Disaster strikes! I’m having a day from hell, and it seems even the sky is against me. We’ve been having some problems with the lights in the shop going out a few times each day. I’m no electrician but there was no obvious cause. Then, as I was enjoying five minutes of peace and quiet after finishing the dreaded end of month procedure, there was a shout from downstairs: Sarah had found the cause of the problem – a leak.

The front of the shop has two large, Victorian bay windows which we use for advertising products and services. Unfortunately, one of them has developed a pretty serious leak which is pouring directly in to the light fitting! Arrrgh!

Today is going to involve a frantic search for a roofer while praying for dry weather. Apart from the obvious health and safety problem, we were due to put the Christmas tree in that very spot this morning. Unfortunately for the tree, the indoor irrigation system is not staying.

Then things got even worse: I put the heating on in the flat only to find that the boiler was not working, almost a year to the day the previous boiler had gone kaput. I’ve got a busy day of ringing tradesmen to sort out this mess ahead of me. At least last month’s record number of MURs will pay for the repairs.

It has been a busy week, but for once I was allowed out of the pharmacy. On Wednesday I made the long trip to Cardiff for a roadshow organised by our buying group. It was a great opportunity to meet suppliers we currently don’t know and say thank you to those we already have a good relationship with.

It was a good evening, and I came away with lots of ideas that I can use to improve my business. The range of support materials produced by GSK to boost pharmacists confidence in dealing with respiratory MURs was particularly interesting, and I am looking forward to putting these materials into practice.

As a bonus, I walked away with a year’s worth of post-it notes and pens, which will definitely come in handy around the shop. I am not quite sure what to do with the strange freebie which consisted of a pair of wheels to turn my shoes into skates, though; it’s probably not the best gift for somebody as graceful as Dumbo with the balance of Bambi!

The following day I travelled to Taunton for my LPC, who needed somebody to attend the regional chlamydia conference. I was happy to do this, because it is nice to be an ambassador for pharmacy amongst other healthcare professionals. Everyone was very interested to find out the secret of why Dorset has the highest proportions of chlamydia screens completed in pharmacy in the south west, and I was only too happy to tell them!

My dispenser has been on holiday this week, which has been a challenge because it has left a lot of additional work on my plate. Luckily, we haven’t been too busy and I have survived.

However, it has focused my mind on an issue which I have been considering for months: what staff do I need? Is my skill mix correct for my current workload? And is it correct for the future?

The answer I have come to is that it isn’t. Like most community pharmacies, we have increasingly found that our income is derived from NHS services and is less reliant on OTC sales and other retailing activities (although I’m not ready to stop selling soap yet! At least not until we have a more rewarding contract).

Recruitment always holds a degree of fear for me. It is always awkward when you have a new person in a small team: how will existing employees react, and will the new employee be able to adapt to our ways of working?

Over the next few months, I hope that we can find a member of staff who can take on services such as Smokestop and allow me to spend more time away from the dispensary.

One possible solution could be to employ a pre-reg pharmacist, which is something I am keen to do in the medium term, but it doesn’t answer the sort-term problem. Either way, I am going to have to face my fear and find a reliable extra pair of hands.

It is fair to say most pharmacists don’t get this sort of problem. It is also fair to say that I never had this sort of problem before, either. It all began with a phone call....

“Is that the pharmacist?” the voice enquired.

“Yes” I replied.

“I need you to make something for me…”

“Umm, what is it? I’ll see if I can help.”

“It’s a bit unusual...” I got the feeling in the pit of my stomach that you get at the top of a rollercoaster. “I need to transport some trout sperm!”

Last time I checked, I wasn’t offering a fishy IVF clinic. Nothing in the training, or the Code of Ethics that prepares you for a query like that. The local fish farmer wanted a mixture made to extend the life of his rainbow trout semen, so he could transport it more easily. I like a challenge as much as the next man, but could I really have met my match?

I got on the phone, first to the NPA, where I think I won the craziest query of the month award, then to the ever unflappable Craig and Hayward. They couldn’t help, but I did get a warning: some specials companies won’t touch veterinary products because some of them can be quite explosive! Things were getting better and better...

I finally tracked down a supplier who would be prepared to make it, but after all of that I’m not sure it’s worth the hassle. Trout 1 Mike 0.

Things got a little serious here for a moment this week, when I was approached by a young girl who needed help. She had missed two periods, and when a pregnancy test came up positive she came in for advice about what she could do next.

She had been to see her GP, who had given her the impression he could do nothing unless she spoke to her parents. She didn’t want to do that because she was afraid her whole world could fall apart. To some extent, I felt out of my depth. I was certainly out of my comfort zone, but as she had reached out to me I had to do something.

Suddenly my whole day became engulfed by this issue. My immediate concern was for her welfare, particularly her emotional wellbeing – she was obviously worried and looked like she needed a cuddle from her mum. She was so frightened she wouldn’t even give me her name.

Typically, there was nobody around to get advice from, as the whole Safeguarding team for Dorset was stuck in a training session! Eventually I got somebody on the phone, and was able to talk the scenario through and come up with an action plan. Fortunately I was able to guide her to an appropriate source of care. A job well done, but some definite lessons learnt for next time.

It has been a week of misunderstandings. First, on my return to work after a day off, my dispenser and counter assistant burst out laughing.

“What’s so funny?” I asked.

“Just something that happened yesterday” she replied.

It turns out that they had an unusual request from the trainee assistant of one of the other shopkeepers in the town. She had asked for “two stereostrips and an immigrant”! It was easy to see why they had burst out laughing – she had actually been sent in for some Steri-strips and Imigran! I’m glad that I wasn’t there when she came in because I might have wet myself!

A couple of days later a patient came in to talk to me about her mother’s tablets, she told me that she was taking “Nicaraguans”. ‘Not again’, I thought to myself. What could she mean? After a bit more questioning it turned out to be nicorandil for her angina!

In more professional matters, a major breakthrough has come in our relationship with one of the surgeries. I was asked to come to speak about a PCT waste management audit, which has now been postponed for the expected swine flu surge. Instead, we spent time talking about how the pharmacy could help them to get their budget balanced. We are going to be offering targeted MURs to educate and reassure their patients who have recently had medicines changed (to save money). We will deliver this and show them what we can achieve.

