Mike Smith puts the world to rights…

Community pharmacy will need to take steps to minimise the impact of the government’s proposed £170 million cuts

It’s time for pharmacists to take action to minimise the impact of the government’s proposed £170 million cuts. My last column was written just two days after the Department of Health (DH) published its letter announcing a 6 per cent cut to pharmacy funding, which meant I had little time to comment. I have now had time to reflect on the letter, along with the many briefings and comments since, and although this has helped me to form some clear opinions, further developments will mean my words may be out of date by the time you read this, but here’s what I think so far.

During my career, I have written several articles and given many presentations under the heading “Time for action”, but I worry that they have had little impact. Back in 1987 I remember meeting up with one of my university lecturers, the late Professor Bryan Veitch, at a PSNC dinner. He was then community pharmacy advisor to the Welsh government and I was a member of the PSNC. I remember asking him what we should be doing. His answer was: “come to us with some new ideas”. That was so true then, and it is just as relevant today, some 30 years later.

The fact is that we spent many years protecting the status quo around a financial model that relied on purchase profit to subsidise our activities. And now this has come back to bite us.

We cannot change history, but we can influence our future with action now. I really do believe that chief pharmaceutical offer Keith Ridge and his colleagues at the DH don’t understand what community pharmacy does for the patients it serves. The confused strategic thinking (or lack of it) of successive governments led to the opening of 1,000 100-hour pharmacies, following the disastrous meddling with control of entry, and now we face the sledgehammer approach to close as many as 3,000.

It is vital that we make clear that the impact of the proposals on our patients, and their health, will be very damaging. If financial attrition is used as the means of reducing numbers, it will be those in more isolated areas and suburbs who will be at risk. The clusters mentioned by the DH will be largely unaffected.

If the closures are to be managed, there are many questions to be answered, such as who will drive the process and where will the money come from to compensate those who close? And there must be an embargo on any further opportunist openings that will inevitably follow such closures.

According to Mr Ridge, “hub and spoke issue has tremendous capability”. Personally, I see it as a bit of a red herring. The suggestion that 80 per cent of dispensing can be carried out in this manner does not stack up. There is certainly still significant work to be done before it could be implemented across the sector, including a detailed assessment of the logistical challenges, and cost and safety considerations associated with implementation.

I fear that the £170 million in cuts is not negotiable. The steps we must take now are to ensure that the further cuts Sue Sharpe warns of do not materialise. My suggested course of action is as follows: 􀀀

• Support the excellent PR campaign launched by Ian Strachan at the National Pharmacy Association ô€€€
• Read the post on Facebook by Calum Plenderleith, a pharmacist who explains just what he does in a nine-hour shift, and then make the same noise yourself ô€€€
• Pharmacy has a real role to play in reducing NHS waste, but there must be a quid pro quo ô€€€
• Patients are happier in their homes. The Carter report states that hospital bed blocking costs NHS England £900 million a year. Community pharmacy can support the discharge process and domiciliary care – a win/win for the patient and the NHS ô€€€
• Work up a funded scheme for patient compliance – another win/ win.

Make your case, provide input to the consultation and involve local patients, GPs, the local press and your MP. We have to work with the DH on the future of our profession, but I must repeat the words of Bryan Veitch 30 years ago – we must go to them with new ideas. It is time to stand up and be counted.