Independent proprietor Sid Dajani doesn’t know whether to laugh or cry at the current state of the NHS. He wonders where it’s all heading

The Patient Safety and Quality team at NHS England Wessex invited me and my local fellow pharmacists and their teams to a patient safety event. They told me that there's a range of national initiatives underway to change the safety culture in the NHS to one that is more open and honest, so we can learn from things that go wrong and take steps to prevent them from being repeated.

I also recently attended an awareness event in Winchester about new ways of commissioning and, after a long day at the office, I resented yet another exercise in why change is so important by even more philosophasters of health and the NHS. These people think two turkeys make an eagle and are great at creating a cat's cradle of unworkable bureaucracy and beadledom to prove their worth. They fail and so another multi-billion pound reform takes place, which creates more jobs and diverts more money away from the front line.

Cameron promised no top down reform at the last election. I wonder which bit of the NHS he was referring to, because I can't think of anything that hasn’t been tainted, damaged, made worse or broken. Did he talk to Lansley when he made that assertion or did Lansley fail to give him the full picture?

So here I am wasting my time again, like I did when PCGs came in, then PCTs. New faces, new badges, new mouths, but uttering the same old tired words about the same old issues.

There is no new vision and the new commissioning powers are as deaf, blind and naive as their predecessors

We all know, don't we, every bit of the NHS is heaving, sweating and straining, especially in these winter months. Using a festive euphemism, the NHS is creaking like the traditional pantomime dame’s corset. The news is alive about unplanned and emergency NHS services so perhaps we can dare to think the NHS is now more receptive than ever to doing things differently and getting things done. Thankfully I didn’t hold my breath.

A lack of vision

Moving backwards and forwards like a nervous learner driver parallel parking, the same old ground was covered repeatedly. Two things were clear through the haze: there is no new vision and the new commissioning powers are as deaf, blind and naive as their predecessors. In other words, same old road to nowhere but with new processes we have to learn and get our tired heads around.

The evidence is clear. The Department of Health has ignored calls made by our united profession around the visionary ‘Now or Never’ and ‘Now more than ever’ reports in both its Call to Action and its Five Year Forward View.

After years of neglect and years of being treated as third class healthcare professionals or first class shopkeepers, we need national contracts aligned with GPs, we need national services such as flu and common ailments, we need NHS support and we need full read and write records access. And that’s just for starters.

Theoretically, patients will be able to access their records by April 2015. We, however, won't be able to until 2018. Go figure! It's simply not true to blame the RPS, poor leadership or having too many factions – that's a merely a diversionary tactic to focus attention away from the root cause problems and use us as scapegoats because, while we are fighting amongst ourselves, others are getting away with being dysfunctional. Many of us have been banging away at the NHS for years and that includes Ash (doesn't need a second name anymore, much like Rocky, Madonna or Jesus) who is now both president of the RPS and is Mr NHS OBE. But it's going to need more for real change to happen.

From Korea to Australia

The powers that be are still focusing on structural not cultural reforms and unless someone radical comes along to bang some heads together from within Whitehall itself then I predict that the current reforms will lead to the same outcome as previous reforms, and that's as predictable as a North Korean election! We all see it, but they don't and they are risking patient care and the NHS in the wake of their ignorance and to me that's more devastating than an Australian bush fire.

I have asked the PPD to review a previous review that only found an error of £250 in my favour. They've now come back and told me their error was actually £780. Either I'm the unluckiest contractor in the UK, they're in league with Alliance Healthcare to rip me off further, there's a campaign of hate against me, or we are all losing hundreds if not thousands of pounds a month.

I'm definitely not being paranoid because every month I can prove shortfalls and prove the PPD are finding that I'm owed money. I have yet to find an error in my favour!

Time to do the right thing

So if it's not just happening to me then it's happening to all of us and, if so, then is the NHS reliant on these shortfalls? It should do the right thing. Stop these mistakes happening and give these unclaimed monies back to pharmacy. It's nothing short of negligence.

Sometimes the system encourages errors. Please muse over the unnecessarily complicated specials endorsement system in place, ie, putting XP if a brand is used (which can be confused with the supplier) and if not then using SP for exactly the same product. There is a price difference, but with the same logic as an unsigned script and despite mechanisms being in place to send a copy of the script back for clarification, they omit to pay you either the SP or the XP and pocket the cash! There are some whose favourite pantomime and inspiration come from, it seems, Ali Baba and the 40 thieves.