An Onlooker's Notebook

Years ago, when I got on a train, especially if it was full of commuters, nearly everybody would be reading a newspaper. Now, those newspapers, for the most part, have been replaced by the screens of smartphones. So perhaps it is no surprise that Chemist & Druggist has decided to ditch its paper version and become on-line-only from December. Something that has been in print since 1859 will have a physical form no more. What of other publications in the field? The PJ, in print since 1841 and weekly from 1870, reduced frequency from weekly to monthly late last year and now seems to be heading for a future as a digital-first publication.

And what of ICP? Its publisher still believes that readers value something that they can pick up and enjoy. Production values have been greatly improved of late with that view in mind. That is not to say that a digital presence is not important. ICP’s offering on-line has been much enhanced, too. A balance approach is what I call it. Seems about right to me.

HARSH TREATMENT

Hopes that a change of minister might mean a change of heart on the proposed cuts for providing pharmaceutical services for England have proved to be misplaced. The Department of Health is imposing funding cuts from December for this year and further reductions for next. Alongside this, there are half-baked proposals for the so-called Pharmacy Access Scheme, which would offer extra payments to pharmacies a mile or more by road from the next one. The top quarter of pharmacies are be excluded. The PSNC reckons that just three pharmacies in London will qualify. Overall, the DH expects 1,356 pharmacies to receive a payment.

It is no wonder that the PSNC rejected the Department of Health’s offer prior to the imposition, something that was reported on the Today programme on BBC Radio 4, when Sue Sharpe (PSNC chief executive) was given some air-time to say that she thought the plan would cause chaos as more people would be forced to go to GPs. When the BBC followed this up with an item on its website, a DH spokesman was quoted as saying that £112m was being invested to put 1,500 pharmacists in GPs’ surgeries. This suggests to me that the cuts are being used to fund this particular initiative. Indeed, the “Final Package” document from the DH spelling out the imposed settlement includes details of a Pharmacy Integration Fund to support the development of clinical pharmacy in a wide range of settings, including GPs’ surgeries.

It seems the move to having clinical pharmacists in surgeries will be driving community pharmacies out of business. And if most clinical pharmacy input is provided within surgeries the aspirations of the remaining community pharmacists to develop in this direction could be choked off. What we are seeing here is a crude re-engineering exercise being imposed in what can only be described as a dictatorial fashion.

As I have said before, the Department of Health and NHS England seem to have a poor view of community pharmacy. This was exemplified when Simon Stevens, chief executive of NHS England, told the Public Accounts Committee recently that pharmacies “dole out” medicines, which seems to imply that anybody could do it.

The dispensing process might look simple but it sits within a framework that is made complex by therapeutic, legal, professional, contractual and organisational imperatives. Medicines are not like Midget Gems, as Ian Strachan tellingly pointed out at the Independent Pharmacy Awards. They are highly potent with potential to kill as wellas cure. Mr Strachan was quite right when he said that to talk of doling medicines out was “an insult to the men and women who work in this sector”. And the “dole out” process includes unfunded delivery services and monitored dosage systems, which, as Mr Strachan pointed out, enable people to live independently in their own homes.