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Release the pressure!


Release the pressure!

Pharmacists must have time to recharge their batteries and not constantly worry about whether they can pay their bills. Investment in our sector must be at a local and national level, says Nick Kaye


I have five children whose ages range from two to 18 years old and I have basically been carrying nappies for two decades! I find it hard to get the balance of work and life right.

When I’m at home, I feel guilty about my pharmacy team at work. I often think ‘is the locum going to be okay?’ and ‘did I remember to organise that special before I left?’

When I’m work, the opposite is true, I know I am missing out on school plays, sports days and the children growing up. I’m supporting my wife enough with the daily tasks of living. Actually, probably not come to think of it. Who am I kidding? Absolutely not!

I don’t think I’m unique in this constant turmoil we as pharmacists are living through. I believe most community pharmacy owners feel this and it’s made even more difficult by the current financial pressures.

Life sometimes feels like a constant fight and for those of us privileged enough to be in leadership roles at local and national level, there is, as there should be, an additional sense of responsibility to those we represent when things are so tough.

At a local level, and something that much added to that pressure, I had an LPC meeting recently where, for the first time, the local system asked the question ‘is community pharmacy able to cope?’

I have never been asked this before by our local system. Yes, there have been concerns about individual pharmacy businesses or pharmacists but never questions such as ‘is the system broken?’ For the first time, I paused in my reply. It spoke volumes to me and my worry is that the network is really struggling.

It feels very different on the frontline. It’s harder than it ever has been in the past. We also worry about this question because we have always had a system that was prepared to invest in community pharmacy but now that further investment is being questioned. This could mean a lack of local investment on top of an underfunded national contract and you can see how this could spiral downwards.

However, are we so different from other parts of the NHS and primary care? Last month, the junior doctors went on strike we have seen general practice collapse in our system to emergencies only. It feels like a boiling pot of pressure with the safety valve stuck shut!

We have seen nurses, paramedics, physiotherapists and now doctors as well as global companies pulling out of UK community pharmacy. Surely the chronic underfunding of community pharmacy in England is next to be addressed.

Yet despite this, we as a sector are providing the best service we can under extreme pressures of cost and staffing issues. Working in a community pharmacy is an amazingly rewarding job but it is also a hard job. It’s hard to keep your concentration mentally, it’s hard physically to be standing up for 10 to 12 hours a day and yet I believe it’s the most the rewarding place to practice.

The safety value of this pressure could be so easily released with a couple of simple fixes. We must not be dispensing anything below the drug tariff – that’s just not sustainable. We should be remunerated for the advice we give – if that is walk-in or over the phone, no-one would expect professional advice for free.

I remember a story that was relayed to me a while ago about a bill a friend received for repairs to his boat, which had an engine that made a terrible noise. The fee was £2,000, an engineer came and hit the engine casing with a hammer, the noise stopped and the engineer left.

My friend was outraged because the fee was huge compared to the work carried out, so they demanded a breakdown of the bill. It read as follows: Call-out £100, hammer £50, knowing where to hit the hammer on the engine casing £1,850.

At present, we are giving out all our knowledge and experience for free. So, let’s have a properly funded walk-in consultation service or telephone consultation service. Then there is staffing. Let’s have an additional roles reimbursement scheme-funded pharmacist or pharmacy technician.

This, as I have said before, will fundamentally change the way in which community pharmacy is practiced and with most of the ARRS money underspent, we could really utilise that. These are very simple steps that could stabilise the entire pharmacy network. It would be really cost-effective and add value.

This is not too much to ask when so much is asked of us as pharmacy owners on a professional and personal level. Community pharmacy ownership is a way of life, not just a job, but it should be a way of life that allows you to give the care your community requires.

And at the same time, we as pharmacists must have some time to recharge our batteries and not always worry about whether we can pay the bills. Investment in our sector now needs to be at a local and national level.



Nick Kaye is the chair of the National Pharmacy Association and a pharmacist based in Newquay. These are his personal views.




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