A few months back a colleague and I arranged a get-together of independents to discuss a couple of issues related to pharmacy business. Those that attended seemed to enjoy the opportunity to talk to their peers about the stresses and strains of running a pharmacy in the current climate of DTP, quotas, cuts and recession. It doesn’t sound very enthralling, but it was! Maybe it had a little black comedy, maybe a bit of masochism, but at least everyone was in the same boat.

This week, we have been frantically arranging another meeting. Hopefully it will be much better attended this time as we are giving a bit more notice, and have arranged some really good speakers to come and inspire independents to grow their businesses despite the doom and gloom in the general economy. The invites have gone out, so all can do now is wait and see if people come.

I completely understand that giving up an evening doesn’t seem like a good deal, but in the long run independents have got to stick together. At least we can share the load, and share some ideas. Of course, we are still making ‘excessive profits’ according to the Department of Health, but I’m sure none of us will agree! I never thought I’d say £500m wasn’t a lot of money, but our agreed purchase profit has remained the same since the contract was launched. And now we’ve got more pharmacies, so everyone gets less.

Two different problems emerged this week, with one common cause: teeth. On the home front, baby Gracie has been cutting her first two teeth, which has meant restless nights, tears, and tantrums – and Gracie wasn’t very happy either!

Meanwhile, a major bugbear of mine has reared its head at work. It never ceases to amaze me how many ways the average dentist can find to get a simple prescription wrong. If it isn’t missing the patient’s name or some crucial clinical detail, they’ve forgotten to sign or date it. One particular dental practice in a nearby town has given me virtually every combination of these mistakes over the past few months. When I ring to clarify the prescription, I’m told that the dentist doesn’t speak much English.

Don’t get me wrong, I think that the best use of the Daily Mail is wrapping tomorrow’s cod and chips and I’ve no axe to grind on the issue of foreign healthcare professionals, but how can they possibly communicate with older patients? One prescription I received this week from was missing the practice stamp - as if I couldn’t guess where it had come from!

At other times, it is obvious that key details of the prescription have been added later by the receptionist. In some ways that is probably safer – giving a dentist a prescription pad is like giving a two-year-old a pack of crayons!

A close shave with a dragon to report this week - fortunately us Welshmen are not scared of these mythical beasts! What am I talking about? Well, it all started a few weeks ago when I heard about a mysterious visitor on my day off.

“He did what to the locum?” I asked.

“He mummified him!”

Thinking that somebody was trying to confuse me I thought it was best not to enquire any further. And a few days later all of my questions were answered when the mysterious visitor returned brandishing something he wanted to show me...

This is going to be good, I thought, as I led him to my consultation room. “Roll your sleeve up,” he commanded, and I nervously did as requested. Out of his bag came a packet, and out of the packet came a bandage. Relief washed over me like a wave: a revolutionary new type of rechargeable cold compression bandage! The results were pretty impressive as I felt my arm first go cold, then go numb. I thanked my visitor for the demonstration and said that we may be willing to stock his product (they only lived in the next village). Then a few weeks later whilst watching Dragon’s Den I saw the product being demonstrated on one of the Dragons. Since we had bought a starter pack of the bandage it was great to see it, but now I realise that we have inadvertently gone into business with Deborah Meaden!

Beaminster has been a tiring place this week. Right now I am pretty exhausted - the weekend can’t come soon enough! For the last couple of weeks we have been short staffed after the sad news that a member of our staff’s parent had died. We are employers, but firstly we are human beings; we like to treat our colleagues as more than just employees, so offering a helping hand when they need it is at the core of our management ethos. It has been really satisfying to watch as our other staff members have risen to the challenge. Our colleague has been in all of our thoughts and we hope that she will be up to returning to work soon.

Meanwhile, we have been busy delivering our full complement of enhanced and advanced services: MURs, EHC, Smokestop, chlamydia screening and treatment. Chlamydia has been a particular focus for us in the past few weeks as we’ve been busy handing out test kits to young people and even offering treatment via PGD. The fantastic news from the screening service is that NHS Dorset is the top PCT in the South West for pharmacy based screening, which is a really positive boost to all pharmacy contractors in our area. The £10 fee per kit returned has definitely been a good incentive to put some effort in! But then, to put it all into perspective, along comes the recently announced discount clawback and all of the income generated from these services has been taken away.

After nearly a year in Beaminster, I am still encountering a few ‘firsts’. This week I was brave and threw myself into the exciting new world of advanced services when I completed my first MUR – Dorset style!

It was Monday morning, and I was bleary eyed and busy, when a patient came to the counter and asked if she could talk to me about her medicines. I thought it was a golden opportunity to do the MUR I keep putting off. I had spoken to the patient many times before about her medicines, and she was very clued up about what they were for and how to take them... or so I believed.

I steeled myself for the challenge ahead, reviewed the patient’s PMR and made some notes before we headed the consultation room. We began by talking about the MUR process, consent and information sharing, before building up to discussing the inhalers she believed were giving her some problems.

We spoke at length about inhaler technique and the timings of doses, before coming up with an action plan. The problem, I suspected, was paradoxical bronchospasm, which meant her inhalers could be causing the same problem which they were supposed to be solving. We discussed monitoring her breathing for any patterns in respiratory symptoms and summarised the action plan for her GP.

Brilliant, I thought, the first MUR under my belt and some potential benefit for the patient. Then I got a phone call a few days later telling me she had unilaterally decided to stop her inhalers and her breathing had improved! Arrrrgghhhh!

Beaminster Pharmacy has stepped onto the front line of the fight against swine flu as we are now a fully operational antiviral collection point. I had always been in favour of becoming a collection point, not because it is another source of income but because I felt the people of the town were being a little ignored by the powers that be.

One in six people in our town has no access to a car, according to the most up to date government statistics. A trek across the county to access another collection point was in my view discriminatory. Finally the call has come, and I am able to perform a useful function in a pandemic which for me has yielded more paper than patients.

On our first day as a live collection point we were asked by the local surgery to supply antivirals for a one-year-old child. The pharmacy was just about to close but I agreed to stay open. Fortunately the supply was a relatively straightforward process, which was a relief because mum was anxious and I felt that my time was best spent advising her about controlling her child’s temperature and other symptoms.

We are told that the Department of Health is planning for a peak of cases in October; we can only hope that we are now ready to deal with any influx of cases, but for the moment it is the calm before the storm.

One symptom I have noticed of being self-employed is paranoia. As soon as the shop goes quiet, dark thoughts start to creep into your mind: has everyone gone to a rival? Suddenly got better? Taken up homeopathy? It is quite scary – you start to mull over all of the reasons why people might not be coming in and buying things.

