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Here's to 2018!

Our correspondent hopes that the new broom at the PSNC will sweep clean

The new chief executive of PSNC, Simon Dukes, is due to take up his post in May. No doubt there are good reasons for the wait, but I can’t shake off the nagging suspicion that a complete lack of urgency prevails within PSNC’s hallowed portals. What should be obvious to a blind man on a speeding horse is that he’ll need to hit the ground running, (or maybe galloping).

I have to admit to some misgivings. Currently, Mr Dukes is chief executive of the fraud prevention service, Cifas. I looked at their website. Fighting fraud is a complex business where the goalposts change constantly, and Cifas has been a remarkably successful organisation. And yet...

The problem is that PSNC has form. From my perspective, Sue Sharpe’s tenure at PSNC has been an unmitigated disaster. I’m sure there are people in the know who will come to her defence, but I can only tell it as I see it as a contractor. Results are what count. The many false dawns we have seen over the past decade, the current situation with the cuts in pharmacy funding and the complete breakdown in relations between PSNC and the Department of Health, smack of failure at many levels, and especially of leadership.

PSNC has simply stuck its head in the sand and refused to engage creatively with the challenges of an implacably changing health service. Yes, we’ve made the odd suggestion here and there, but little of substance that would bring community pharmacy kicking and shouting into the 21st century.

Nuffield report

I recently wrote about the Nuffield report and how it had identified that the fee per item dispensing fee was holding back our development. Over 30 years later, PSNC continues to insist the dispensing fee must generate the majority of our income. It’s

a completely untenable position and has been for years. I can’t help thinking that if we’d had a pharmacist holding the top
PSNC job, instead of a lawyer, things might have been different.

Simon Dukes is neither. He has a degree in Politics and History and an MBA. Previously he worked for eight years as a senior manager in national government before spending two years as deputy director for the Centre for the Protection of National Infrastructure, whatever that is. If he has any knowledge of community pharmacy it will be sketchy at best, though a knowledge of politics and of our history with politics may prove useful.

PSNC chairman Mike Pitt says a rigorous search and selection process was followed and that the decision of the appointments panel was unanimous. But, not only isMr Dukes not a pharmacist, he has no experience of working in healthcare or in the NHS. Nada. Zip. Zilch. Of course, it’s possible this could be an advantage. He will bring no baggage, no preconceptions, no personal axe to grind, but neither will he bring any experience or knowledge of the pharmacy sector.

When I think about it, I’m glad he will bring no baggage with him. A new broom can sweep clean. For years, PSNC’s outlook has been determinedly ostrich-like. It has failed to keep up with the NHS as it has changed, particularly since the revolution of 2010-11. There is no vision, no strategy, and no willingness that I can detect within the organisation to lead community pharmacy, to take difficult decisions, to prevent us from becoming irrelevant. Yes, I’m afraid that’s how bad it is. Reading between the lines, that is the tenor of the message that I discern oozing between the bricks of the ivory towers of Richmond House. We are irrelevant and past our sell-by date.

Ch-ch-changes

Think about all the changes that are happening around us. No, really, think about them. We all of us need to wake up and smell the coffee. Where is community pharmacy in the Five Year Forward View? Who has taken the slightest notice of the much-vaunted (in pharmacy circles) Pharmacy Forward View? Where is community pharmacy and where are the voices of community pharmacists in the Sustainability and Transformation Plans? What role will we have in Accountable Care Systems? And what has PSNC done to prepare us for all these changes, to enable us to take an active role as participants and decision-makers, rather than as spectators who will have decisions made about them?

I’m sorry if this sounds terribly pessimistic. I don’t mean to be. I’m simply trying to make you – us – aware, and to motivate you – us – to get off our collective backsides and do something, including PSNC.

I’m an optimist by nature, and I believe passionately that community pharmacy
has a unique and valuable offering in community healthcare. But we have been standing still for far too long and we are being overtaken – by events and by other services. We have to reposition ourselves,
to make the strongest possible case about the value we bring to communities all across Britain. That’s what Simon Dukes has to do, and quickly. I welcome him and wish him well. He needs our support, and, despite my misgivings, he will have mine. He’s going to need all he can get.

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