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Choices and decisions

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Choices and decisions

We have to be prepared to go the extra mile in return for every NHS pound that funds us

Mukesh Lad, chairman of the LIPCO federated group, talks positive about the options after funding cuts

There’s no doubt the Department of Health has managed to achieve what it intended with the funding cuts. Pharmacy has become a frenzy of engagement, activity and debate – something our representative bodies have never before been able to achieve. Despite years of endless conferences, campaigns and even a government-backed call to action, it’s taken a £176m threat to our income to jump-start a reaction.

Every rank of pharmacy is finally talking to its counterparts. PSNC, NPA, RPS, Pharmacy Voice, CCA, AIMp, and even the buying groups, are trying to pull together to create a unified strategy. Hurrah! But why did we have to get to this point to change how we’re represented in the national arena?

We now have to take responsibility for safeguarding our future. Independent pharmacy life is already stressful, heavily bureaucratic and financially challenged, without this further blow to the back of the neck. Ah, see how easy it is to revert to type, always complaining? The time has come for us to accept we’re not the only ‘victims’ of this government economy drive. If we had the time – oops, there I go again complaining – to look at every healthcare profession, we’d see it’s hitting everyone hard.

Now is not the time to retreat into the dispensary licking our wounds. I’ve even heard mention of the ‘S’ (strike) word. Extreme measures aren’t the answer. It’s time to prove our worth, once and for all. It’s too late for words. It’s time to act and show how invaluable we are to the patient and the NHS, but we have to be prepared to go the extra mile in return for every NHS pound that funds us.

Time to integrate

Of course it’s reasonable that we voice our concerns but, more importantly, we need to show willingness to integrate with other primary care colleagues and demonstrate our capability to deliver healthcare services in the community. There’s no point constantly bleating ‘they won’t let us’. Pharmacy needs to demonstrate good quality and high standards without expecting to be paid more for doing so. For example, are you delivering your 400 MURs every year?

Independents need strong policies on domestic matters that impact our business, such as finance, management, technology and promotion. I doubt individual pharmacies have these strategies in place but it’s up to you to strengthen your core to avoid imposition of regulations from outside your business.

A foreign policy is about having reliable allies, and the greatest available to us are our patients. We need to keep them onside, especially when there are major changes on the horizon, because they are automatically affected. They need to understand we’re at the mercy of a government imposing new regulations.

On any battlefield, we need to determine our individual strengths and weaknesses in order to identify opportunities to fight the threat. A good collection and delivery service is one of your strengths and this could be extended to all local residents, especially those in close proximity to your existing patients. Invest in good marketing techniques and don’t be tempted to do it yourself – you’re a pharmacist, not a jack of all trades! Would you be happy with a PR expert dispensing prescriptions?

Review your weaknesses and be honest with yourself. Look at all areas in your pharmacy and improve them. MURs offer the opportunity to impress healthcare colleagues, yet independents, on average, only deliver 51 per cent of their potential. Why let this happen? Review how you recruit and deliver for MURs or NMS. Maximise this opportunity by taking advantage of the new supporting frameworks coming onto the market to target patient groups. We cannot expect to receive more than the £28 fee already available for this service until we prove the quality and improve the quantity of our interventions.

By delivering improved patient satisfaction we can confirm to commissioners our ability to support integrated working. MURs and NMS are two advanced services that are not part of the global sum. The funding is ring-fenced and you should be maximising every opportunity in this area. Unless we use it, we could lose it.

Be honest

Change always means opportunity, and the entire health economy is being reshaped. GPs are struggling with workload and having to cut back non-essential services such as travel vaccinations. So it makes sense for independent pharmacists to invest in training and up-skilling of their teams to deliver this type of additional service. Always remember though, you won’t deliver it unless you promote it. Private PGD services allow us to accommodate those customers and patients, often referred to as the ‘worried well’, who are willing to pay for the convenience of prompt access to healthcare and advice.

The contract change due to come into effect later this year is possibly our biggest threat for many years. But don’t let this distract you from more localised issues already on our doorsteps. Losing EPS nominations is a serious threat to your repeat prescription business and our multiple pharmacy colleagues and internet providers are using effective promotional campaigns to steal our customers.

The only way to fight these challenges is collaboration and support between independents. I know ‘we have history’ but we have to overcome our self-imposed barriers if we want to survive. Independent pharmacy federations are rallying their members in order to provide support and advice on securing their financial future. In Leicestershire, a series of workshops held in March and April are highlighting investment in dispensing technology, effective promotion and marketing, smart financial strategies and technology for delivering structured MURs.

Informed choice is the only way to secure your future. Collaboration with each other will allow us to share the cost of informed, beneficial support and enable us to deliver a more positive patient experience to improve the professional image of independent pharmacy. One small step for patients is one giant leap for independent pharmacy.

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