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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.

To sell up, or not?

A Leicester contractor asks Mukesh Lad whether now is a good time to sell his business

Pork pies on the box

Am I naïve in hoping that politicians might occasionally tell the truth? I’m not talking about any old politician – I’m talking about the Prime Minister. I have just watched the unedifying spectacle of David Cameron on parliamentlive.tv misinforming Parliament over the government’s record concerning community pharmacy. I expected spin, a down-playing of the figures, but blatant misrepresentation?

CCGs are coining it from pharma

I attend a Lambeth Borough Prescribing committee meeting where pharma company rebate opportunities is a key item for discussion. A legal opinion is included in the papers suggesting CCGs are able to take rebates as incentives. Company names and percentages are mentioned but commercial sensitivity, we are told, restricts wider reporting. I am surprised to see numbers ranging from 10-35 per cent and shocked to see higher incentives for reaching manufacturer-set targets.

A pharmacist that takes pride in their work

At a time when all we seem to hear about is moaning medics, it is good to be able to report on a pharmacist who takes a pride in his work and how he goes out of his way to serve his community. And a pharmacist, too, who does not regard running his pharmacy as going to work because he enjoys it so much. I am referring to Zafar Khan, who has been operating a 24-hour pharmacy in south-west London for a couple of decades. Zafar featured in a heart-warming segment on BBC’s The One Show on April 14.

No sense in NHS strategy

It's a strange time of day, 3am. Quiet. Just the occasional creak from the central heating. The birds can't quite decide if it's time to announce the dawn. To the east, a finger of cold light nudges into the horizon, turning the Vantablack into Payne's Grey. Unfortunately I’m appreciating all of this because I'm ill. Since January I've been a patient of the NHS during the week and a victim at the weekends. It’s a contrast like no other. Longer waiting times, being forgotten, lost blood results, and I'm not exaggerating.

Should we fight, or talk?

Our recent Leicestershire federation seminar on ‘Securing your pharmacy future’ attracted over 50 independent contractors from as far afield as Leeds and Kent. With an agenda covering key business survival strategy, the biggest concern on the mind of every pharmacy owner was the financial viability of their business. Keynote speakers included business advisors from pharmacy banker Santander and leading specialist pharmacy agent Christie & Co. Both institutions insist our sector is still buoyant, but they did warn about the impact of eroding pre-tax profitability on pharmacy valuations.

Strong-armed, or what?

Iain Duncan Smith recently created a furore when he resigned from the government as Secretary of State for Work and Pensions. Yet, in the midst of the media storm his resignation created, an equally sensational story about the NHS crept under the radar. It came from former Lib Dem MP and minister in the coalition government David Laws, and it concerned the vexed question of how much extra money the NHS actually needs up to the year 2020.

Protesting about the cuts

I am attending an occasionally held NPA and NPA Insurance joint meeting today to align the strategies of both. NPAI is a wholly owned subsidiary of the NPA and it is important that the organisations work together in the best interests of members. Such meetings allow the parent company to understand the regulatory challenges of operating an insurance company and NPAI to understand the challenges faced by community pharmacists in their day-to-day practice. Satisfaction levels are high and the dedicated team for claims handling consistently receives excellent feedback.

A calmer view

Last month I was very angry. I’ve now calmed down and taken the time to read properly the letter sent by the Department of Health to PSNC concerning the proposed funding cuts. The dictatorial tone of the letter is set by its threats of cuts and closures, so a knee-jerk response is unsurprising. However, the stakeholder briefing for the future of community pharmacy is much more positive. It acknowledges the vital role of community pharmacy, and that we could play a much greater role in optimising medicines, treating minor ailments, supporting people with long-term conditions, preventive care and promoting better health.

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