It has been a quiet week or two here and I have been thinking up all sorts of logical reasons for why. The truth is that there is no way to predict how busy you are going to be from one week to the next in pharmacy. One day you have a full complement of staff and are running around at full pelt for the whole day, the next you are catching up on the date checking and cleaning.

The quiet hiatus of a rainy August has been shattered by a very busy week. This is not a bad thing; I never complain about being busy, because in truth I am thankful for the work. There is no such thing as a safety net when you are self-employed, get swine flu and are staring at a £1,500 bill for emergency locum cover.

Services have exploded this week, with four new Smokestop patients in one day, including two I saw through my lunchtime! I’m really starting to feel the benefits of this service now, it is great to be able to offer it to our customers.

Apparently I am running a charity to supply medicines to the impoverished National Health Service. My wholesaler has just written to inform me that our discounts have been reduced to 2.5 per cent under the level of our clawback; in other words we will lose 2.5 per cent on every medicine we supply which is made by more than half a dozen manufacturers.

This is simply unsustainable under current market conditions. Manufacturers are passing higher costs onto their customers and yet the Department of Health still seems to think we are making ‘excessive’ profit. The truth is that now the supply of branded medicines has become a loss making activity, and while we may be told that higher purchase profits on generics more than balance this loss we have to remember that every pharmacy will be affected differently depending on its dispensing mix. Our basket of goods is heavy on branded goods, which although prescribed generically to tick the PCT’s boxes still require us to supply a loss incurring medicine.

It is a shame that the impact of independent contractors on drug prices is not properly recognised; because of the keen competition to get the best price we have driven down the cost of medicines to the NHS by huge sums of money. The introduction of parallel importing in the 1990s alone must have saved the taxpayer hundreds of millions of pounds because it has kept the prices that pharma can charge competitive with other European markets. Something has to be done.

While all hell was breaking loose in the pharmacy today, I was visited by a German doctor wanting to buy gentamicin ear drops.

“Bother,” I thought – or something similar in meaning but less printable. Remembering the EU changes to prescribing eligibility, I confirmed with the NPA that the gentleman did indeed have prescribing rights in this country. Then I phoned a German registration authority. I can remember a couple of words from my school German, literally – ‘krankenhaus’ and ‘zweibel’. Luckily, everybody at the registration authority seemed to speak English, which was good because hospitals and onions weren’t going to get me very far.

After speaking to every English speaker in the office, I eventually learn that there is no central register of doctors in Germany but that every state holds its own list. But in front of me I have a doctor number and the gentleman’s home address, so I am confident we have all the information we require.

The gentleman, Basil Fawlty in height and textbook German accent, was getting very impatient. “Vhat seemz to ve ze problem?” By now I am thinking this £2 bottle of gentamicin by rights should cost the customer £30 because of the time I have spent on the phone to another country and the chaos his impatience is causing in my shop.

“Does the gentleman have a doctor card with his picture on it?”, I am asked.

“I’ll just go and check.” As I go back to the counter, I watch in disbelief as Mrs German Doctor drags him out of the shop! All of that time and effort for nothing!

A few weeks back, just after we had closed on a Saturday afternoon, the phone rang. After playing a quick game of ‘Where have we left the cordless handset?’ I answered. It was a voice I vaguely recognised, but which was oddly out of context.

“Can I help?” I asked.

“Is that the pharmacy?” the caller replied.

“It is, we’re closed at the moment, but can I help you?” As our home phone number is the same as the shop we often get phone calls like this at the weekend, and usually if I can I will help.

“Is that Mr Hewitson?”

I hate being called by my surname, especially on the phone, because you know it is never going to be good news.

“You looked after my wife, back in Gloucester.”

My nerves raced, thinking that it was indeed going to be bad news.

“I just wanted to say thank you.”

Stunned silence.

Then the patient’s name popped into my head. I can only presume that the caller’s wife had just died, but for once I managed not to ask the obvious for fear of upsetting him. “It is very kind of you to ring,” I said.

“I just wanted to say thank you for the kindness and care you showed her,” the caller signed off, a little choked with emotion.

It isn’t often that our contribution gets noticed, and I am always very pleased when things have gone well enough for somebody to say thank you.

While at face value this can seem like a small gesture, it can mean a huge difference to us as people as well as professionals.

“Can I return this?” asked my customer, somewhere in her mid-80s, placing a paper bag on the counter. “What seems to be the problem?” I asked innocently, my hand reaching into the dark recesses of the bag. It was only when I had removed the item that I started to get nervous: a packet of Sylk vaginal moisturiser. I knew that once again I had engaged brain before mouth with potentially disastrous effect.

“I bought this last week – I thought it was sunscreen,” my customer replied. “I was just about to put it on my nose, then I realised what it was.” It was all I could do to stop bursting into laughter, but thankfully professionalism prevailed. My poor customer, bless her, just kept repeating: “I don’t do that any more.” Fortunately, a bottle of factor 50 later and I think she left happy!

The rest of my week seems to have been swallowed up by flu. For the last fortnight, in preparation for the autumn, I have been trying to write a pandemic contingency plan. The deeper I get into it the more things I realise need to be considered, which is a pain when your time is strictly limited. I’ve been trying to get both of our local practices in a room to see how we can help each other, which is no mean feat when you consider the dispensing practice element, but I remain hopeful that we can all work together.

Welcome to a very tropical Beaminster! It seems that, for once, the PCT’s heatwave health promotion campaign has not doomed us all to a cold, wet summer, and everyone is enjoying the warm weather. Our new restaurant, The Wild Garlic, of owner Masterchef Mat Follas fame, is also booming, with waiting lists for tables for the next six weeks – the launch last month seems to have got them off to a flying start.

We are also in the midst of Beaminster Festival, an annual arts and music festival that seems to be bringing in the tourists – local handmade soaps are flying out of the door. So at the moment life seems good – the baby even came second in the festival fancy dress competition in her homemade mermaid outfit!

However, the heat is making life a little unbearable in the dispensary – it took me nearly an hour to pluck up the courage to tackle the repeat prescriptions this afternoon, and even then it was only after an enforced ice-cream break! The plus side is that high temperatures seem to make people more impulsive in the shop, which is great for takings, though it won’t be so good if they all decide to go to the beach instead…

All this optimism almost has me convinced that next week’s launch of Eli Lilly’s selected wholesaler scheme will succeed in solving the Zyprexa stock shortage overnight – as their customer services team assure me it will. And if the heat keeps up like this I’m half expecting prescriptions for Cornettos!

