Pharmacy Complete

Healthier future

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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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Pharmacy Reset & Recover

As community pharmacy reflects on and learns from its excellent response to the COVID-19 pandemic, the time is now right to move forward and plan for reset and recover.

Large multiple pharmacy groups are already announcing significant restructuring and remodelling plans in response to the financial, operational and landscape challenges, but where does that leave independent pharmacy? 

Negotiations on COVID-19 related costs have now begun plus discussions on next steps for implementation of the 5-year contractual framework. However, community pharmacy owners cannot wait and there is an urgent need to develop their own recovery plan.

The outcomes of our research through conversations with owners and managers of independent pharmacies has shown that pharmacy contractors and their teams are facing a number of critical problems:

  • Financial
  • Personal strain
  • Feeling out of control and overwhelmed
  • Team performance
  • Capacity and time
  • Competition

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.

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Collaboration, integration and transformation

As we all move forward into a reset, reform and recover phase, it is critical that we learn from and build on community pharmacy’s excellent and dynamic response to the COVID-19 pandemic.

Collaboration

If there is one of the many hashtags doing the social media rounds over the last two months that best fits the Coronavirus response it is undoubtedly #allinthistogether 

We have complete admiration for pharmacy teams who are putting outstanding and safe patient care, often ahead of personal safety, at the heart of their communities. This is against a backdrop of current underfunding, major cash flow and workload challenges, late and limited supplies of personal protection equipment and poor recognition, beyond a few words of thanks from politicians and NHS England, of the critical role we play in the current pandemic crisis.

One of the many objectives of the Healthy Living Pharmacy programme when we created the concept, was and remains to collaborate better for the greater good of pharmacy and the health and wellbeing of our communities. If there is any silver lining to this dark COVID-19 cloud, then it is the way in which pharmacy teams, other healthcare providers and local volunteer groups have all worked together for the benefit of the population.

Integration

This could be a defining moment for pharmacy. What we are doing now will cement in the minds of the public, other health professionals and, one would hope, NHS commissioners, the role of bricks ‘n’ mortar community pharmacy at the frontline of healthcare in the heart of our communities.

What we must all ensure is that this intra and inter-professional collaborative approach continues beyond the pandemic and drives the need and opportunity for pharmacy in the community to be fully integrated into the local health and care systems. To be sustainable, this must also extend beyond (yet still include) the important safe supply of medicines to a broader role in clinical care and prevention.

Before COVID-19, which seems an age ago now, the NHS long term plan, the GP contract and the community pharmacy contractual framework began to align behind this integrated approach. Once this is all over, we must go back to the key objectives which are and should still be to focus on:

  • the prevention of illness;
  • personalised care;
  • utilising data and technology; and
  • making the best use of collective resources across all local health and care providers.

The only way these objectives will be achieved is through effective collaboration and integration. How we achieve that to support the delivery of the objectives requires individual, organisational and system transformation.

Transformation

We are going to experience a radical and rapid evolution in what community pharmacy looks like and does in the next five years, those who adapt will continue to successfully operate as healthcare providers.

Healthy Living Pharmacy was never just about brief advice and interventions on healthy lifestyles, although that is an important output. The HLP model was, and remains for those who fully embrace it, an organisational development framework to transform pharmacy in preparation for what was to come. One based on workforce and premises development plus effective engagement with the local population and other providers of health and care.

What we see now is a shift from a contractual framework almost totally reliant on procurement and supply of medicines to one which is increasingly more service-led and quality based, driven by financial, population health and consumer demand.

Digital healthcare is now moving at such a pace with web-based information, consultations, algorithms and ‘health-bots’ now common place. Distance selling pharmacies now provide around 3% of prescriptions and growing fast, so transacting product alone is no longer a unique option nor a sustainable model for bricks ‘n’ mortar pharmacy.

We need to find a new model which can only be provided face-to-face. Turkish barbers and coffee shops are everywhere. Why? – because you cannot get a haircut or a cup of coffee online! So, what is our new unique face-to-face offer?

