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I will not grieve for NHS England and its parade of highly paid executives who know nothing of our world, insists Mike Hewitson…

When the Health and Social Care Act came into being, promising not to use the NHS as a political football, I thought there might be progress. But it has been the worst thing that ever happened to community pharmacy.

For years, NHSE chief executives have avoided accountability of any kind. Simon Stevens should have been fired long before he found himself in an even less accountable place – the House of Lords!

Labour’s announcement that it will be consigned to the dustbin of history left me a bit giddy. I am pleased to see the back of a malign and incompetent organisation which has spurned all evidence and good sense when it comes to our sector.

NHSE never understood or cared for community pharmacy

It is absolutely clear NHSE never understood or cared for community pharmacy. It was far too focused on hospitals which have been consuming more and more of the budget and delivering less and less for it.

Let’s not forget that when Stevens gave evidence to the Health Select Committee, referring to community pharmacy, he said something like ‘we spend £2.8 billion distributing £7 billion worth of drugs. This doesn’t seem very efficient’.

I have had my own personal dartboard with a revolving cast of NHS directors, mainly from finance backgrounds, who felt community pharmacy was part of the problem, never the solution.

Consequently, no politician I have ever spoken to would hold the same views because they see us as integral to community and neighbourhood health.

We were always seen as something ‘other’ 

Recently, I took part in an NHS 10-year plan staff event. I was not surprised to find out I was the only community pharmacist in the room of over 100 people. I didn’t enquire too much in case they turfed me out.

That’s how the relationship has felt with the rest of the NHS for a long time. We were always seen as something ‘other’ than the rest of the health service, even though we see more people every day than general practice and A&E combined.

At that event, they asked people to submit anonymous answers to different questions via an app. My final comment of the day was simply ‘abolish NHS England’, which drew the attention of the moderator, who made snide comments about something I was deadly serious about.

I suspect with the announcement NHSE is to be abolished, he’ll be a bit less smug. But the bottom line is NHSE has never understood us and has repeatedly stood in the way of anything which might have helped.

Our relationship has only got worse 

I only have to think back to 2014 when there was a proposal for a nationally commissioned minor ailments service, which was pulled at the last minute. From there, our relationship has only got worse as we suddenly became the target for more than our fair share of cuts and efficiency savings.

At the 10-year plan event, I was amazed there was nobody from local Government in the room (apart from me, as an elected unitary councillor, but if I’d told them that, they’d have definitely drummed me out of town!).

The latest buzzword in health is ‘neighbourhood’ teams but at LPC level, we’ve been struggling to break into these conversations. I, 100 per cent, expect them to invent something with no thought to community pharmacy or how it contributes to the challenges facing both the NHS and society as a whole.

I will not grieve for NHS England and its parade of highly paid executives who know nothing of our world.

No politician took accountability for a system over which they had no control

It was clear even before the general election was called, that no politician was going to stand for taking accountability for a system over which they had no direct control. This change was inevitable and I am pleased it has arrived.

Our challenge is to ensure we don’t end up repeating the same mistakes as NHSE. Dispensing volumes are forecast to hit 1.3 billion items by 2030, which might sound like we’re in the right business, but we’ve got a fixed price contract, so all that means is we will have to dispense more and more items with no increased funding.

Our contract was never envisaged to handle these volumes of prescriptions when it was first created. I think we were hovering around the 750 million items-a-year mark. If we hit 1.3 billion items, with 2,000 less pharmacies, this will equate to a 65 per cent increase in workload for the pharmacies that remain.

The country can’t afford this level of medicalisation and we can’t afford this level of activity. We need an entirely new approach to managing demand and prioritising the spend we make on pharmacy and medicines.

I would get frontline clinicians to help design the solutions because I’ll be honest, our leaders have failed to grasp the size, scope and urgency of the problem.

I will not weep for the passing of NHS England.

Mike Hewitson is a pharmacy contractor and councillor at Somerset Council.