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Time to follow the public health carrot

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Time to follow the public health carrot

Independent contractors have got used to doing more work for not much more income over recent years, but the latest contract settlement clearly heralds a new era of ‘more for less’.

It doesn’t feel like much of a thank you for routinely shaving £250m off the drugs bill every year, but it’s probably what everyone except the most fervent optimists expected. PSNC has been warning that this was on the cards for some time and only those with their head in the sand should be particularly surprised.

And whatever the merits of individual cases, all public servants are having to tighten their belts. With the NHS facing a £20bn shortfall, or even bankruptcy, depending on who you believe, if you want to make good money you might be better off re-training for a career in banking. If it’s any consolation, even the shrewdest, hardest negotiators in the NHS – GPs – have seen their income fall for the third year in a row.

There is unlikely to be a significant carrot to tempt independent contractors to focus on service provision, but the dwindling money on offer for existing roles represents a fairly large stick. Some independents will have to find new sources of revenue or consider shutting up shop. Traditional business theory recommends cutting costs during hard times, but pharmacies’ staff, regulatory and support costs can only go upwards in the current environment. Different business strategies, such as ‘federating’ with local colleagues, may offer some respite but competition for services, from all directions, is going to get tougher.

Perhaps the closest thing to a tempting carrot is apparently being dangled by Public Health England. Its national director of health and wellbeing, Professor Kevin Fenton, recently proclaimed himself to be among community pharmacy’s “biggest fans” (news, p6) and is full of ideas for how pharmacists can deliver more in public health. And since public health is now mainly funded outside of the contractual framework, these new roles should generally attract new money. Any type of funded role in hypertension screening and management would be an early Christmas present for the profession, as would encouragement behind greater participation in NHS Health Checks.

Let’s hope that Prof Fenton’s energy and enthusiasm can persuade those holding the purse strings in public health to join our fan club. Because, let’s face it, we need every member we can get.

Steve Bremer, Editor

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