Howard Duff: Let's end the supply vs services debate
Pharmacy can't continue to rely on dispensing volume for income, says the RPS's Howard Duff
It is the question that has been plaguing pharmacy for years: are we right to base our funding on the supply of medicines? Those in the ‘yes’ camp point out that, historically, this function has served pharmacy well. Those in the ‘no’ camp argue that we cannot rest on our laurels because the world is changing.
News that the RPS English Pharmacy Board is working with the National Association of Primary Care (NAPC) to consider how community pharmacy and general practice can work better together has once again highlighted this question. We would like to test the appetite for aligning the community pharmacy and GP contracts. But it is debatable whether we can consider any alignment if we continue to focus on supply.
The public now expect ‘supply’ to be easy for them – anonymous, direct and available at the click of a button. Unless we can build upon the value that pharmacists can provide to the function of supplying medicines, this will all too easily be lost to organisations and methods that can cut costs and provide convenience. I often hear about the ‘Amazon model’ that has wiped out the bookshops that I used to love browsing. I don’t think Amazon could do what community pharmacy does for a minute, but sooner or later an innovator will enter the market that can.
I honestly think that we are making things easy for this mythical future innovator. We are commoditising the supply function that we undertake as pharmacists. Up and down the country, pharmacy businesses have put together clever spreadsheets and models that show how much income is derived from those pieces of green paper and how many minutes of pharmacist, technician and counter assistant time they require to process. I have used them myself, so I know how vital these models are in planning adequate workforce cover.
But there is a real danger that the dispensing process becomes more and more like changing a tyre in a pit stop and less like professional care for patients. The more our role feels like Ocado or DHL, the lower the barrier is to market entry. The more that we ensure we are contributing to better patient care and that patients value what we do, the more we will raise that barrier. For community pharmacy, raising the barrier is what we should all be focused on.
I am passionate about community pharmacy, having worked in the field for most of my career. For me, the best way to ensure that patients want to continue to use our services is to provide them with improved health outcomes through application of our professional expertise in their treatment. In this vein, I firmly believe that pharmacists need to take over some day-to-day treatments and health checks for patients, such as monitoring and treating people with long-term health conditions, alongside handing over medicines.
Only by ensuring community pharmacy is fully integrated within multi-agency provision of primary care can we ensure a robust future for the profession and better care for patients.
How do you think we should secure the future of community pharmacy? Respond to our consultation to give us your views.
You can take part in our consultation through the RPS website. Read the ‘Improving patient care through better general practice and community pharmacy integration’ consultation document and respond with your comments using the consultation form.
Howard Duff is director for England at the Royal Pharmaceutical Society