Contractor views

There are none so deaf ...

You may have seen the report of the Pharmacy Voice audit of the non-supply of OTC medicines. It’s fascinating. The audit was conducted in over 5,000 pharmacies and analysed situations in which a decision was made not to sell an OTC medicine that a patient/customer had requested. In nearly two-thirds of cases, the reasons for not supplying were either because advice was given instead, or an onward referral was made to other healthcare providers or services; over 20 per cent were referred to their GP or out-of-hours GP service, a further 5 per cent to a walk-in centre, and 1 per cent to the local A&E department.

Onlooker remembers Kirit Patel

Kirit Patel, cofounder of the Day Lewis group, was a popular figure in pharmacy. So much so that a week after his untimely death at the age of 66 on July 16 over 3,000 people turned up at his home in Surrey for a party to celebrate his life. There would have been more but I got the date mixed up and turned up a day late. Kirit was an accidental entrant to the world of pharmacy. Sent from his home in Kenya to board at Truro School, his A-levels weren’t good enough to achieve his primary goal of entry to medical school so he went to Portsmouth school of pharmacy instead.

Silly season frustrations

It is the season of sunburn, bites, stings, hayfever, burnt sausages and badly cooked chicken. Or – as we call it in the trade – Imodium Season! Soon the flu season will be upon us, but it always feels like the silly season because you just cannot prepare for the random or silly things that people do. A lady brought in a urine sample for a pregnancy test in a sealed plastic takeaway box wanting me to verify what she had tested at home. It was half full!

Coping with Capita

Tuesday July 5 I am at a Southwark commissioners’ meeting this evening. It has been called by members of the local GP federation. They wish to learn more about our LPC’s service-provider model with a view to working for mutual benefit. There are suggestions of operating through Local Care Networks in the presentations. GP federations have been funded to assist with their set up, whereas our provider company has not. A key difference is that GPs seem to have used their funds to create various remunerated positions and are looking to make them sustainable through additional funding of commissioned services. We have, on the other hand, started a low-cost model without extensive infrastructure or office facilities, opting instead to pay for administration costs through top-slicing monies received for services. This, to me, seems to be a more efficient model than PCT-like administrations with associated costs and red tape.

Some good news

Continuing with its nomadic existence, Pharmacy London meets today in London Councils’ offices at 591⁄2 Southwark St (shades of Harry Potter). Strangely, it is cheaper than hiring a room at the RPS’s new premises, even after members’ discount.We have a dilemma. Some see Pharmacy London as the pre-eminent organisation for pharmacy contractors across London in both a representational and negotiating role. In recent times, it has done both. NHS England has used PL for disseminating information and negotiating the vaccination service. However, increasingly, NHS England has been using our meetings as reason for cutting other engagement at local level.

A shameful decision

Finlay Hesketh is a young boy with Duchenne muscular dystrophy (DMD), a cruel muscle-wasting illness that has few treatment options and which sees sufferers becoming wheelchair dependent by the age of 12. Later, they will need artificial ventilation to help them breathe and death usually follows before the age of 30. It’s horrific. A new treatment is available – ataluren – which has been described by NICE as a “step change” in care that can delay the loss of the ability to walk for up to seven years, offering children the chance of a normal adolescence and allowing them to stay in school for much longer.

A nail-biting wait

Brexit has introduced a great deal of uncertainty concerning the future of the of the British economy. Investments are being delayed and the markets are jittery. Let’s be honest – we all like certainty. Being certain about something enables us to plan, to invest and to look to the future with confidence. So what should we make of the fact that Parliament has broken for its summer recess and the expected announcement regarding the government’s plans to cut funding for pharmacy in England by £170 million has not been made?

The times they are a changin'

We live in historic times. We watch events through the pages of a newspaper or magazine, the lensof the camera and the window of the screen. Former prime minister David Cameron asked the question and got the wrong answer. Well, they do say ‘ask a silly question ...’ The referendum turned British politics into a public act of autosarcophagy where Boris Johnson saw his chance, leveraged a campaign off the back of Nigel Farage and UKIP and temporarily embraced Michael Gove.

Preparing for the cuts

Tuesday May 3This evening, I take my dispensing technician to a mandatory summary care records (SCR) face-to-face training event, having completed the prerequisite CPPE module. Seldom have I attended a meeting that has been such a complete waste of time, not to mention scarce NHS resources. The slides are all present on a downloadable ‘app’ and the CPPE module comprehensively covers everything. The presenter asks us to turn to the person next to us and discuss how one might ask a patient for consent. We all know this is something we have done in pharmacy for as long as we have been practising.

Community pharmacy LLP?

