LPC chairman Dilip Joshi fights through the traffic to foster better relations with GPs and finds that a trip to the Chelsea Flower Show makes him recall his student days

Thursday, May 14

The LPC meeting this evening is attended by two senior local authority commissioners. They know they are in the firing line and field question after question on late payments (some as late as six months), data capture issues (for example, where a subcontractor used for other LA payments has failed to issue identification numbers to our contractors) and general inefficiencies and lack of staff to deal with them. I state that we act as honest brokers but are often in the firing line ourselves for not adequately challenging the LA. The commissioners leave, grateful that the LPC is there to assist them and promise to provide a six-month advance payment for services – a notional figure, based on previous activity, against which contractors can issue invoices.

Monday, May 18

I am in St Albans attending the NPA Membership Committee meeting today. All agree that, while high-level representation is necessary, supporting independent members in the day-to-day activities of running their businesses is where our focus needs to be and will be of most practical value. We discuss IT support systems for members, including Check34, a tool for prescription data monitoring, and agree as a high priority development of a more comprehensive IT offering to help independent members who do not have the back office support enjoyed by CCA colleagues.

Following the meeting in St Albans, I drive to Dulwich in South London – not a journey I’d recommend during peak hours – and arrive in time for a meeting of Lambeth pharmacists and GPs, which the LPC and LMC has organised. Local care networks formation means that healthcare providers will have to work together and this meeting is designed to overcome local politics and to get a better understanding of how we each work. The meeting is well attended and table discussions result in many ideas, including pharmacists visiting local surgeries and GPs visiting pharmacies. Both pharmacists and GPs state a wish to have more positive contacts other than when errors occur or problems arise. Issues identified include electronic prescriptions, stock shortages, branded generic prescribing and workflow for repeat prescriptions. I leave pleased with the day’s work even though it’s yet another late night home.

Wednesday, May 20

I attend the Chelsea Flower Show today with my wife, courtesy of a couple of tickets presented to us by a family friend. The displays are wonderful and full of colour. In one display, there are over 50 varieties of daffodil, all in full bloom – the skill of exhibitors is amazing. I find myself reflecting on my pharmacognosy days and seek out a display of herbal medicinal plants. I recall reading an article in the Daily Mail online (May 18, 2015) ahead of the show in which TV horticulturalist Chris Beardshaw states: “Can't sleep? Try the medicine cabinet in your garden”. He claims the garden is a ‘medicine cabinet’, with herbs providing safe, effective alternatives to drugs for problems such as insomnia, mentioning scientific research supporting herbal remedies that have been used for hundreds of years. He also says: “Clever combinations of herbs mean that the total remedy is greater than the sum of its parts, so less can be used of each individual ingredient. Could you imagine a garden with only one flower?” To my mind, his comments reinforce the idea that medicines – of all types – should only be available from pharmacies, where expertise is available to manage expectations and make appropriate interventions – the “garden with only one flower” analogy, in particular, seems to me to be quite wrong.

Thursday, May 21

I attend an NPA Insurance Board meeting today in St Albans and receive performance reports, including a ‘treating customers fairly’ (TCF) report. Regulators require insurance companies to use TCF as one indicator of performance and, as an independent contractor representative on the board, I always want to see high satisfaction levels from members. We have consistently seen high satisfaction and retention levels, and reports on claims experience are particularly good. NPA insurance has an experienced and dedicated team that understands pharmacy and works for the benefit of members. In considering alternatives, contractors need to be truly satisfied that comparison is like-for-like and that includes experience where an insurance company is really needed: when a claim is made.

Wednesday, May 27 The LPC office receives a phone call from Lambeth LA that patient group direction contracts need to be signed and returned by the end of the month – in two working days’ time! Last year, after quibbling about a lack of funds, the local authority used a courier service to deliver and collect signed contracts from each Lambeth pharmacy. This time they are more financially prudent – there is not even a stamped and addressed envelope for returning the signed documents. I telephone the beleaguered commissioner who says, “I know, I know.” And, in response to my protests, agrees to be flexible in accepting signed returns and begs the LPC to assist as best we can. We send an urgent message through the office to our contractors whilst suggesting a meeting with the commissioner to avoid this happening again. Déjà vu, methinks. We are, however, accumulating several Brownie points that I hope will stand us in good stead in future negotiations.