Serious threats to your business could be closer than you think. Mukesh Lad, chief executive of Mr Pickford’s Pharmacy and chairman of Pharmacy Northants- MK, urges contractors to take control of their pharmacy’s future

If I said stop smoking, NHS Health Checks and many of the other services you currently provide could soon be delivered by non-pharmacy providers, would you be worried? And what about the hub and spoke models being trialled by multiples that could allow the Department of Health to alter the supply model for prescribed medicines? Does that concern you?

Far be it from me to scaremonger, but I can’t ignore the voices resonating at the many meetings I attend. From our own pharmacy leaders to the articles being published in our professional press, we can no longer afford to ignore the rising hum of warning.

Local authorities are obsessed with value for money, return on investment, maximising budgets and meeting performance and delivery targets. We’re not used to operating in this culture. We’ve been spoon-fed our contractual and enhanced service obligations for so long by our dearly departed primary care contracting teams that most contractors are adopting the “it’ll be alright because they need us” attitude.

Umbrellas at the ready

I’m talking about real storm clouds much closer than the long ignored new NHS horizon. These threats are about to rain down on us with major disruption, particularly for independents who don’t have the protection of a large umbrella. Where’s our back-office support and specialist human resource to write tender bids and interpret 70-plus pages of legal jargon in the obligatory NHS Contract?

A year on from the biggest shake-up in NHS history, most pharmacy owners are still getting to grips with organisational change. But this has become the least of our concerns. Urgently, we must somehow embrace local government aspiration to revolutionise the delivery of health and social care. With huge national variation in commissioning you must take time to find out what’s happening in your area. Talk to your LPC.

PSNC chief executive Sue Sharpe recently concluded a rally-call presentation saying: “Contractors need to determine and own their destiny”. Think about this significant statement. At what point do we stop relying on others to protect our business?

At what point do we stop relying on others to protect our business?

Constitutionally, bodies such as PSNC and LPCs are only able to help and support us. It’s not their responsibility to take our business risks while we continue to talk about “our pharmacy”. If it’s our pharmacy then it’s our responsibility to respond to change, making the necessary commercial adjustments. We have to render ourselves fit for the future. Calling on help and support from our negotiating committees to inform our decisions and choices is always a wise move of course, but it’s us who have to act and we have to do it now.

Time to take stock

I’m sure you all need your annual holiday as much as I do. But take the opportunity for a little quality thinking time as you sit back and relax. Take stock of healthcare delivery changes around you. Start to review your business plan in accordance with the commissioning priorities of your local health and wellbeing boards.

A useful, if perhaps daunting, framework with which to structure your thoughts is the GPhC inspection model currently being rolled out across the country with great speed and determination. Much emphasis is being placed on the look and standard of your premises, the presentation of your staff, the quality of service you provide, and whether you are being innovative in integrating with the healthcare needs of your local community. The inspection is no longer about the pharmacist giving the right answers. It’s about staff working as a team, from the superintendent to the delivery driver. All will be interviewed and you need to ensure your entire team understands the minimum requirements of the GPhC inspection standards.

The report levels you’re trying to avoid are ‘poor’ and ‘satisfactory’. ‘Good’ is what you’re aiming for. It’s certainly telling that, so far, there’s no such thing as ‘excellent’ – simply because the inspectors haven’t decided what it should look like.

Financial planning

Key to your financial planning is the proportional split of your NHS/non-NHS business. While I remember the days of a 70/30 split, it’s now more likely to be 90/10. This confirms our dependence on NHS services and the difficulties of having to rely on one customer base only.

Most of our income is derived from the core essential and advanced services, so maximise delivery of these by targeting all 400 MURs each year together with as many NMS consultations as possible. Plan to make optimal use of your pharmacy team.

Maximise the benefit from parameters within your control. Make sure you always buy drugs at the best price – it’s within your control. The pharmacy contract and the funding settlement, on the other hand, are imposed on us by the Department of Health. Despite negotiating prowess on our behalf by PSNC, we’re still vulnerable because we’re reliant on this one customer and it’s not within our control.

I reject the notion of ‘inadvertent’ risk created particularly by our multiple colleagues. They’ve been watching pharmacy trends and making tactical investment in change. We now have to be prepared for evolution and ready to respond. If we don’t take control of our destiny now, someone else will.