Britain has been thrown into turmoil and who knows from where the next surprises will come, so the prospect of time off this summer is an enviable one. I’ll be putting my annual leave to good use this year, reflecting on recent events, refocusing priorities and shaping the future of my business. Britain is leaving the European Community. If I wasn’t already aware from the incessant press coverage, it became painfully obvious from the cost of my holiday Euros! In the words of the Brexiteers, it’s time to “take back control and make Britain great again”. And listening to the Remainers, working together is a given for a more secure future.

Time to wake up

Both the British Medical Association and the Royal College of Nursing are holding their annual conference as I write. Speakers in both conferences have highlighted the pressures on the NHS.  The RCN revealed that beds were in such short supply that frail elderly people were being moved in the middle of the night and that, in order to move patients out of A&E departments, some were left on trolleys in corridors or received treatment in storerooms. The BMA said that the National Health Service was “bursting at the seams”.

Waiting for a train

I’m holed up on the concourse at Waterloo station waiting for a train that’s four hours late. I’ve found free Wi-Fi from a restaurant. I’ve no idea where they are or who they are but, by way of thanks, have a mention. The announcements drone on. Cycling and skateboarding are forbidden and security services will blow up my luggage if I’m careless. Welcome to London. Lovers embrace and mid-embrace it’s hard to tell if they are about to separate or have just found each other. A man eats a roll poking out of a paper bag. I watch as he takes a bite of the bread and the top of the bag at the same time. He appears not to notice – they must taste the same.

A nauseating portrayal

I’m sure everyone has an opinion on Brexit. Don’t worry – I’m not going to try to persuade you one way or the other. Writing on the eve of the referendum, nothing that I say now will influence the outcome. Like many, I’ve had a bellyful of the posturing, half-truths and evasions on both sides of the argument, but there is one issue that has made me angry: the frankly fatuous claim that if Britain stops sending the mythical £350 million every week to Brussels, the money could go to the NHS.

NHS under threat from ‘more for less’

Jeremy Hunt is in trouble. “This is his IDS moment”, says Chris Ham of the King’s Fund in a Guardian Online article today. “Hunt now faces unpalatable choices about the direction of health policy, akin to the dilemmas that led Iain Duncan Smith to resign as Work and Pensions Secretary. Just as Duncan Smith felt his mission to reform welfare was undermined by budget cuts, so Hunt’s ambition to improve quality of care is at risk from financial constraints.”

Onlooker on Brexit

As a result of the Brexit vote, the free movement of pharmacists to the UK from EU countries could eventually come to an end. But presumably this will not mean that they could not come at all. If there is, as promised, an Australian-style points-based system for immigration then some might pass the points barrier. However, if points are related to need they might not be welcome, since the unrestrained schools of pharmacy in the UK are churning out too many pharmacists and the DH wants to reduce pharmacy numbers with its remuneration cuts.

One year on: confusion reigns

Is it really a year since the election that saw in this Conservative government? I remember giving a qualified welcome to Alistair Burt, the new health minister with responsibility for pharmacy. Naively, assubsequent events have shown, I made some suggestions regarding how we could help with a number of problems that the Health Service was facing then and is still facing now.

Onlooker considers regulation in Northern Ireland

A note caught my eye in the new NPA section of ICP to the effect that there is an official consultation in progress on the future of pharmacy regulation in Northern Ireland (ICP May, p49). Unlike the rest of the United Kingdom, regulation and professional representation are still carried out by the same body in the country – namely the Pharmaceutical Society of Northern Ireland. The PSNI has so far escaped the fate of the Royal Pharmaceutical Society, which had its regulatory role wrested from it when the General Pharmaceutical Council was formed in 2010.

Striking out

I write something, press the button and wonder. I wonder who will read it and what response it will have. A few months ago I wrote about the junior doctors’ strike, and by about lunchtime my Facebook page and in-box had melted. Blimey, are there some hacked-off junior doctors out there! If there was a composite letter it would say: “Thrilled to become a doctor, hate what the profession will become”. Add to that, “wish I did something else”, and you’ll get the flavour.

Food for thought

It seems the larger multiples are all in favour of MURs. There have been reports of Cohens, Lloyds, and Boots putting significant pressure on their pharmacists to deliver more MURs. It’s not surprising – it’s been estimated that if every branch of Boots reached the maximum 400 per year, it would boost their profits by about £30 million. No wonder they like them!

It’s a plan, Jim, but not as we know it

I have just read PSNC’s Pharmacy 5 Point Forward Plan. It’s underwhelming. The opening sentence is clear: the NHS wants “radical changes.” The PSNC plan is about as radical as a group of knitwear designers coming up with a pattern for a bobble hat with two bobbles, but in different colours. At its most extreme, the word “radical” suggests revolutionary change; at the very least, it implies significant innovation.

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