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Double, double, toil and trouble


Double, double, toil and trouble

Sid Dajani feels fright night has set in at the Department of Health

Halloween has moved away from being just one day dedicated to remembering the dead, including saints (hallows), martyrs, and all the faithfully departed, into being a much longer commercialised fright fest. The fact that it has seamlessly morphed into bonfire night, too, simply elongates the misery and the nightmare for anyone with Samhainophobia.

Unfortunately for pharmacy, the scary season looks set to last. The nightmares and the daymares are not just linked to austerity but two developments that prove our suspicions. One is a governmental leak around plans for patients not to be able to access a pharmacist any more without an appointment, or with a much longer waiting time.

The government’s response was simply to say it was saddened by the leak and that it needed to consider every option possible. Surely bad ideas should have been filtered out right at the beginning and assigned to the NHS compost heap of bad ideas? If idiocy is an excuse for a defence then that’s no different to a felon standing up in court and pleading that he had to consciously break the law in order to be found guilty! It beggars belief.

Even more damning though is how the Department of Health (DH), through its Chief Pharmaceutical Officer, Dr Keith Ridge, can be so blatantly blasé about what evidence it chooses to consider and champion. For example, it has accused community pharmacy of confusing issues by not having a single voice; that we are not clinical pharmacists (despite carrying out clinical screenings and services); and that we have a poor evidence base for helping patients.

Time and time again we have proven otherwise until it cannot defend itself. Then the DH goes about finding new ways and new excuses not to invest in more services and delay progress: the national Minor Ailment Scheme debacle being a case in point. I could go on about wasted resources and missed opportunities but, in the latest fiasco, the DH independently commissioned a review of community pharmacy with the intention to use the recommendations to inform its approach to the commissioning of NHS community pharmacy services.

After two years, the Murray Review was published and in it Mr Murray acknowledged that community pharmacists and their teams are “an under-utilised resource” and discussed the “great untapped potential to improve care for patients and reduce pressure on other parts of the NHS… through the better use of the skills of the community pharmacy team”.

To refresh your memory, among the recommendations were:
• Consideration of making smoking cessation services an element of the national contractual framework • Use of the Vanguard programmes to develop the evidence base for community pharmacists
• Joint work by PSNC, the Royal Pharmaceutical Society and national GP representatives to explore what practical steps could be taken to unravel professional boundary issues.

The report also called for NHS England to set out how it intends to deliver on its commitment to ensure that minor ailments services are commissioned across England by April 2018. It stressed the need for community pharmacists and their teams to share information with clinical records held by other healthcare professionals, and said pharmacy technicians should be able to work under patient group directions to improve better use of the skill mix within pharmacies.

The report concludes that there needs to be “renewed efforts to make the most of the existing clinical services that community pharmacy can provide and to do so at pace”. So far we have had smoking cessation services removed, worse commissioning, financial cuts on several fronts as well as the DH confirming it will now do nothing about the review except ‘consider it’. Would the DH have been as detached if the report was damning against us? I’m not talking as a contractor here, but as a healthcare professional whose services have been under-funded for many years and whose patients have been denied access to quicker, cost-effective services.

I’m sure the DH has another agenda and that’s to close pharmacies down, even though it relaxed the rules to allow more to open up in 2007! Most recently Lloyds has said it will close 190 pharmacies and I’m thinking this is how the DH wants to save money and improve services.

Under the steer of Dr Keith Ridge and his team, it looks like our Halloween will soon transcend into the risible pantomime season, though I’m wondering if a Peking opera – where despite what is said and done, a different agenda exists – wouldn’t be more apt? And as we further slide into a right royal mess because of the continuing erosion of the community pharmacy network, the powers that be seem intent on turning us into a cut-price horror healthcare profession. All trick, no treat.

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