Mike Smith puts the world to rights…

Following on from my comments about the excellent strategy for Scotland produced by chief pharmacist Rose Marie Parr, I have just returned from a trip to Scotland, and had the good fortune to meet Rose Marie in Edinburgh while I was there. The strategy is well worth a read – do visit gov.scot to have a look.

visited several community pharmacists during my trip and it was encouraging to see some aspects of the strategy already in place. Key is a break away from the obsession with remuneration and thinking more closely about identifying and developing services along with normal practice.

Of course, the financial challenges are just the same north of the border as in England, but they have looked at ways of working with the Scottish government to move forward in the face of these difficulties. To see the minor ailment service and the chronic medication service in operation demonstrates to me the way forward in England, but so far we’ve heard nothing but talk. I understand that Keith Ridge claimed at the All Party Pharmacy Group that CCGs are decommissioning minor ailment schemes because “things have moved on”. Well, watch this space, I say.

There are several differences that have helped to drive pharmacy forward in Scotland:

• A chief pharmaceutical officer (CPhO) who sees community pharmacy as an integral part of the health service l Fewer pharmacies working more closely together
• Community Pharmacy Scotland – which works closely with the CPhO and health department
• Health boards have a pharmacist member by right, and are not dominated by other professionals
• The CPhO and chief medical officer work closely together
• Online prescription services are not allowed in Scotland.

Many pharmacists are independent prescribers, and it is the ambition that all pharmacists in Scotland achieve this status. It is clear that pharmacists can supplement the work of GPs, relieving some of the pressures that we now read about almost daily.

Inevitably, I have to contrast this with the situation in England. We seem to be in deadlock, and contractors are facing enormous pressure on cash flow. Frankly, an additional 15p per item is little more than a gesture at £1,500 on 10,000 items – a drop in the ocean against the thousands of pounds that we are losing with our NHS payments.

We have to accept that purchase profit will be under continued scrutiny, and there is little hope of serious negotiation around fees until the ongoing judicial reviews and appeals are over. Without doubt, the next area to come under review will be specials. The NHS will leave no stone unturned to achieve savings, and we have to identify alternative sustainable income streams.

I also attended the recent Day Lewis conference – a great example of how pharmacy can grow by recognising the opportunities afforded by the current remuneration model and researching and meeting the needs of the populations they serve. The Patel family are doing a great job following the loss of my dear friend – the inspirational Kirit.

My feeling is that there is a wonderful opportunity for community pharmacy in front of us, but we have to look for these new roles. We have great locations, great premises and highly trained staff. This is the time to play to our strengths and sweat these assets.

I close by wishing you a peaceful and happy Christmas with your loved ones – your reward for working so hard. Let us all make our New Year’s resolution to drive community pharmacy forward by some radical thinking outside of the box. Good luck!

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