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Advocate of the Year Dilip Joshi gets back to representational work following re-election to the NPA board and his LPC but also manages to get away from it all for a while

Tuesday, April 1

April Fool's Day! I prepare to go to two meetings today: the first is a South London Area Team (SLAT) meeting in Victoria, followed by a meeting in St Albans of the NPA's governance committee. The second meeting is more straightforward and considers a few issues before the new board has its first meeting on the 29th. For my sins, I have been re-elected to the board for another term and look forward to representing the independent sector with renewed vigour. The SLAT meeting is as disjointed and disorganised as ever. I wonder whether these events are held as a means to tick a box, to really engage locally or, as I suspect, to convey messages that would otherwise need to be sent on an individual LPC basis. SLAT representatives grumble about a shortage of manpower and reduced capacity €“ welcome to the real world! €“ and seem to see these meetings as a means of getting South London representatives in one place and to believe (incorrectly) that we are jointly able to make commitments on behalf of our LPCs. On this occasion, we are given a 15-minute audience with a senior director for the first time and he promises funding for projects that demonstrate €transformational€ change. I wonder whom the April Fool's joke is on as I make my way to St Albans.

Thursday, April 3

I attend the first LPC meeting of a new four-year term, having been re-elected, and wonder how close I might be to my sell-by date. As the committee is new, our CEO chairs the first part €“ the election of the chair. I am grateful for the overwhelming support shown by the members in re- electing me, boosting my confidence to believe there might still be life in the old dog yet. In keeping with the 'old-dog' theme, I start thinking of 'new tricks' and suggest the next meeting is held during the day with the sole agenda item being:
strategy for the new term. It is agreed that all members will make a two-minute presentation and that a brainstorming of topics take place.

Monday, April 7

Today, together with NPA membership director Carol Kennedy Filer, I meet the national president of the Pharmacy Guild of Australia, George Tambassis. We have an interesting discussion over lunch and I am impressed with the success that the Guild has had in promoting community pharmacy. It offers a patient medication record (PMR) system that has the largest market share, perhaps a missed opportunity for our national organisations. Like us, Australia has moved to an electronic prescription service but, notably, a hard copy token is required to be taken to a pharmacy rather than the UK practice of nomination by GP surgeries €“ this minimises the risk of patient direction. Pharmacists are also paid when an intervention is made that results in supply being withheld; this waste-reducing measure has been talked about in England but remains to be implemented. Our negotiators would do well to press for some of the successes the Guild has had, even if previous attempts have fallen on deaf ears. The Australian model shows how pharmacy can flourish with the right support and (unlike with our paymasters, whose words are not always translated into action) is recognised and rewarded by government for its contribution to healthcare. I consider how we might adopt such a system but the problem we have is we are at a point where serious dismantling and reconfiguration would be required. As the old joke goes, when asked for directions for how to get somewhere, the response is: €I wouldn't start from here!€ I reflect that €“ although the grass appears to be greener down under €“ community pharmacy in New Zealand has a very different relationship with government to Australia and a constant pressure on cost reduction has sapped morale and confidence to the extent that colleagues there even look at us with envy. How bad must things be in New Zealand for that to happen?

Wednesday, April 16

A healthy living pharmacy (HLP) steering group meeting takes place today and commissioners state that all future services will be commissioned only through HLPs. This is a direct challenge to contractors to engage or be left behind. A majority of pharmacies have embraced the HLP concept but there is now a clear message to the remainder that services will be withheld. In this world of ever-diminishing returns from traditional activities, this is a clear wake-up call for those continuing to bury their heads in the sand.

Monday, April 28

Today is the first day of a two-day meeting of the NPA Board and its subcommittees. This is the first meeting of a newly elected board, which serves for four years up to 2018. Ian Strachan is elected as chairman and promises that supporting the independent sector will be the organisation's primary goal. The NPA is the pre-eminent organisation supporting independents and the board agrees to ensure the NPA continues to engage and tailor its offering to best meet members' needs €“ a practical example is the support materials for GPhC inspection visits.

Wednesday, April 30

I leave for a five-day golfing break in Spain. I'm looking forward to good weather, good company and good golf but I may have to settle for two out of three, with my golf likely to be the variable.