This week I learnt two lessons in herding cats.

Firstly, a few of us independents got together to discuss a couple of issues and went for a curry afterwards. Doesn't sound like much of a feat when you write it on paper, but I know how busy these guys are; my intray is piled just as high with important pieces of paper the PCT wanted yesterday. So I was just pleased that someone made the effort and, who knows, maybe next time we might get a few others along. It was a very enjoyable evening in the company of people I like, respect and can empathise with. One of my colleagues had been in pharmacy in Dorset for 22 years, but this was one of only a handful of times that some of the independents had gotten together. One message that I think we all got was that being independent doesn't have to mean you are alone.

I'd urge independents everywhere to talk to each other, share ideas, commiserate and encourage their colleagues. It was interesting the very different viewpoint that we as a group had versus any other gathering of pharmacists I have ever been to: definitely a bit more commercial, but always with a view to the funnier side of life behind the counter!

And secondly one of our cats sparked a bit of excitement when he decided to 'go walkies'. Thankfully, a full scale search and rescue mission by my wife and, it seems, half the town, resulted in his safe return. People are still coming into the shop now asking if we've found the cat!

Excitement is starting to grip Beaminster over the opening of Masterchef champion Mat Follas’s restaurant, The Wild Garlic, on Saturday. Smugly, my wife and I are in possession of the hottest ticket in town, an invitation to the opening night. We are both looking forward to this a great deal, not least because it is our first night out since before baby Gracie was born. My enthusiasm is not tempered even though it means my day off will be spent trailing around Exeter while my wife chooses an outfit!

But the town’s bated breath anticipation is based on reasons more pragmatic than simply the celebrity and celebration. In these economically bleak times it has been a huge boost for our hard-pressed local shopkeepers that the opening of the restaurant may bring new people into the town.

Watching the comings and goings at the restaurant, the late nights and long weekends, I can appreciate just how much work Mat is putting into his business. If hard work and effort alone were enough to guarantee success he would already be off to a flying start. From my own experience at Beaminster Pharmacy I know it is impossible to run your own business without pouring much of yourself into it, heart and soul, which is why I was extremely saddened this week by the demise of one of our two butcher shops. The opening of two new Waitrose supermarkets in nearby towns meant his high end meat and game was no longer drawing in enough regular customers, and the recession did the rest. I can’t begin to imagine how he feels right now, and my heart goes out to him.

Please use your local shops – they are for life, not just for Christmas.

Success! At last, patients are starting to use some of the new services we have to offer. In the past week we have taken on our first Smokestop client, and have been able to provide speedy access to emergency contraception for the younger members of our community. What’s more – it felt good!

While I still believe it is dispensing that pays our bills, it is great to have services as a new source of income for our business, particularly when it looks like we’re about to take a hit on next month’s category M.

My Smokestop client came to me as a direct referral from one of our local GPs, which makes me feel more optimistic about the future of multidisciplinary team working in our town, and makes me want to succeed in helping the patient even more. Having gone through my training for this service back in February it is great to finally have someone I can help. In a few weeks time my quit rate will either be 100 per cent or it will be a big fat zero, but it won’t be for the want of trying.

The patient arrived five minutes before lunch, but there was no way I was going to give him any excuse not to quit – so we worked through it. Hopefully we will both be successful, which would be a massive boost to my confidence in the service and the excellent remuneration that is on offer in Dorset.

The only thing is, getting the patient to quit might be the easy part – you haven’t seen the paperwork!

Last week the French, this week a visitor of an even more special kind, and an  opportunity to tick off yet another life-long ambition.

A gentleman was wandering around the shop obviously looking for something. “Can I help?” I asked.

“Do you have razor blades?” the gentleman replied. I pointed in the vicinity of the blades.

“On holiday?” I enquired, because of the obvious American accent.

“Just visiting for the weekend.” After a few more minutes of conversation, it turned out he was staying with a regular customer.

This rang a bell in the back of my mind... then, bingo! “You must be the astronaut.” My customer was a scientist and a member of some of the early space shuttle missions, and had travelled from Washington DC to give a guest lecture on behalf of a Dorset hospice.

Truly a humbling experience to meet a man who has achieved so much, and yet was prepared to sacrifice his precious time to help people he has never met on the other side of the planet.

The words ‘bumbling’ and ‘idiot’ have scarcely gone together better in a sentence; I could hardly string a few coherent words together, but at least I have now achieved my boyhood dream of meeting an astronaut.

I suppose at the very least it highlights the added value of talking to your customers,

and not just from a clinical perspective. You never know when the ordinary looking person in front of you has an amazing story to tell – and, you never know, it could be

out of this world!

This week has been a testing time for international relations as our French twin town have been visiting, and the town’s traders were given about two days notice to put together window displays with a French theme. Apparently nobody thought a guillotine was appropriate, so my wife made a French flag instead.

On a busy, short-staffed, pre-Bank Holiday Saturday a customer came to the counter: “Parlez vous Francaise?” My mind went blank – five years of high school French down ‘le toilet’. Luckily, the patient had the one ailment that I could talk about: “mal a la gorge”. My heart leapt at the brilliantly simple sore throat and, after ten minutes of pigeon French and some hand gestures, we had arrived at a suitable combination of products for the customer’s daughter. He seemed pleased and demanded a photograph; at the time I thought he was just being polite, but with hindsight I am concerned it was some form of insurance policy in case my recommendation was wrong – some form of photographic clinical governance. Hopefully this will not catch on in the UK! I steeled myself for more bilingual consultations by hiding in the back of the dispensary for the rest of the morning, but fortunately I was not required.

On Sunday morning I made my usual croissant run to the patisserie, hoping to eat breakfast in the sun in our newly tidied garden. But I found to my horror our visitors had eaten the place clean! Not a crumb in sight.  Entente cordiale – I don’t think so!

After nearly six years in practice I was starting to think that I was fairly unflappable. I’ve dealt with all sorts of situations, kept my cool when others would have ‘lost it’, and calmed down furious patients, but something has really started to get to me. It isn’t very interesting, but it is an issue as serious as anything else facing pharmacists on the front lines – the availability of key medicines.

