LPC chairman Dilip Joshi reports on a month that saw the commissioners within his patch brought together by his committee to exchange views but that did not bring to an end his problem of a lost prescription bundle

Monday, March 2
This morning I learn that I have been awarded the Faculty fellowship of the RPS. Having undertaken a number of examinations and assessments over the years, I am surprised how eagerly I was awaiting the result and how pleased I am with the outcome. Having been reluctant to start the process, I am happy that I completed it and can see much more value in the Faculty than in the CPD system we have at present. I have long felt that CPD recording can be a ‘tick-box’ exercise with little real value and that an overhaul is long overdue. Perhaps discussions should take place to enable Faculty activities to replace the present CPD model. In the early afternoon, I have a meeting with a Pfizer representative and, interestingly, they are one of a number of pharma companies beginning to approach the LPC with offers of support after a long period of restructuring.

Thursday, March 5
I am attending a Southwark minor ailments scheme (MAS) ‘task and finish’ meeting today. Of the three boroughs we represent, Southwark has been the least engaged in the past, but restructuring here has been beneficial to contractors and there is a sudden will to be at the forefront of commisioning pharmacy services. Arguments in favour of a formulary (with a good range of products) already developed by Lambeth and Lewisham win the day. An early rollout is agreed by all at the meeting.

Friday, March 6
London has had some of the largest cuts in NHS administrators in the country, with 30 per cent in 2013, followed by a further 14 per cent in 2014. Today I attend an LPC/London region meeting to be informed of the change in structure and to agree future engagement. Regions have merged so that there is only one director of primary care for London, with eight assistant directors in place of the local area teams. We are informed that this means fewer meetings and a smaller capacity to deal with local issues. I consider how paradoxical the situation is where, on the one hand, there has been an inexorable move of the NHS towards local arrangements and, yet, the administrative structure has become more centralised and standardised, resulting in reduced ability to respond to local needs!

Yours truly (centre) at the Lambeth, Southwark and Lewisham LPC’s commissioner event on 12 March

Thursday, March12
A highlight this month is today’s LPC commissioners’ meeting that we have worked hard to arrange over several months. We have representatives from all three boroughs, including public health directors, CCG chairs, commissioning directors, a Public Health England officer, and local authority managers. Our meeting is sponsored by a number of pharma companies, which are represented at a meet-and-greet session over coffee prior to the meeting and are invited to stay for my opening address and presentation setting out the LPC vision for joint collaborative working. After the pharma representatives leave, commissioners make presentations to the brief of “how they could best use community pharmacy to deliver their agenda”. This is followed by individual borough ‘table discussions’, with feedback to the whole group. Informal discussions continue over lunch and cement many relationships.

Tuesday, March 17
An "army" of pharmacists should step in to help treat patients at GP practices across England, it is reported by the BBC today. I have written about this issue before and also about how shortsighted it is for pharmacy owners to call for second pharmacists without adequate funding. Dilution of the worth of pharmacists, as seen in depressed locum rates in recent times, will inevitably cause longer-term damage to the profession. Unfortunately, the concept of employee pharmacists working in GP surgeries is supported by the RPS. But this does not address the core issue of pharmacist numbers and longer- term workforce issues. Furthermore, the advantages of community pharmacies, such as ability to engage with ‘hard-to- reach’ population groups, is likely to be undermined. A much better model is to work closely with our GP colleagues, but have pharmacy services based in pharmacies.

Tuesday, March 31
Still no news on the lost prescription bundle I reported last month. We have, however, a better understanding now of what happened. A woman regularly collects our prescriptions and brings a pre-printed label to attach to the parcel. On this occasion, she was parked on a yellow line and asked us to hand her the parcel saying she would apply the label in the van. It appears that the driver forgot to apply her label and the parcel was left at the depot. We are now in dialogue with the couriers and have given them a description of the parcel (which had a prescription label of ours on it), and CCTV evidence of it being collected. The lady also remembers collecting the parcel and told us the depot where she had taken it.

I reflect on how easy it is to take prescription collection for granted and on the consequences when it goes wrong. I urge colleagues to review their procedures, ensure the destination label is firmly affixed to the parcel before it leaves the premises, a