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Minister a messenger?

I am attending a breakfast meeting with Simon Enright, NHS England director of communications, hosted by Luther Pendragon, a PR agency in London. I am the only community pharmacist amongst a dozen invited guests from various healthcare sectors. Simon has responsibility for communications strategy and delivery across all audiences, including NHSE’s 6,000 staff, local NHS, the professions, wider stakeholders and the public. Heleads a team of 50 people headquartered in London and Leeds as well as regional communications teams throughout England, and reports directly to NHS England’s chief executive, Simon Stevens.

Cop out from Capita

Friday September 2 I see an email from a Capita official which simultaneously acknowledges a problem and abdicates responsibility. Apparently, the regional team received a large number of queries from London contractors regarding missing payments for August but the email states: “As Capita is contracted to manage and make monthly payments on behalf of NHS England, they should be contactedat PCSE.enquiries@nhs.net, copying the London Regional team at england.lon- pharmacy@nhs.net.” The email does not make any apology nor does it mention the financial impact on contractors.

The times are a-changin'

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 Now, those newspapers, for the most part, have been replaced by the screens of smartphones.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?

Presented with a fait accompli

It was gratifying to see the media coverage of the government’s cost-cutting measures for community pharmacy this past week or so. No matter that the spokeswoman from Pharmacy Voice on Radio 4’s Today programme seemed a bit nervous, the message was clear: community pharmacy is facing big cuts and pharmacies will close. Establishment payments will reduce from December, with a 12 per cent cut in the global sum from December to March, followed by a 7.4 per cent cut in 2017-18. The pharmacy minister, David Mowat, calls them ‘efficiency savings.’ They are weasel words.

Tackling resistance to antibiotics and good sense

Today is just another day, and in the pantheon of world events it’s bit of a non-starter. By the way, if it’s your birthday, forgive me. Of course it’s important! But I’m on my way to the House of Commons to deliver a speech on antimicrobial resistance, in light of the latest strategy to tackle drug-resistant germs. There will be at least 100 MPs there for flu jabs, along with civil servants and various dignitaries, and I will be outlining what a world without antibiotics would look like if we don’t develop both a national and a global strategy, and now.  

An old friend and colleague remembered

Kirit Patel was an independent community pharmacist at heart, even though he had grown his business to nearly 300 branches and achieved success in other areas. Like many, I attended the life-celebration‘party’ at his home and funeral and, like the man himself, the party was anything but sombre. Today, at the start of a new month following his passing, I find myself reflecting on personal experiences rather than his achievements that are well- documented elsewhere. My MBA was from the same university as his, inspired through discussions with him and, I believe, it has encouraged me to think more broadly. He was a gracious host and I had the pleasure of visiting his home on several occasions, as well as attending his son’s wedding in Kenya.

A state secret?

I wonder how many of us knew that NHS England has a head of community pharmacy strategy. Her name is Anne Joshua; however, in her biography I can’t find any mention of experience of working in or with community pharmacy, or even primary care. Previously, she worked for 10 years as the associate director of pharmacy leading the Health and Medicines Information Service at NHS Direct, before becoming the NHS England pharmacist lead for the NHS 111 Digital Urgent Care programme. I wouldn’t hold any of that against her, and I have no reason to believe that she did anything other than a first-class job in these roles, but ...

A shocking disciplinary case

I was shocked to read that the nurse who contracted Ebola while working to save lives in West Africa ended up before a nursing disciplinary tribunal. Pauline Cafferkey has endured great suffering as a result of being infected by the virus when helping those in great need, so to be up before the tribunal on a technicality beggars belief. It was suggested that she might have been guilty of professional misconduct by concealing a raised temperature when she got back to Heathrow airport from Sierra Leone.

A visionary alternative

It is difficult to know what the final outcome will be of the government’s plans for pharmacy. I assume that the worst case scenario is that the full £170m cut originally proposed would be implemented from December. And the best case consists of whatever the Department of Health can be persuaded to do as a result of further negotiations and campaigning. There is no doubt that the strength of representations, including over two million signatures on a petition, has not passed unnoticed by politicians and government officials.

Question time

The season of flu vaccination is upon us and I have been busy doing my online refresher training, promoting the service, getting the staff trained up, checking and signing PGDs, notifying NHS England and ‘prepping’ the PR. Last year I alone did 800 NHS and private vaccinations and, although we can vaccinate right through until March 2017, the next two months without doubt will be our busiest – so busy that I envisage we will transmogrify from a community pharmacy into a ‘co-immunity pharmacy’!

One voice?

The One Voice Pharmacy group has urged its locum members to boycott Tesco for two weeks in September after the multiple announced a cut to its hourly rate. Bizarrely, One Voice Pharmacy said that a boycott was not the same as a strike, that locums already arranged should be honoured, and that the last thing they wanted was for Tesco pharmacies to end up without pharmacists.

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.

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