Pharmacy Complete

Pharmacy consultancy

Michael Holden

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Pharmacy representation and leadership

When PSNC, now Community Pharmacy England (CPE), set out its transformation plan, it included two key actions critical for the future of community pharmacy:

  1. a single vision and plan for the future
  2. a single voice for the sector

We have yet to see either, albeit the Kings Fund and Nuffield Trust who were commissioned to write the former have now published a summary of themes and proposals for feedback. Evolution continues to underpin the theme, but the sector cannot wait another 12-24 months; the pace of change in the contractual framework and pharmacy practice must accelerate and funding to match it.

Unsure why the sector could not write its own vision and plan, Pharmacy Voice did so back in 2016 with its collaborative Forward View blueprint. Most of that is reflected in the latest vision so have we just lost 7 years of progress?

Is it the current lack of a single voice which is holding the sector back?

The NPA has produced its prospectus for pharmacy services: Making Changes Meeting Needs and CCA have launched their vision for the future of community pharmacy. All credible thinking, but where is the joint vision across the whole sector that the NHS want to hear? Importantly, the prospectus does highlight the need for a clear vision and unified leadership. We frequently see individual, sometimes divergent, and even divisive statements from AIM, CCA, CPE and NPA, but no single vision, strategy or plan.

The recent announcement of £645 million going into the contract sum has to be welcomed, but is well short of the £1 billion black hole in the funding just to bring it back to a level before the 5-Year deal. Will the fix come too late for some who are currently operating at a loss? Some would argue that this more down to the current unfair reimbursement scheme as opposed to the under-valued remuneration fees, yet we hear little about the former in all the media speak, other from the impacted contractors feeling the pain.

Negotiations are taking place to try and fix the current funding crisis, and CPE have offered an attempt to demystify the process. However, contractors need to hear about outcomes, not process.

Questions pharmacy owners keep asking me:

  • How much of the new money will be spent on IT infrastructure?
  • What will have to be done to access the rest?
  • How much will actually get through to the bottom line?
  • When will it come?
  • When will I get paid a fair price for the medicines I supply?

We have one contractual framework, one negotiator, so why not one vision, one plan and one voice?

One vision, one plan, one voice – #pharmacysvoice

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Time for change

The current landscape is probably the most challenging that community pharmacy has ever faced, certainly in our professional memory. A combination of the ongoing under-funding and the workload and workforce pressures are a perfect storm for pharmacy owners, pharmacists and their teams. 

The COVID-19 pandemic has changed the way we all think and act and it has accelerated changes in consumer expectations and behaviours. It has also positively changed the NHS’s view of community pharmacy and how it may use it in the future as an integrated part of primary care. However, the Treasury’s view of funding has not changed and no sign that it will despite the various pharmacy organisations lobbying for that. #OneVoice

Online shopping, increased use of distance selling pharmacies, digital health and technological innovation has and continues to require community pharmacies to adapt to a new health and business landscape.

Large multiple pharmacy groups have already announced significant remodelling plans in response to these challenges.

Where does this leave independent pharmacy? 

The outcomes of our research through conversations and working in and with independent pharmacies has shown that they and their teams are facing a number of critical problems:

  • Financial – cash-flow and reduced margins
  • Personal strain and mental ill-health
  • Feeling overwhelmed and out of control
  • Team recruitment, retention and performance
  • Capacity and time to plan and deliver

In addition, new and extended NHS services have been announced including GP referrals into the Community Pharmacist Consultation Service, the Hypertension Service, the Discharge Medicines Service, Smoking Cessation Referrals and a Contraception Service. These and others in the CPCF pipeline are welcomed as part of a further integration into health provision in primary care. However, there is no new funding associated with these, only recycled money within the existing 5-year contract sum = more for the same, or in real terms, 30% less!

Pharmacy must find a way to take back control; to create the time, capability and energy to embrace and deliver these services. Pharmacy must also be less reliant on a single payor (the NHS) by developing their non-NHS service and OTC income.

Pharmacy owners can delay no longer, there is an urgent need to develop their own recovery plan.

