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The only constant

Is the Government's Pharmacy First announcement a sign of positive – and enduring – change?

A lot can change in a month. Not long after we sent our last issue to the printers, pharmacies in England got the news some have spent several years waiting for, as the Government decided Pharmacy First is a goer after all.

Sure, there are still questions that need answering. We know which conditions will be included in the service (at least to begin with), but we don’t know quite when it will launch, or just how much of the two-year £645 million investment will go towards it. And as Numark’s Nigel Swift has pointed out, it’s not clear if this is a “one-off cash injection” or the beginning of a long-term commitment.

Despite these notes of caution, the investment has to be seen as a Good Thing. It may not come close to covering the shortfall pharmacies have borne since 2016, but it shows that the Department of Health and Social Care and NHS England have begun to realise that the £2.592 billion global sum is nowhere near sufficient to sustain their ambitions for change in the sector. 

Mind you, that’s not the same thing as fessing up to the damage that has been done in the last seven years. During a 17 May debate at the House of Lords, health minister Lord Markham was asked whether any future pharmacy closures could reasonably be seen as a failure of Government policy.

“No,” he replied. “What I want to be tested on is how many people are using their pharmacies for primary appointments – that is the real measure. The fact that this will drive more footfall to pharmacies will mean that more pharmacies will probably gain extra business and stay open.”

Looking at it one way, this is a fair reflection of Lord Markham and his colleagues’ priorities, but it could also be seen as a get out of jail free card if we do continue to see net closures rising. My sense is that ‘3,000 pharmacies too many’ is not official policy as some have feared, but those in power certainly don’t appear to have targets for the number of pharmacies they want to survive either.

Our lead interview this month is with Shabina Azmi, chief pharmacist of Bedfordshire, Luton and Milton Keynes (BLMK) ICB. When I spoke to her and BLMK chief executive Felicity Cox in May, I was impressed by their determination to redesign care pathways and create new ways of working that are “irrespective of profession, sector or place”, in Shabina’s words.

They shared fresh thinking about the potential to use ARRS to benefit primary care as a whole – including community pharmacy – and showed an understanding that embattled pharmacy teams need to be supported along the journey being undertaken. If change is the only constant, it’s encouraging to know that there are those rolling it out locally who understand how hard it is on the ground.

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