Why do I spend 3 hours a week chasing phantom supplies of Actonel, Adalat and Aprovel? I blame the French! Well, Europeans in general, if I’m honest. My customers often ask me why I can’t give them their life-saving anti-coagulant or their equally important blood pressure medication. “Its all to do with the value of the Euro,” I tell them. I feel dull even talking about this at the time, let alone writing about it now, but sooner or later a patient is going to come to serious harm because I and many other pharmacists just cannot get some drugs quickly enough. The stock quota systems imposed by Big Pharma are patently not working and could put patients lives at risk.

Having endured another week of ‘manufacture imposed supply quotas’, facing a bulging pile of owings I snapped. The unlucky victim - Wyeth, customer services. To their credit they dealt with a tired and sarcastic grouch admirably enough, but I’ve got to write a letter of complaint to Wyeth and six other companies to bemoan the quota system –  when I’ve got the time!

Until then, our French twin town is visiting, so I’m laying low for now, hoping not to spark a diplomatic incident.

When I was an employee, time off was so easy - just book a locum and take a week off. Now I'm self-employed and have to pay for the locum myself,  I’ve either got to really want a day off or I have to have a very good excuse!

The local surgeries run a carers support group to help both carers and carees, and they normally have a speaker come to their meetings to try to provide them with advice and support for what is a vital but under-recognised role. I volunteered myself to talk on the subject of 'medication' – keeping the title as vague as I could meant, in my head at least, little or no prep work. I also figured that it would be a good excuse to take the rest of the day off with my family.

My aim for the meeting was to try to establish what issues carers face with medicines, to signpost the various help that is available, such as our collection and delivery service, and to provide a point of contact with any medicines related questions. The group was about 25-strong, and seemed receptive to pharmacy, even though a large proportion were dispensing patients for the surgeries. The event was definitely worthwhile because it gave carers in the town a lot of opportunity to ask questions – and I was able to promote MURs and services, so I think we both benefited.

It was only afterwards that I discovered I’d spent the whole day dishing out this sound advice with baby vomit on my shirt…

The Case of the Exploding Sausage: it sounds like a storyline from farcical 1980s sitcom Allo, Allo, but I promise every word of this story is true.

It was the Saturday before Bank Holiday; we'd had a busy morning but there were still plenty of people around so I decided to keep the shop open for a bit longer. A lady came in and asked: “Do you keep acidophilous?”

“We’ve got three different types; do you know which one you want?"

"I'm not sure," the lady replied. A confused and slightly embarrassed look came over her. Red-faced, she added: "My husband wants to put it in a sausage.”

Not quite the answer I was expecting but, undeterred, I said that I didn't think it would matter too much as the acidophilous were all going to be fried alive as soon as the sausage was cooked. The lady then asked if she could buy saltpeter.

"Another sausage?"

“Salami," she replied. Whilst my chemistry might be rusty, my history is not – could my customer be attempting to make gunpowder? It’s the only use I know of for the said ingredient. Maybe an Al-Qaeda plot to use exploding sausages as a weapon of mass destruction? Not wanting to draw the attention of UN weapons inspectors to our little corner of Dorset, I politely said that I couldn't help with this request. This place gets stranger by the day…

Swine flu has arrived in Beaminster! Well, the panic has – sales of surgical masks and alcohol hand sanitiser have gone through the roof! Despite my best efforts to calm the panic, it seems that people do have genuine concerns about the safety of their nearest and dearest, and if it makes them feel safer is it so bad to profit from the situation?

At the other end of media hysteria, we’ve had possibly the most important OTC product launch of the last five years, Alli. While the advertising Armageddon that I was promised doesn’t seem to have materialised, I have managed to sell a few packs and have had meaningful conversations about weight loss with another couple of patients. Both of the successful consultations were interesting experiences as I never make the decision for the patient; I present the facts, answer questions and ensure that if the patient wants to try the medicine they can do so safely. “Not a miracle cure” is a phrase I have used every time, because I think it is important not to raise expectations too far.

Unfortunately for all of us, a 7st Daily Telegraph reporter conducted a highly scientific and representative sample of 10 pharmacies in south west London and was able to buy orlistat without too much bother. And another – from my personal nemesis, the Daily Mail – has produced a hatchet job on the product, and thinks that the OTC licence is just a way of circumventing pesky GPs who want to save patients from this highly dangerous drug!

This week I’ve had a run in with one of our addicts. Last week he had missed his normal weekend collection and had turned up a day later demanding his medication. But because of the way his prescription was written, and a little thing that I like to call ‘The Law,’ I couldn’t supply the remaining weekend doses. As I like to try to help people where I can, I phoned his doctor to explain the situation and to ask for a new prescription to cover the required supply. We even sent a member of staff around to the surgery to collect the prescription.

Today he came in to say that I “had made a mountain out of a molehill” and, as he proceeded to get increasingly irate, to be honest I felt that he might even get physical at one point. As I tried to explain the professional and legal implications of what he was asking, I began to feel as though the working relationship that I had built with him, and possibly my other addicts as well, was just wasted time. I ask myself: do they actually appreciate the service that they receive? To top it all off, as he paid for his prescriptions he said that because I had asked for this extra prescription I should be the one to pay for it, and refused to pay the charge (I’d let him owe me as he’d had no cash at the time!). Should I make an official complaint to his keyworker or try to salvage the relationship?

I’m going to let you in on a little secret, as long as you promise not to tell my wife….

It all started a couple of weeks back: I booked myself on to the local PCT’s minor ailments scheme training evening, but chose to go to a session on the other side of Dorset because my local session clashed with our wedding anniversary.

On the day of the course we had been particularly busy and I wasn’t sure I could be bothered to drive for an hour and sit through the training. It was made all the worse by the fact that both my wife and daughter were having a well-earned rest, of which I was extremely jealous. But I reminded myself that ‘The Man’ was soon going to be checking my CPD record and that this was going to be good for the business, and so begrudgingly I set off. After an hour of driving, I spent what seemed like an age in the seemingly impenetrable Wimborne oneway system trying to find the venue – and made it by the skin of my teeth, with two minutes to spare.

“Is this minor ailments?” I asked of a man clutching a BNF, feeling pretty confident that I had managed to locate the correct venue.

“No, this is anticoagulation.”

Then came the real sledgehammer: “Minor ailments was yesterday!”

As I had already had a mouthful of the buffet, I felt morally obliged to stay. Maybe I had read my diary incorrectly, or maybe CPPE has started a guerrilla CPD campaign… either way I still haven’t had the courage to tell my wife!

“Can I sign the petition?”

“Er, what petition is that, then?”

“To stop you being taken over by Boots!”