The Pharmacy Complete Reset and Recover Programme has been developed utilising all our knowledge, skills and experience and is designed to support all the required elements to help address these problems and create an effective business recovery plan specific to community pharmacy. Click on the link above to find out more and see how we can help you to help yourself.

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Creating a new future

The last 2 years has probably the most challenging period that community pharmacy has ever faced, certainly in our professional memory. A combination of underfunding and the COVID-19 pandemic has been a perfect storm for pharmacy owners, pharmacists and their teams. Yet those same people have been magnificent in their response, putting their patients and their communities before themselves. However, negotiations on additional funding within the CPCF 5-year deal show no progress and, whilst words of thanks are welcomed, they do not pay the bills.

The COVID-19 pandemic has changed the way we all think and act and it has accelerated changes in consumer expectations and behaviours. It has also changed the NHS’s view of community pharmacy and how it may use it in the future as an integrated part of primary care.

Through conversations and working in and with independent pharmacies it is clear that they and their teams are facing a number of critical problems around resilience, sustainability, capacity to implement new CPCF services and feeling out of control.

Pharmacy must find a way to take back control, to create the time, capability and energy to embrace and deliver these services, but also to develop their non-NHS service and OTC healthcare income. Pharmacy owners can delay no longer, there is an urgent need to develop their own recovery plan. The time has come to work on the business, not just in it. The time has come to find more efficient ways of operating by analysing how things are done, by embracing technology and by exploring market opportunities.

The Pharmacy Complete Reset and Recover Programme has been developed by pharmacists for pharmacy utilising all our extensive knowledge, skills and experience and is designed to support all the required elements to help create an effective business recovery plan. Click on the link above to find out more and see how we can help you.

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The future is local?

As we continue to work our way through a pandemic and all that means to the day-to-day operational pressures of pharmacy practice, the Government and NHS England are looking ahead to 2022 with enabling legislation to further integrate local health and care through a new White Paper now backed up by a new Health and Care Bill. With it comes wide-ranging changes and powers which will impact on pharmacy at a national and local level.

Primary Care Networks (PCNs) will increasingly becoming the building block of out-of-hospital care at the so-called ‘neighbourhood’ level. Integrated Care Systems (ICSs) will have delegated powers for primary care services with a single pot of funding to commission health and public health services, including pharmacy services, at the ‘system level’ with the planned demise of CCGs. Local Pharmaceutical Committees (LPCs) influence on their local ICS, and Community Pharmacy’s relationship with PCNs will therefore be critical to its future.

So what does this mean? The skills to effectively engage, communicate with and influence ICSs and PCNs will be key – we have to be in it to win it! This is not about selling what pharmacy does, it’s about effective influencing and creating the opportunity to ‘buy’ from community pharmacy. At the same time, community pharmacy must redefine and reposition its core purpose as community-based health clinics which also supply medicines safely and efficiently.

These changes in the healthcare landscape will also impact on the current review of pharmacy representation and support. There is a need for greater alignment of LPCs with ICSs and improved support for Pharmacy PCN Leads in addition to the appropriate resourcing of PSNC to negotiate a better CPCF.

To date Pharmacy Complete have worked with LPCs across England to develop over 400 Pharmacy PCN Leads. Initially through face-to-face workshops then from the start of the first lockdown by utilising web-based technologies and blended learning to transfer the required knowledge and skills. This has inspired and enabled Pharmacy PCN Leads to not only engage with their PCN, but also with fellow contractors in their area. That collaborative approach across contractors at a local level is as important, if not more so, as it is at a national level.

Our Effective Engagement and Communication leadership development programme is designed to provide Pharmacy PCN Leads and others in local leadership positions with the capabilities to maximise the positive impact they can have and be ready for a more integrated local health care system.

The healthcare landscape is changing so pharmacy must adapt. The future is local.

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Community Pharmacy as the front door

We recently wrote an article for Pharmaceutical Field on the increasing role of community pharmacy in England as the front door of the NHS supporting medicines adherence, treatment of common illnesses and as a major player in the prevention and protection of ill-health. It seems that the vision for pharmacy within the NHS Long Term Plan is finally being realised, enabling community pharmacy to play its part in addressing demand on NHS resources. The article can be viewed here.