As GPs’ collective action rumbles on and with no sign of a new funding deal any time soon, what can pharmacy do to make its voice heard? Shilpa Shah considers

We are now six weeks into a new Labour government and, in Wes Streeting, a brand new health secretary. So far, there have been lots of visits and promises being made to various healthcare sectors and healthcare professionals across the NHS.

As ever, the question on community pharmacy’s mind is: when will it be our turn?

Parliament is now in recess, and Community Pharmacy England has made clear that there will be no news on negotiations this side of September. GPs started their collective action on August 1, which has got me thinking about what we as a sector will do if are funding model is not drastically improved.

There are so many things that community pharmacy does to deliver quality care – much of which cannot be quantified –but we cannot carry on the way we are for much longer.

The main thing that I've noticed about other healthcare sectors is how they stick together. Neighbouring surgeries may not be best friends, or even know each other, but when it comes to negotiation of contracts and services, they make decisions together and agree on the action they will take.

We all know that the GP collective action is likely to push a lot more patients into the pharmacy for support in accessing health advice or medication. This will be more unpaid work, but most pharmacy owners will not shout about this loud enough. Those that do may be shouting alone.

I have had a career in community pharmacy now for 25 years and I think one of the biggest things we could do to instigate change and to support Community Pharmacy England with its work, is to work together as a sector.

We need an improved funding deal to prevent more pharmacy closures and allow the sector to thrive, rather than barely surviving as many are now. But if this does not come to pass, I have some suggestions for actions we can take as a sector to limit the damage:

Stop free deliveries. I spend time explaining to pharmacy owners that hardly anybody offers free deliveries, if we look at Amazon, Supermarkets etc. The feedback I get is that if they stop offering free delivery, their neighbouring pharmacy will carry on and they’ll lose patients. Whilst everyone understands that dispensing alone is not viable, there just aren’t enough services to finance pharmacy viability. Items also give pharmacies the footfall for both retail and services.

Many pharmacy owners do not want to let down their patients, I can fully understand that. Perhaps, though, it’s time to start deciding which patients really need a delivery service and which patients have a car on the drive when you go to deliver or are out and so can’t take in the delivery. Need and convenience are two different things. If we introduce a charge and explain the reasons clearly to patients, most will understand.

I’m sure they would rather their pharmacy was around for the next 10 years than closed due to a lack of funding.

Open core hours only. I recall a now retired colleague saying this in a meeting about four years ago. Our accessibility and our non-booking, walk-in service for all is our USP, allowing many other providers to signpost people our way. 

I’m not sure that the NHS know how much we help people at the weekends and evenings. Many of our services can only be accessed via a referral for us to be remunerated appropriately; signposting verbally means we don’t get paid for most services.

Local Authorities rely on our accessibility for their residents. Many pharmacies are already reducing to core hours. For those pharmacies that are high volume dispensing, you could still maintain the same staffing rota and do your dispensing outside of the core hours so that you can focus more on services during the hours that you are open to the public. It may also give people a better work life balance which may also ensure better retention of workforce.

Stop ordering medication on behalf of patients. Controversial I know, especially as items currently form the bulk of funding and create our patient base. The administration involved in ordering medication on behalf of patients and chasing missing items is time taken away from direct patient-facing services. 

But if you offer a good service patients will vote with their feet and still ensure your pharmacy remains their nominated pharmacy. I think that the biggest issue will be the GP surgeries not being able to cope with the phone calls and emails that they will receive for ordering of medication and then the time taken to chase for missing items etc by the pharmacy.

Many areas are starting to insist that patients only use the NHS app to order, but I wonder if they have thought this through. With so many people struggling digitally, especially in deprived areas, will this not create further digital inequalities? I think some areas think that the pharmacy staff will support patients in downloading and using the NHS app but with the current workforce challenges we do not have the capacity to do this.

If areas are adamant that they want to go down this route they need to have volunteers in places like shopping centres and libraries who can help people with the technology. My concern is how many people will now simply not take their medication because they couldn’t navigate the system to order it. The solution is quite easy: with electronic repeat dispensing, the surgery can limit their administration and we see the patient monthly and can check how they are. It will also help manage stock levels, with all the current out of stock medication in the UK.

Follow emergency supply regulations. So many people are signposted to community pharmacy when the surgery is open for an emergency supply of their medication (often by the surgery staff themselves). We should be following the regulations and using our professional judgement to decide if the patient really needs the medication urgently. And if the surgery is open, should it be their responsibility to furnish the patient with a prescription?

Many pharmacies don’t charge, but which other professional doesn’t charge for their services? If you get locked out of your house and call a locksmith, that’s an emergency, but have you ever had a locksmith do your work for free? If you have a leak in your house and call a plumber, that’s an emergency, but has any plumber ever done the work for free? In my experience emergencies often cost more than planned work.

There are pros and cons to any action that we decide to take and one size will never fit all. But though it pains us to inconvenience our patients, we need to do something. And most importantly, any action we take must be taken collectively by everyone.

Shilpa Shah is chief executive of Community Pharmacy North East London. She writes in a personal capacity