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Clapping solves nothing


Clapping solves nothing

By Outsider

This column isn’t going to be clapping anyone. 

We are all aware of the extreme situations we face on a daily basis and those situations are managed and dealt with each day by people. People like you, the person next to you, and so on. There aren’t enough superlatives to recognise all that good work, so I’m not going to use any. There are plenty of other people writing those words.

Those business continuity plans were worth all that paper and ink, don’t you think? I’m so glad everyone spent so much time cut-and-pasting someone else’s. Wait. I’ll stop before the whole column becomes an angry rant.  

Of course the business continuity plans were useless. I remember being part of the cabinet office emergency planning sessions in the early 2000s. While they seemed worthy at the time, I’m not sure a document came out of it, certainly not one that would have been much use now.

In 2007, my pharmacy was one of the last standing as the floods shut the city centre I was working in. We spent all afternoon taking work from nearby pharmacies who had been inundated. At some point, I had to go and assess emergency supply requirements for patients from a residential home who had been evacuated into nearby emergency accommodation. There wasn’t a plan for that either.

Rules are made to be broken, they say. And by they, I mean the GPhC and NHS England

No good plan survives first contact with the enemy – especially a highly virulent respiratory virus with a significant mortality rate and a poorly understood incubation period. It would have been nice to have had a plan though, even if it was a bad one.

I’m being facetious. There was a plan. Always is a plan. Unfortunately, it was known to few and shared slowly, if at all. When emergency PPE kit arrived from the contingency stockpile, everyone should have known it was technically out of date. The merits of expiry dates for sterile appliances packed in plastic backed paper packaging aside, a simple message explaining why it was still safe would have saved a lot of anxiety.

Reassuringly, in many cases, common sense has prevailed, although it surprises me that a big chunk of that common sense has come from the leadership of the large multiples. Sensible decisions were made quickly by Boots, Lloydspharmacy and others about the need to protect pharmacy teams by curtailing opening hours amidst unprecedented demand. Christmas and Easter had come at once.

The cries were heard. Gating pharmacies, protective screening, taping of floors to enable social distancing, innovative queuing systems. All of these sprang up quickly, and not just in the multiples. Rules are made to be broken, they say. And by they, I mean the GPhC and NHS England. 

Unfortunately, it took days for NHSE to release a sample SOP essentially relaxing NHS terms of service to allow this eminently sensible course of action. Government Gateway to blame, perhaps?

Seriously, though, everyone is doing a brilliant job and we should all be very proud, etc. However, we don’t need to moan about not being name checked in every Boris briefing, do we? Equally, we don’t need clapping. Not at 8pm on a Thursday, not any time, ever.

What we do need is the political clout to get a decent post-mortem after the fact. Business continuity plans are only ever any good in a community if there is local leadership to enact them. When pharmacy A shuts, its patients go where? NHSE&I should coordinate this, but its local teams were reshuffled and not in post until 1 April.

When wholesale prices soar for even the most high commodity Cat M line, where’s the leadership to say we’ll stump you a boost on your FP34 advance because your cashflow is going be really tight in four weeks’ time?

When under pressure prescribers start increasing prescription duration to three or six months, where’s the leadership to say, it’s okay, just give one month at a time and we’ll make sure you don’t lose out on fees? Seriously, how much easier would life be now if EPS repeat prescriptions had been a QOF target!

When the leader of the free world says that chloroquine can cure… (ok, that’s enough – Ed).

What I’m trying to say is that when we get the chance, let’s make time to analyse not just the stuff that was hard, chaotic and went wrong in the moment, but the measures that should have been in place to stop it from even getting anywhere near that bad. 

In the meantime, and I do mean this with the greatest of sincerity, once more unto the breach, dear friends, once more… I’ll see you all on the other side.

Outsider is a community pharmacist

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