September always seems to bring a rush of activity and this year has been no different. In fact, it has probably been worse, says our correspondent…

September always seems to bring a rush of activity –and this year has been no different – in fact it has probably been worse. I hope our friends at the Department of Health realise how much effort is involved in earning the zero per cent increment in our five-year contract settlement.

We are now up to (at the time of writing) number 16 on PSNC’s CPCF checklist. The beginning of October means that as part of the Pharmacy Quality Scheme we should now be checking that patients with diabetes have had foot and eye checks in the past 12 months. The window has opened for updating my NHS111 profile and to demonstrate I can access summary care records.

If you have kept up so far you must remember to make your expiration (sorry- aspiration) payment declaration by the end of October. I must confess I’m not even sure how much the payment is worth at the moment, but I am determined to be aspirational now rather than later.

I need to start thinking about how we are going to manage our patient safety audits because they need to be under way by the end of November – and while the team is in audit mode we could cover off the NSAID audit for next year too.

…. And so it goes on. Taken individually nothing we are being asked to do is unreasonable or falls into the ‘too difficult to be worth the effort’ category, but it all takes time, and that is at a premium. Do I go to the Pharmacy Show, or spend some time with the long-suffering family? Do I go down to the rugby club to enjoy an early morning (UK time) international or do I try to keep on top of the paperwork?

I have often envied the support that a multiple’s head office can provide for its branches, but I suspect at the moment they are struggling to keep on top of co-ordinating the requirements for the new contract framework. Trying to get overstretched branch managers to comply with the various requirements of the Pharmacy Quality Scheme must be like trying to herd cats.

My staff may think I am something of a control freak but with income as tight as it is missing one of the contract deadlines could be costly, and often there is no second chance. Still, I can’t complain about the blizzard of reminders and instructions from PSNC. I just wish they were a bit further apart.

Still, away from the everyday travails of community pharmacy there has been debacle of the party political conference season to provide some entertainment. I’m never quite sure whether to take these events seriously. AIMp, the CCA, NPA and PSNC jointly organised roundtable events at the Labour and Conservative party conferences. I hope they felt the effort was worthwhile.

I had to laugh when the Commons voted against a three-day suspension that would have made it easier for Tory MPs to travel to the party election fest in Manchester. It was a bit of rough justice after Lady Hale’s damning judgement on the Prime Minister’s attempt to prorogue Parliament.

The Labour Party event has been variously described as a ‘train crash’ and ‘internecine warfare’ but since Jeremy Corbyn had a couple of things to say on the health front, I thought I’d have a look at his speech. It was a revelation. I am no fan of Boris Johnson, but reading Corbyn’s polemic really did make me appreciate why many people cannot see him as a future prime minister.

In his speech Mr Corbyn condemned Vertex, the maker of a cystic fibrosis medicine called Orkambi. The manufacturer refuses to sell the drug to the NHS for an affordable price,’ he proclaimed.

Orkambi is a combination medicine, made up of ivacaftor and lumacaftor. There are around 3,970 people in England who could benefit from the product. However, despite recognising Orkambi as an important treatment, both the Scottish Medicines Consortium and the National Institute for Health and Care Excellence have not been able to recommend Orkambi for use within the NHS on grounds of cost-effectiveness and a lack of long-term data.

But Labour is going to tackle this. ‘We will redesign the system to serve public health - not private wealth - using compulsory licensing to secure generic versions of patented medicines. We’ll tell the drugs companies that if they want public research funding then they’ll have to make their drugs affordable for all. ‘And we will create a new publicly owned generic drugs manufacturer to supply cheaper medicines to our NHS saving our health service money and saving lives,’ said Mr Corbyn.

This rhetoric plays well to those who believe pharmaceutical companies enjoy patent protection and a supply monopoly for new medicines they develop that allows them to charge any price the market will endure. There are economists that believe the industry is no longer fit for purpose. While some groups of drugs like antibiotics are regarded as too unprofitable to research others, like new cancer medications, are unaffordable.

I’m not convinced that using compulsory licensing to override big pharma’s patents for products like Orkambi will be helpful. History suggests the prices of such products comes down as more competitors enter the market and production costs fall. I’d be much more interested in a publicly owned generic drugs manufacturer that would help alleviate the shortages of some of the more everyday products on my dispensary shelves.

However, in practice it is likely to face the same regulatory issues, supply chain problems and difficulties sourcing active pharmaceutical ingredients as any commercial manufacturer.

It has been reported that in the last two years, the NHS has spent around £2bn on drugs where public money helped fund their development. This means taxpayers are paying twice – first for the research, then for the price the NHS is charged for the medicines. It may be that big pharma has more of a position to defend here.

Oh, and Labour will make prescriptions free in England, as they have been in Wales since 2007 when charges were abolished by the Welsh Labour government. (No mention of the fact that the SNP also managed this in Scotland in 2011).

I have no problem with the abolition of prescription charges. The charge raised around £554.9 million in 2016-17 which is not exactly peanuts but I have never appreciated being a tax collector.

Picture: excentric_01 (iStock)