Although I am quite accident prone, I never thought I could unintentionally sell my pharmacy. But this was not the only conversation I had of this type over the space of a couple of days. After the first, I was confused; after the third I was worried.

Maybe I had sold my business without realising it? I checked the contents of the drinks cabinet: no sign of any serious deficits. I could vaguely recall the day, month and year, and knew who the Prime Minister was – so no sign of any major cognitive defects, either. Yet one of my employees even came in on her day off to see if she still had a job next week. If you, like me, are even more confused than normal I wouldn’t blame you, so let me start at the beginning…

As April loomed large we had been making a final push to ensure we had our 125 completed patient satisfaction surveys and, with only about 20 to go having given out nearly 300, I asked a regular if he had filled one out. “No,” he said, “what was that in aid of?”

“To make sure we’re doing our job properly,” I replied, “and also so that nobody else can try to open a pharmacy by saying we aren’t.” It was a fairly light-hearted, off the cuff remark, but all of a sudden people were very worried about the future of their highly valued local pharmacy.

Despite the unnecessary confusion, I have taken this interesting episode as a great endorsement of the job we’re doing.

This week’s waste medicine collection made for a bit of an eye-opener. The good people of Beaminster threw away about 100 litres of medicines in the previous eight-week period. As a taxpayer, and the person who put all of those prescriptions together, I’m crying - on the inside at least. We all moan that patients waste medicines because it’s all to easy to keep ticking a list than to upset the doctor, and maybe that’s something I can concentrate on when I get my MURs up and running next month. But what about spending a little bit of time trying to get the local pharmacist into the surgery to try and use our expertise to make the system less wasteful?

One idea I had was to use a patient group direction to allow us to supply a small amount of extra medicines to align the patient’s repeat prescriptions. This would save the surgery time, the patient time and confusion, and would make life much easier for us when we come to dispense the prescription next time. In addition, aligned prescriptions produce less waste so this would be a winner all round. Now all we have to do is convince the PCT…

Life changing events – passing your driving test, going to university, getting married, having children – don’t come along too often, so when they do you have to make sure you enjoy them. It is my great pleasure to be able to share with you the joyous news that my wife Sarah has successfully given birth to a little girl. Our daughter, Gracie, was born on Saturday, weighing in at a healthy 8lb 2oz. Mum and baby are both at home and doing well. As most new dads will admit, we could probably do a 30-minute presentation to a complete stranger on the tiniest details of our new offspring. Please allow me one word – “perfect”.

My other baby – the pharmacy – has been in the hands of locums all week. One locum, David, gave up his day off at short notice to allow me to be at the birth, a debt I can never repay. It seems that the whole town is sharing in our joy; we can’t walk down the street without someone stopping to ask if they can see the baby. One elderly lady even phoned to request a home visit – from Gracie. So at three days old Gracie has already done her first home delivery!

It feels like the whole town has been abuzz with rumours this week. Virtually everyone in Beaminster has been following the fortunes of local amateur chef Mat Follas in the MasterChef final, and the grapevine went into overdrive that he was going to be taking over the empty restaurant in the square. But, alas, not yet…And something else that hasn’t happened yet is the birth of the baby, now nearly two weeks overdue! It wouldn’t be so bad if I didn’t have to have the same conversation in the pharmacy about twenty times a day:

“Has your wife had the baby yet?”

“Not yet.”

“Well, what you want to try is….”

The end of that sentence has been varied and, without word of a lie, has suggested  everything from curry and castor oil to driving over freshly ploughed fields and laying carpets (I didn’t suggest that last one to my wife as I think I know what the answer would have been!). Thankfully, there’s not much longer to go now and at least I’ve got more of a plan about what to do when the baby eventually comes, thanks to the local knowledge of one of our regular locums, Stephen, who has been a huge help in arranging cover and contingency planning in case of a sudden labour.

I always knew that I wanted to work for myself – it would be fair to say that it was my dream, as sad as that might sound. But it goes without saying that buying a business is not something that you should enter into lightly, and it caused me no end of heart- and headaches. The process itself is very testing for a first time buyer, as it is extremely complicated and can be treacherous. Not having done it before, you don’t really know what to do or when to do it. But, fortunately, I made my most important decision early on in the process: I got good help.

Without my professional advisors - my accountant Umesh Modi (Modiplus) and my lawyer Hilary D’Cruz (Ansons LLP) – I am sure I would not be here in Beaminster Pharmacy today. When I think back to a year ago, I can’t believe how little I knew about buying a pharmacy, and I can’t even begin to count the number of stupid questions that these life (or at least business) savers had to answer. Both were responsible for rescuing our purchase on the (all-too-many) occasions when things got bumpy. I remember Hilary at one point absolutely terrifying the man from the bank, and I was so glad she was on my side!

So if you, too, are thinking about making the leap into the unknown of pharmacy ownership, the best advice I can give you from my experience is to pick the right team.

Last week I wrote about problems with the accuracy of one of our PPA payments; this week I decided to do something about it. All too often, us pharmacists tend to be far too reasonable about things which ought to make us angry. As a profession, it feels we lack fight, particularly when it comes to arguing with the Department of Health for more cash. Sometimes I think we should get doormats made with the word Pharmacy printed on them, and send them to the DH, PPA, Dispensing Doctors Association, and even the Society, because it feels like we get walked all over. One of my favourite quotes is from Gandhi, who said: “You have to be the change that you want to see in the world." In this case, I want to show that I am prepared to stand up for what I believe in.

So I’ve written a letter of complaint to the PPA about the problems - with their systems - which led to my payment being incorrectly processed. As daunting as it is taking on an organisation the size of the PPA, I feel that we have got to fight to get a better system, rather than simply moaning about it.

Back at the start of the month we received our first PPA payment. Because of the publicity surrounding PPA (Prescription Pricing Authority) errors in the recent past, and because it was my first full payment, I asked the PPA to manually check our prescriptions. And guess what? It was full of errors, although not the kind I’d hoped for! Following an extensive check of our batch it was found that we have been overpaid to the tune of 1 per cent of the total payment. “How could this be?” I asked incredulously. “Human error,” the PPA replied. “Operators are under a lot of pressure to meet targets for bonuses”. Needless to say, my jaw hit the floor.

