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Ho, oh, no

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Ho, oh, no

 By Outsider

’Twas the night before Christmas, when all through the house,
Not a creature was stirring, not even a mouse.
The till it was empty, the shelves they were bare,
All hoping that someone in Treasury would care!

Apologies to Clement Clarke Moore, but I suspect most in community pharmacy are not feeling that seasonal. Indeed, the only things that could make this season more miserable would be heavy snow further curtailing the ability of the team to make it to work, a break-in and a damaged roof. It’s no good leaving us toys, St. Nick. We need stock, millions for pandemic expenses and a couple of weeks off.

Pharmacy is really lacking a Father Christmas figure right now. PSNC isn’t measuring up. For all the bluster in Simon Dukes’ online blog, PSNC will at some point have to stare firmly into the mirror. Despite lauding improved relationships between LPCs and stakeholders in the recent online meeting, what really matters is that we have an effective national negotiator – a point the Wright Review threw into stark relief over half a year ago.

And what progress has been made? None. Instead, we now have a steering group, and seven of the 10 appointees are existing PSNC members. We are expected to trust these turkeys to come up with an implementation proposal by Easter. 

It doesn’t look like we’ll find Kris Kringle lurking in Whitehall either. Pharmacy is persistently falling through the Westminster grate that lies between the Departments of Matt Hancock and Rishi Sunak. They may have spent £18 billion on procurement so far during the pandemic, but pharmacy remains massively out of pocket. There has been no real sign of progress on payment for early pandemic related costs – PPE, premises modifications and additional staffing. Moreover, the funding we were graciously advanced earlier in the year remains outstanding and, as always, a third of our contractual money is imperilled by the retained margin calculations. The recent spending review shows no sign of relief. While the Chancellor appears keen to continue to write blank cheques for some things, there was no mention of pharmacy.

The sector has delivered the Community Pharmacy Consultation Service, flu vaccinations and the nascent hepatitis C testing service. Next month will see the discharge medicines service launch and next financial year the demise of those pharmacies that don’t meet the Healthy Living Pharmacy standards.

It doesn’t look like we’ll find Kris Kringle lurking in Whitehall either

Pharmacy is consistently delivering for Matt Hancock and Jo Churchill, but all we get in return is the occasional public letter of thanks. If only we’d had the foresight to be Conservative party donors or jewellery designers based in Florida. At this point, the Government shouldn’t be surprised if pharmacy packs up its bat and ball and goes home rather than partaking in any Covid vaccination roll-out.

We won’t though. We’ll stick it out. We’ll brave the proverbial snows and storms of winter (and Brexit) and keep our pharmacy bastions open. We’ll scrimp and save and wait for the thaw to see what spring brings.

So as lockdown 2.0 eases and normal retail returns for Christmas shopping, if we did have a bearded, clinically obese (high risk of Covid) and jolly benefactor, what would we want him to leave under the dispensary tree?

1. Scrap or fix retained margin and the discount system, please. I’ve hinted (shouted) this before, but the last thing pharmacy businesses need is uncertainty around whether we owe the department or they owe us.

2. Scrap prescription charges. If we can spend what we’ve spent on PPE contracts, we can afford to lose the paltry £2-300 million prescription charges bring in. Scotland, Wales and Northern Ireland have already proved the case, but think of the time that would be saved: by pharmacy, the pricing authority, counter fraud, the courts and, most importantly, by avoiding the additional health burden of people not taking medicines they clearly need.

3. Pharmacy Voice 2.0. No, I’m not sucking up to the editor, and I’m not sure how, given the politics of the sector right now, we’d get anywhere close. What I do know is that the pace of change is so fast in education, commissioning systems, policy and regulations that it’s too wide for PSNC. 

4. Funding. Our dispensaries need a Christmas money tree. We need the £370m advanced funding to be forgiven, and we probably need the same again. Bake that into the contract going forward - it’s a fraction of what has been thrown at general practice over the last nine months.

But I heard him exclaim, as he drove out of sight:
“Happy Christmas to all, and to all a good night!”

Outsider is a community pharmacist

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