I‘ve noticed an increasing contempt on the part of GPs as a result of our inexhaustible flexibility on medicines delivery services, says Terry Maguire…

Great news: two new commissioned services this autumn. Under the Pharmacy First banner, a UTI service is being rolled out across the network and about forty pharmacies will pilot the Sore Throat Test and Treat service with the hope that it will be rolled out next winter.

This is the tangible commitment our chief pharmaceutical officer Kathy Harrison spoke of during the Independent Pharmacy Awards in September. More importantly, the Winter Pressures Task Force – a key policy group at the Department of Health – has recognised the potential of community pharmacy in mitigating pressures this winter.

This is the direction of travel that will assure stability of our network. Others will disagree and emphasise the instability caused by an inadequate funding. And then there are the hobby horses many will wish to ride.

For example, calls for payment for a medicine delivery service has become louder and louder and is forming into a campaign. The success in getting MDS payments has fully embolden some to attack hard on this new front.  

You might even get drawn in by the rhetoric. For too long contractors have had to bear full costs of a prescription collection and medicines delivery service. We have to pay for the drivers and vans crisis-crossing the towns and byways of Northern Ireland delivering essential medicines to patients’ doors.

Why should pharmacy contractors have to bear the full cost of an essential service? If pharmacy wasn’t delivering many patients simply wouldn’t get their medicines. Think of the health consequences, the impact on patient care and increased costs to the health service through hospitalisations.

Beyond the satire this is the reality of our thinking and serves us poorly at a time we should be focused on delivering clinical services. Yes, I deliver medicines to patients’ homes but only for those in genuine need, within walking distance and when staff levels permit.

If we think that a medicines delivery service is a unique selling point for community pharmacy, just wait until Amazon get in the game. I am increasingly noticing the contempt in which GPs hold us as a result of our inexhaustible flexibility.

I had a phone call mid-October just before 5.30pm, a ring-through for an urgent prescription. The patient used another pharmacy and lived some distance away.

Could I deliver it. No! The GP was taken aback. He asked me how the patient was going to get the medicine. Perhaps a family member, I suggested, and I asked him to post the prescription. His practice didn’t post prescriptions he told me, so our driver could collect.

Since it was a different part of town and we don’t have a driver that would not work for me, he said he would see. He agreed to telephone the patient back having been told we close at 6pm. At 5.45pm the patient’s son collected the medicine, spent over £20 on bits and bobs and thanked me sincerely for being open.  

Two days later, the prescription had not arrived, so I telephoned and was told it had been collected by the driver of the pharmacy the patient normally used.  The abrupt receptionist advised I telephone them.

It was at this point I broke. I appreciate that the 22 minutes waiting on the phone was a catalyst and, as my staff said, ‘I went off on one.’ But it was professionally assertive not belligerently aggressive.

I made the point that both the Medicines Act as Amended and the Health Service Regulations required the GP to supply me with the prescription and I wanted it or I would escalate the matter to the SPPG. The next morning it arrived in the post.

Many reading this will view me as cantankerous, bad-tempered, petty and small-minded and very possibly, I am all of these things, but I wish to make a point.

Pharmacy delivery services is a problem we have created for ourselves, an unnecessary cost to our businesses and contempt from GPs, not because we care about patients and their wellbeing, but because we see delivery services as a competitive edge, which of course it is, yet only until the pharmacy next to us buys a bigger van with a glitzier logo and a younger driver.

It might increase the prescription numbers but does it really improve the bottom line? Call me old fashioned but I like to have patients and their families visit my pharmacy as it gives them an opportunity to shop which, believe it or not, is still part of my business model.

I hope the Community Pharmacy Northern Ireland Board discussion will not be taken up fighting for delivery service payments to the detriment of discussion on how we develop clinical services that patients who visit our pharmacies might benefit from – and which will help our struggling health service.

Terry Maguire is a leading pharmacist in Northern Ireland.