We had been overpaid because the operator had put the wrong quantity of Xalatan and Xalacom into the system - twenty one times (equivalent to £250). Instead of felodipine, I had been paid for a combination product containing felodipine and ramipril (£87). In addition, I had been refused payment for measuring out methadone into separate containers for weekend supplies to help my patients. If my error rate was as high as the PPA, I can only imagine that my PCT would have shut me down long ago. And, more to the point, if I was overpaid this month, what’s to stop me being underpaid next month?

While the rest of the country was in the midst of the annual “Why does the country grind to a halt when it snows?” debate last week, we had a visitor. It was a visitor we have spent the last four months waiting and preparing for: the inspector. My last inspection was four years ago, and was an absolutely terrifying ordeal. This, I am pleased to announce, was nowhere near as painful. The focus of the inspection was on our handling of controlled drugs, which was the first area that I had tackled after I took over - you have to be so careful these days to make sure that you are complying with best practice.

Luckily, before I left the security of employment, my ex-employer Dudley Taylor Pharmacies had spent a lot of effort doing the same exercise, which I felt had prepared me well for this task – thanks, Elaine! Overall, the inspector seemed happy with our systems and felt that we were on the right track, which I was quite pleased with as it had taken a lot of hard work and effort to modernise our procedures. Our next inspection, whenever that may be, will almost certainly be by the new GPhC, though, so who knows what that will bring.

Another week, another first: I attended our Local Pharmaceutical Committee meeting, as an observer. I wasn’t really sure what to expect from the glamorous world of local pharmacy politics, but I must say I was pleasantly surprised. I suppose I must have had some pre-conceived ideas about the composition of the committee and the quality of the debate. On the contrary, there was a good balance of younger members and older members who brought a huge reserve of experience and common sense, and the debate was anything but than stale!

The core of the LPC’s work is to try and obtain the best deal for its contractors. In this climate, that means trying to make a case that pharmacy is worth the investment of time and money in an era when PCTs are short of both. Making this case cannot be easy, and pharmacists are our own worst enemies, particularly in justifying why we are the best means of delivering a service. On the other hand, it must be soul-destroying when you have a worthwhile service of proven value and its funding is cut, or you can’t even get it off the ground because medicines aren’t always seen as a priority by people who should know better.

Sometimes I feel like a circus performer, spinning a series of plates and trying to make sure I don’t drop one. These first few months have been such a hectic time of new experiences and hard work that I can’t believe how quickly the time has gone, which is why I try to keep Sundays as pharmacy-free as I can.

My little Sunday morning ritual is going to buy freshly-baked croissants from the patisserie, followed by proper coffee (rather than the usual half-cold instant that I expect most pharmacists, including myself, get during the working week) and the Sunday papers. Unfortunately, there is no-such thing as a lie-in for us as the church bells wake us up at 9am without fail. But in the afternoon there’s no shortage of country pubs and the seaside is just a few miles away, and I can’t imagine a better place to live.

So despite the huge amounts of work involved with the move and the business, my quality of life has definitely improved. I no longer spend an hour in the car each day (I’m unlucky if I have to use it twice in a week), and I don’t have the frustration of a working for an organisation and feeling undervalued or powerless. Although, there certainly are new frustrations to experience as a contractor…

This week I found myself in a little bit of hot water with the PCT, who had come to do our annual contract inspection. It would be fair to say that life has overtaken me since December, and paperwork has been the last thing on my mind. The day got off to a bad start when I realised I had forgotten to do my pre-visit handbook, and I think it went downhill from there! The PCT’s focus for this round of visits was on clinical governance, which meant a lot emphasis on procedure. Working through the checklist, it was obvious that I have still got a lot of work to do…

On a more positive note, the more I meet Julia, who is responsible for commissioning pharmacy services at the PCT, the more impressed I am by her level of insight into the pharmacy contract. With signposting and recording interventions in particular, she really does want the data to be recorded to help improve and inform patient care, rather than applying the tick-box approach that some PCTs seem to want. It is easy to be guilty of cynicism with this contract – it feels very burdensome and paperwork-heavy, and doesn’t always feel rewarding to deliver – but who knows what we can achieve with people like her on our side?

With only seven weeks to go, we’re starting to turn our attention to the impending arrival of baby Hewitson. Today we were visited by our midwife, Sally, to discuss our wishes for the birth. Already I had begun to think about how I am going to plan to be at the birth, with the obvious problem of trying to find locum cover at short notice uppermost in my mind.

Unfortunately, my cat apparently didn’t like the look of my locum list, and helpfully decided a few weeks back that he’d urinate on it! So my choice of locums has been somewhat limited since then. Thankfully, I’ve been able to reconstruct some of the list, and am going to get a few in over the next few weeks to introduce them to the pharmacy, just in case.

The midwife touched on the possibility of a home birth. We both immediately discounted this as an option, but I must say that I am starting to see the benefits, as it would mean that I would definitely be at the birth. Although I’m not sure if customers would appreciate the sounds of a baby being born upstairs…

You can’t turn on the news at the moment without gloomy predictions for 2009. And it’s easy to see why people are scared. As the owner of a small business, I’m scared! I can’t say that I’m overly impressed with my NHS payment this month. Our first full cheque should provide us with enough money to pay off our wholesale bills and remunerate us for the service we have provided. Fortunately, we cover our wholesale bill, but I have to laugh at the supposed fortune we have made in professional fees! It appears that I am subsidising the NHS, as they are taking back more discount than I have been given for the month!  Throw in a few prescription switches and we’re about even for month one.

It is possible that I made a few purchasing mistakes in my first month – there was so much going on that I didn’t really have the time to spend on buying correctly. And, as I learnt from my previous employer, despite all of the talk of service-driven remuneration it is still the purchase profit which pays the bills. Which makes me even more cross when I think about all of the services that pharmacies up and down the country are offering to PCTs free of charge. Happy New Year!

’T’is the season… to look back at the year and reflect on all the things that have changed. But, for me, that list is too long - so instead I’m going to look forward to 2009. If there was a pharmacy Father Christmas (Pharther Christmas?) this is what I’d like under the tree:

- enhanced services which benefit the people of Beaminster and which allow me to earn reasonable reward for the effort involved, rather than generic, one-size–fits-all solutions to problems which don’t affect my town

- no more direct-to-pharmacy distribution schemes. I don’t want to sound too political, but they are driving me nuts! Less discount, more work, less choice, more hassle...

- people making decisions which affect me to have actually worked in a pharmacy at some point in the last decade

- a visit from the DIY fairy to finish off the flat before the baby arrives

- a day off!

Joking aside, next year is going to be tough for a lot of people. It’s all too easy to forget how fortunate our industry is – even if it doesn’t feel like it at times.

