced.”

These efforts are part of the reason AIMp membership is rising, she says: “It’s not just the way the sector is shaping up; it’s also because of what people see AIMp achieving. People see this and they know who is fighting hard for them.”

There has been more behind the scenes work with policymakers – and this is starting to bear fruit. “Just before Christmas, a minister texted me about supply issues and I was able to raise my concerns about bureaucracy and the fact we’ve been put in this situation due to a lack of planning from the Department, and pharmacy was not included in the discussions.

“Since then, whenever they make changes to Serious Shortage Protocols or something, they bring the sector together to brief us about it, which is a step in the right direction.

“Our sector works very hard and the way it’s treated is not what it deserves. I’ve got a platform to do something about that and I’m doing the best I can. I’m naturally like that, whatever job you give me I’m keen to make a success out of it.”