The fixed funding in the contractual framework is insufficient to support the existing community pharmacy estate. This means that new skills and skill-mix must be developed; operational efficiencies must be found; technology must be embraced; we must develop new services and products that people and commissioners want to buy; consistent high quality consumer experience must be delivered; community pharmacy must collaborate and be fully integrated into local health and care systems; and we must effectively promote what we do.

All this change needs to be actively led at all levels but, as with most effective change, it must start at an individual level.

Let us help you to help others.

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Pharmacy Transformation

Some would say that transformation in pharmacy will never happen, some that it is overdue; others would say its on the horizon, but most are witnessing that it is here and now! We are going to experience a radical and rapid evolution in what community pharmacy looks like and does in the next five years, those who adapt will continue to successfully operate as healthcare providers.

In 2009 we looked ahead at what was fairly predictable and being looked for by commissioners. That led to the development of the Healthy Living Pharmacy (HLP) initiative. Ten years later it will be embedded as an essential requirement in the contractual framework and we finally have prevention high on the agenda for the Government and the NHS. HLP was never just about brief advice and interventions on healthy lifestyles, although that is an important output. The HLP model was, and remains for those who fully embrace it, an organisational development framework to transform pharmacy in preparation for what was to come. One based on workforce and premises development plus effective engagement with the community, the population (the consumers of our services) and other providers of health and care. That was the first time that the need for unilateral leadership development was identified and implemented in pharmacy to lead the required change in culture and activity.

What we see now in the shift from a contractual framework almost totally reliant on procurement and supply of medicines to one which is more service-led and quality based, driven by financial, population health and consumer demand was inevitable. The need to get upstream of what creates much of ill-health, both physical and mental, – the prevention agenda – puts community pharmacy in a good place providing we have the capacity, will and skill to occupy that space.

Digital healthcare is now moving at such a pace that community pharmacy and other healthcare providers are struggling to keep up. Web-based information, consultations, algorithms and ‘health-bots’ are now common place. Distance selling pharmacies now provide around 3% of prescriptions and growing fast. Yes, Pharmacy2U grew 80% last year, admittedly at an operational loss due to investment write-offs. Echo (Lloyds) and Well are also increasingly significant players in the online market. Now enter the giant… Amazon Pharmacy is now trademarked in the UK in addition to the Far East, US and Australia. Their cost base will be much lower as they have the established infrastructure and distribution networks plus a massive consumer base. So transacting product is no longer a unique option nor a sustainable model for ‘bricks and mortar’ pharmacy.

We need to find a new model which can only be provided face-to-face. Turkish barbers and coffee shops are everywhere. Why? – because you cannot get a haircut or a cup of coffee online! So what is our unique face-to-face offer? You cannot have a vaccination given online; diagnosing effectively and supporting individuals to change their behaviours around safe medicine use or healthy lifestyles is difficult to deliver online. It is said that to change people’s hearts and minds you need to look them in the eyes – we listen with our eyes as well as ears, or at least we should do.

The fixed funding in the contractual framework is insufficient to support the existing community pharmacy estate. This means that new skills and skill-mix must be developed; operational efficiencies must be found; technology must be embraced; we must develop new services and products that people and commissioners want to buy; consistent high quality consumer experience must be delivered; community pharmacy must collaborate and be fully integrated into local health and care systems; and we must must must promote what we do effectively.

All this change needs to be actively led at all levels but predominantly at an individual pharmacy level, no-one is going to do it for you. This requires an enhanced level of leadership and business planning skills. Our recent experience of delivering our Effective Engagement and Communication workshops for PCN Pharmacy Leads has demonstrated a real hunger for these leadership skills and a passion to transform what we do. We have also developed a Transformation workshop to help create the time, capacity and capability to implement and deliver more services.

The future is bright, but only if we truly understand why we must change, how we do it and move fast.

People buy why you do things, not what you do (Simon Sinek).