By Outsider

If the first three weeks of the flu vaccination season are anything to go by, my confidence in community pharmacy’s ability to exceed expectations has been well placed. By close of play on day 21, pharmacy vaccination rates were tracking at three times those of last year.

Variations in the supply situation mean that it’s not an absolutely fair comparison, but it was a stunning start to the season…until a certain chain ‘ran out’ of vaccines and it made the national news headlines.

It’s one thing to mess up your own vaccination campaign, but it’s another thing entirely to shoot all the other pharmacy campaigns in the foot by telling Joe Public pharmacy has run out of vaccines.

Whilst we’re on poor planning, can someone tell the wonks at the Royal Pharmaceutical Society that messaging about collaborative working across primary care is all well and good, but it probably needs to land before everyone starts vaccinating, not half way through! Don’t worry though, at least you can save money on kitchen appliances and gym memberships…

Of course, pharmacy wouldn’t be pharmacy without having to keep multiple plates spinning at the same time, with several of them right now having Pharmacy Quality Scheme (PQS) written all over them. There really is no excuse for anyone not to have claimed the £1,630 for part one of the scheme, as not doing so essentially declares to NHS England and the General Pharmaceutical Council that you’re not Covid secure. 

The remaining £4,890 for each contractor is now up for grabs and is comprised of mainly low hanging fruit. If there is any pharmacy this year that fails to deliver a single flu vaccination when there is a £1,260 carrot being dangled in front of its nose, then there really is little hope left for them. To be fair, this is one of two criteria that would require a modicum of effort from a disengaged pharmacist, since they will have to pay for and attend a flu vaccination training event.

The majority of the PQS this year is checklists and online training. Risk mitigation writ large. It’s as if, in the middle of a global pandemic and collapsing economy, the only people left standing in the PSNC Towers and NHSE were Bob from accounting and Sandra from legal.

Perhaps I’m being unfair. The clinical folks have probably had their hands full. What is good to see is that, for the first time, we see the GP contract and the pharmacy contract move step by step in the same direction. But let’s not fall into the same trap as those who wish the PQS to be like the GP QOF (Quality & Outcomes Framework). It isn’t, it won’t be and you wouldn’t want it to be. What is comparable is the Investment and Impact Fund, a sort of mini-QOF that sits at PCN level. This is of similar value to the PQS, and contains exactly the same flu vaccination incentive.

Pharmacy wouldn't be pharmacy without having to keep multiple plates spinning at the same time

To get the rest of the PQS monies, contractors will need to have a real conversation with their PCN lead about business continuity planning in their area. Not too hard, and I’ve said enough about the value (or not) of business continuity plans in the past, but if £840 isn’t incentive enough to pick up the phone…

I’ve gone on about the PQS, but there isn’t much more to talk about – at least not where PSNC and NHSE’s negotiations are concerned. We don’t know much more now than we did when the five-year contract was first announced. Sure, progress has been made on the consultation service, and the hepatitis C testing pilot was announced to much fanfare recently. But we don’t appear much further on in any substantive way. 

I seem to recall this framework being sold as something to build upon. At the moment, it feels more and more like a cage to constrain us. Yes, I know there’s been a lot going on, and you can excuse a certain amount of necessary delay. However, at some point, PSNC needs to negotiate services valuable enough to provider and commissioner alike to fill that £250m-MUR-and-establishment-payment-sized hole before the Treasury takes it away from us forever.

In other news, I see that the GPhC is still unable to give a meaningful update on the future for provisionally registered pharmacists, whilst in Northern Ireland the issue is in the past. It does make you wonder whether PSNI will regret choosing to throw its hat in with the GPhC for the 2021 assessment. Perhaps it should have been the other way round?

Outsider is a community pharmacist