Merry Christmas and best wishes for 2009.

Public relations was the aim of this week. I was invited to a town hall event designed to showcase all the different agencies and sources of help available to older people in our area. Everyone from the Benefits Agency to the local police had a stall. As the only pharmacy in a town where half of the population are over 50, I felt I had a duty to attend – besides the fact that one of my out-of-town rivals was also in attendance!

The event gave me the first opportunity to get out of the pharmacy to do something I felt was important. Being self-employed is great because I didn’t have to justify wanting to go to anyone – I just booked a locum and went! It was worth it. I was able to have a number of useful conversations about medicines – unlike the other pharmacy, whose only goal appeared to be pushing MDS and their collection and delivery service. I managed to say hello to a lot of patients and carers, and to network with other agencies that might be able to help us in the future, such as the occupational therapy rehab team. But most importantly, we got to be seen – not to be underestimated when trying to build your reputation in a small community.

This week, I met with my local PCT to discuss the commissioning of enhanced services. Until now, Beaminster Pharmacy has not offered any services beyond the core, essential services, which makes the introduction of new services seem more intimidating - but potentially more rewarding and more exciting. On paper, the list of services available seems very impressive: EHC, supervised consumption, smoking cessation, a palliative care stockholding scheme, minor ailments, needle exchange, and rota and advice to care homes.

I was relieved when I met Julia, the person responsible for commissioning pharmacy services. She was open minded and receptive to the idea of buying services from me. As a result of our conversation we will, subject to the necessary accreditations, be offering EHC, smokign cessation and supervised consumption.

However, I was interested in offering all of the available services, but the PCT is only commissioning some according to local need, which has left me a little frustrated. The problem with this type of commissioning is that it is OK as long as there are services which serve your population - but I’m not sure that my ageing population is going to get much use out of EHC. But that gives me an idea….

To see Mike's video diary, visit C+D's December 9 Digital Edition

This week has literally been rubbish! Having forgotten to put the bins out last week, I’ve been steadily building up a mountain of black bags in the garden. And to make matters worse I have been clearing out both of my stockrooms and have collected a series of weird and wonderful things from an old microfiche machine to a copy of the War Formulary.

Unfortunately, the more mundane rubbish had to go, so we built the Leaning Tower of Black Bags outside the shop on bin day, only for the bin men to refuse to take them. Grrr!

We took the bags to the local recycling centre, and were very relieved to see the back of them. That was… until the tip phoned us to come and collect our rubbish bags before we were fined because they were business waste. Grrrrrr!

Wanting to avoid a telling off at the tip, I managed to grab my bags while none of the attendants was looking. And at 7am this morning I found myself filling a skip with 30 bin bags and assorted junk.

Oooh, the glamorous world of small business!

Typically, sooner or later your luck has to run out. And, over the last 6 months, I have been fairly lucky - finding a business, negotiating and securing the necessary finance and closing the deal in choppy economic waters. So I probably shouldn’t have been surprised when I opened an envelope addressed to the “Pharmacist in Charge” of Beaminster Pharmacy. My heart sank as I saw the Society letterhead: Notification of Routine Inspection. In the words of Homer Simpson: “D’oh!”

Not that I think we are doing anything wrong, but it is simply unnerving to think that you have to go through an official inspection at this early stage. My predecessor tells me she hadn’t had an inspection in 6 years, and I get one in my first 6 weeks! I guess I’ll be sleeping even less over the next few weeks, until I have things to a satisfactory standard.

At least it will be a good opportunity to pick the inspector’s brains about what I should do about the cupboard full of ancient medicines I’ve found in the stockroom. I’m beginning to wonder if any of them will cure the headache they’ve caused

What a first couple of weeks it has been. The town’s grapevine seems to have signalled the change of ownership and lots of people keep coming up to me and introducing themselves, which is touching – if a bit unsettling when you’re in the veg shop!

Our first weekend was spent painting the inside of the shop, but only after a two hour odyssey to find a bank that was open on a Saturday to drop off our first week’s takings. Then, covered in paint, bedraggled and weary on Sunday evening, I decided to go to the local video shop.

Not having anything with my new address on, I threw myself at the mercy of the shop assistant, telling her that I was the new owner of the pharmacy two doors down. “Just the person,” she said, “my daughter has a prescription that I forgot to collect...”

And so, at 8pm on my first Sunday, I found myself providing my first prescription delivery to the video shop.  I guess you are never truly off duty in a small town, the realisation of which will make me think twice before I go out covered in paint again!

But, just when I thought things were going reasonably well, a letter arrived…

This week I met with both of my local GP surgeries, both of which are dispensing practices. The contrast could not have been more different.

The first practice was open and welcoming - each GP had set aside their lunchtime to meet with me to discuss our working relationship, and they had even gone as far as getting sandwiches made! They seemed receptive, although the white paper had understandably made them a little cautious.

The other practice wasn’t really very interested in meeting with me, but we’d made an appointment to go just after a meeting so we could catch them all in the same place. The practice manager was openly hostile to pharmacy, saying that “they’d keep all of the prescriptions if they could”.

This small statement was quite revealing as it showed me the scale of my challenge – some dispensing GPs consider it their absolute right to dispense for all of their patients and pharmacy is merely an annoyance. This has come as a shock to me as I am used to working closely with my local GPs – but I guess it’s is something I’m going to have to get used to in the cutthroat world of rural dispensing!

Change is big in 2008! In America it’s the latest buzzword, as both presidential candidates vie to outchange each other. And for my wife Sarah and I, change has been uppermost in our minds for much of the year, as we have embarked on the biggest gamble of our lives – to buy and run our own pharmacy.

We have been on a rollercoaster ride of emotions for the last six months, exhilarated and elated at times, stressed and depressed in equal measure. But in a few weeks time, all the months of planning and negotiating will come to an end and we will fulfil a dream.

Beaminster Pharmacy, a small, family-run business in a sleepy little market town in rural Dorset, has occupied almost every waking hour of my existence since I first visited it back in March. The pharmacy has been in the hands of the current owners for the last 30 years and has the support of its community, but at the moment offers only the essential services under the pharmacy contract.

Our challenge is stark: win the support of the staff and the community, including its two dispensing practices, and introduce a full raft of new advanced and enhanced services. As if this was going to be easy, 100 miles away from our current home in Cheltenham, we are also expecting our first child in February! Find out how we get on in this regular PostScript column.