Personal testimony is a powerful thing, as Patrick Grice found when listening to the NPA during the UK Covid public inquiry…

It may well have escaped your notice that UK Covid-19 public inquiry, set up to examine the UK’s response to the pandemic, has been taking evidence. A preliminary hearing for module 3 of the inquiry, which is looking at the impact of the pandemic on healthcare systems, took place on February 28.

The NPA is a ‘core participant’ in module 3 and the Association’s opening statement contained some powerful personal testimony from husband-and-wife team, Pete and Sukhi Johal, who co-own Calow Pharmacy in Chesterfield. Without sparing their blushes, this is what they told the inquiry:

“My wife and I are co-owners of a single independent pharmacy. We are both pharmacists. When the pandemic hit it occurred to us that if one of the team became ill or got Covid, there was the potential for the whole team to go down. That would mean closure, leaving patients without medication and putting them in turmoil.

“Our big fear was letting people down. The solution we came up with was to keep running and safe. We split the team in half. My wife led one half of the team while the other half of the team isolated at home. Whichever one of myself or my wife was working stayed in a hotel for that week.

“At the end of the week, when I was working, I checked I was symptom-free before going home. Even then the family would go to a separate room while I would go straight to have a shower and put my clothes in a bag. Only then would I come down to the family. We would spend a day together and then we would swop. We did that for 10 weeks.”

Many other independent owners will have similar stories to tell, of hard work and sacrifice to keep their pharmacies open, and many found meeting the challenge rewarding in itself. But – there’s always a ‘but’ - the NPA went on to point out that despite their central role in the delivery of NHS care, community pharmacies were often overlooked during the pandemic.

Remember, pharmacies initially had to fund and source their own PPE. Pharmacy staff were not initially recognised as key workers. Inexplicably pharmacies were initially excluded from the scheme announced by the DHSC in April 2020 to pay £60k when a health or social care worker died from Covid in the course of frontline work.

Hearing these facts related in the setting of a formal inquiry is quite chilling. It does make you wonder whether the NHS, and by extension, the government, really deserves the pharmacy network it has got – and which it may not have for much longer.

1. Ironically, given the way community pharmacy was overlooked by the DHSC during the pandemic, the NPA was overlooked when the list of core participants at the hearing was read out – an error later picked up by the chair, Lady Hallett.

Thunder cloud or silver lining?

There are, reportedly, lots of LloydsPharmacy branches up for sale. Although Lloyds itself isn’t saying much, you only have to read some of the features in this issue to see that the lawyers and accountants are all over the potential acquisition opportunities.

But acquisition may not be the only way of growing your business. Lloyds is closing its Sainsburys in-store pharmacies and figures circulating from AIMp suggest that this will put around 880,000 patient nominations up for grabs.

Organic growth within an existing business by collaring some of those nominations may be a way of boosting revenue , even if it does mean looking carefully at resources. So which is the better option – chasing more patients for your existing pharmacy, or spreading your coverage though acquisition? Or may be neither…?

PSNC has spelt out its concerns that existing pharmacies will not be able to absorb the number of patients that might come their way from large scale closures, since staff and resources have been cut to the bone.

An NPA survey in February has revealed that 93 per cent of the 222 respondents experienced at least one month of negative cashflow across their business overall in 2022, and 45 per cent said their overall outgoings had exceeded overall income in at least six months of the year.

It’s a sorry state of affairs when businesses might struggle to take on extra business. #SaveOurPharmacies indeed!

Pholcodine is no more. Over-reaction?

I suspect I am not the only pharmacist surprised by the ‘out-of-the-blue’ announcement from the MHRA last month that led to pholcodine-containing medicines being pulled from pharmacy shelves.

The move followed a review of post-marketing safety data which demonstrated that pholcodine use, particularly in the 12 months before general anaesthesia with neuromuscular blocking agents, is a risk factor for developing an anaphylactic reaction to these agents.

Anaphylaxis following use of NMBAs is roughly estimated as having an incidence of fewer than 1 case per 10,000 procedures, but given the lack of identifiable effective measures to minimise the increased risk, pholcodine-containing products have been consigned to history.

Some pharmacists have seen this as an over-reaction, suggesting that they could safely manage sales over the counter. Having seen how effectively pharmacies have been dispensing scripts for sodium valproate, others might disagree.

Patrick Grice is the contributing editor of Independent Community Pharmacist.