A contractors’ WhatsApp chat revealed relentless workloads during Covid, nursing militancy and funding for services being stopped … although £1 million was handed to a golf club! Terry Maguire explains…
 

On the evening of the first Friday in June an impassioned text appeared on the Northern Ireland contractor pharmacists’ WhatsApp. It asked pointedly what had changed for community pharmacies in the 15 months of the pandemic?

We have been busier than ever, dispensing more medicines and dealing with an increasing number of patient queries, and since GPs have locked themselves away, the workload has been relentless.

The Health Board had just announced that funding for Covid-19 services would be stopped and that a business loan, issued to each pharmacy in March 2020 to ensure service continuity, would now have to be paid back over 24 months. GPs, the WhatsApp post argued, were still being paid for not providing services, and pharmacists needed to unite and stop money bleeding out of the sector.

The post gained traction: issues such as the lack (and cost) of locum cover, and de-funding a service at breaking point with consequences for service delivery, were all aired. A humorous cartoon was posted of a man urinating on the telephone receiver while commenting to his wife that “the doctor wants a sample” was agreed to be a good summation of the situation.

There was reference to the militancy of the local nurses who, before the pandemic, had come onto the streets to secure parity of funding with colleagues in Great Britain.

An essential service having funding stripped away in the middle of a crisis, and with a third wave of infections on the doorstep, seemed incredible. Someone was incensed that £1 million of funding was given to a golf club! There was a call to engage with politicians and a suggestion for effective industrial action, such as stopping to provide MDS in September.

By 10.45pm there were 12 pharmacy contractors in the discussion, and we were all asked to signify our support by replying “Not Happy”. A dozen or more replies of “Not Happy” lit up my screen. There was a recap to sustain the discussion. A measured comment from a member of the Contractors Committee asked that the Situation Report that each pharmacy must submit weekly, might reflect the discussion.

CPNI was hearing clearly what was being said, we were told, and would feed it back. And then it all seemed to calm down and the text exchanges went back to normal, complaining about the poor service from Abbott, and asking if anyone knew of a locum to cover the bank holiday.

This discussion was an interesting explosion of frustration from people in an exhausted sector. But does it reflect the true state of things? CPNI is in a good place with the Department of Health and the Health Boards because of the work pharmacies did in the early days of the pandemic and have done ever since. Constructive work is proceeding on service development with associated investment for the community pharmacy network.

A PwC report, commissioned by CPNI, assesses the additional workload on pharmacies during the pandemic and will offer a dispassionate and objective assessment of what we are due. To enviously cite GPs and funding for nurses (or a golf club) as sectors that are much better off than community pharmacy is missing the point.

While it is understandable contractors are aggrieved funding is being clawed back, there seems to be considerable ignorance of how much community pharmacy funding has improved since March 2020.

The long-sought settlement of £132 million for community pharmacy in N. Ireland was agreed after 10 acrimonious years and in no small part due to the pandemic. This has been achieved even after returning the loan and the removal of the small amounts linked to delivery services and business continuity payments. For what it’s worth, a medicine delivery service is not my idea of a professional service.

A lot has changed, and for the better. Contractors have had a financially successful year by any measure, with considerable additional funding added onto the baseline.

Outside the funding for pharmacy services, our businesses have paid no business rates and we have had a business injection of £15,000 - in some cases £40,000. We are benefiting from the Covid-19 vaccination services and there is a commissioning plan that will see additional funded services offered by community pharmacies.

There is a pilot on a UTI service underway and news of a commissioned compliance service. We need to respect the work on-going between CPNI and HSCB that brings additional investment.

It’s incumbent on all contractors to get behind and understand the bigger picture and stop these knee-jerk reactions that in the past have caused so much instability.

In the end it is not in the best interest of any of us.
 

Terry Maguire is a leading community pharmacist based in Northern Ireland.