From locum rates to Lloyds closures: 7 answers pharmacy needs in 2018
C+D’s editor looks back at key developments from this year, and asks what we can expect from the next 12 months
2017 has been an unprecedented year for community pharmacy – from the implementation of huge cuts to funding in England, to the final stages of the decriminalisation of dispensing errors, and the revelations of detailed proposals to reshape how pharmacies are supervised.
But for every article in which C+D has attempted to shed light on what’s really happening across the sector, there are still questions left unanswered. Below are my pick of the biggest issues that will need to be resolved next year.
1. Will pharmacies in England receive further cuts?
Pharmacy owners in England have now weathered their first year of brutal funding cuts – exacerbated by generics price hikes and a 12-month category M clawback. At C+D, we receive heart-rending stories on an almost daily basis of how owners are struggling to keep their heads above water (you can read a selection here).
For those pharmacies who have made it this far, the question is: what next? The Pharmaceutical Services Negotiating Committee (PSNC) is yet to begin negotiations for 2018, and everything rides on whether funding will return to an acceptable level. With PSNC’s next CEO – antifraud chief Simon Dukes – set to replace Sue Sharpe in May, all eyes will be on the negotiator to see what it can secure from its talks with the Department of Health (DH).
2. What will happen at the High Court appeal?
One of the most dramatic events of 2017 was the three-day High Court case against the funding cuts, brought by the National Pharmacy Association (NPA) and PSNC (catch up on all of C+D’s coverage of the hearing, and the aftermath, here).
While the case was ultimately unsuccessful, the judge not only admitted “regret” over the decision, but criticised how the government had calculated the funding cuts. He even left the gate open for an appeal, an opportunity seized by both PSNC and the NPA. No date has been officially announced, so it will be interesting to see whether a reignited #CutsInCourt debate will coincide with the next round of funding negotiations.
3. What can we expect from Steve Brine?
The MP for Winchester and Chandler's Ford – appointed as pharmacy minister after the shock unseating of David Mowat in June’s general election – has pledged to C+D that he “intends to work with PSNC to produce a fair, realistic and sustainable funding settlement for 2018-19 and beyond”.
But can we take him at his word? The minister was happy to throw contractors the modest financial lifeline of increased advance payments for November and December, but then seemed relatively ambivalent about the impact of almost 200 Lloydspharmacy closures (see my next point) – despite it being a direct product of the government’s funding strategy.
Mr Brine: If you’re reading this, pharmacists across England are relying on you. Please don’t let the sector down.
4. Which branches will Lloydspharmacy close?
As mentioned above, Lloydspharmacy announced in October that it will “cease trading” in 190 “commercially unviable” locations. Parent company Celesio UK’s managing director, Cormac Tobin – who resigned unexpectedly a week later – said the decision to cease trading was a response to “changes to government policy on reimbursement and retrospective clawbacks over the past two years”.
While Lloydspharmacy has not disclosed all 190 of the sites it has selected, C+D has spent the last two months painstakingly piecing together their locations. Concerningly, out of the 19 sites we have so far confirmed, more than half will be permanently closed – rather than put up for sale to a competitor (see C+D’s map). Only time will tell whether this ratio will be reflected over the remaining 171 unidentified branches. If so, the potential impact on patients could be huge.
5. Will dispensing errors finally be decriminalised?
The path to the decriminalisation of inadvertent dispensing errors has been a long and winding one. In January, I wrote to Ken Jarrold – chief of the board overseeing the legal defence from dispensing errors – to request a realistic deadline for when this would become law. Mr Jarrold responded that the legislation has been “much delayed by factors outside [the board’s] control”.
At the time, it seemed there was little cause for optimism, and yet we are ending 2017 with draft legislation passed by both Houses of Parliament, and the government predicting the law will be passed in the new year.
It can’t come soon enough – the four-month suspended prison sentence handed down to Northern Irish pharmacist Martin White in the final weeks of 2016 was a reminder of the incredibly serious repercussions an inadvertent error can have not only on patients, but on a pharmacist’s career.
6. Will the DH push ahead with its supervision proposals?
In September, C+D broke a story that is still sending shockwaves around the sector – a working group established by the UK’s four chief pharmaceutical officers has been drafting proposals to amend the law to allow pharmacy technicians to oversee the sale and supply of pharmacy (P) and prescription-only medicines. The ensuing debate was not only confined to C+D – where the original story received over 100 comments – but was picked up by the Pharmacists’ Defence Association, and even drew criticism from pharmacists outside the UK.
Wherever you sit on the pharmacy supervision debate, one question we all want an answer to is whether the plans will be taken further. Despite the confidential documents only coming to light when they were leaked to C+D, the DH has insisted it will hold a public consultation "before it settles on a firm set of proposals". With so much of the process up to this point shrouded in secrecy, will the government really take the views of grassroots pharmacists into account before it makes such as seismic change?
7. Is the tide turning for locum rates?
C+D’s Salary Survey revealed last week that the decline in the average locum rate across the UK has levelled off, after dropping for the past decade. The average UK rate may have risen by just 34p-per-hour since 2015, but when you remember that rates fell consistently for the previous 10 years, it looks like something is changing.
In 2018, we’ll wait to see – in the words of C+D clinical editor and locum pharmacist Kristoffer Stewart – whether this is “the start of a locum rate revolution, or simply an anomaly”.
Share your stories
Whatever the next year brings, we at C+D will be here to inform, champion and support pharmacists and pharmacy staff. To help us continue to share your inspirational stories – more important than ever in these testing times – make sure to get involved in our #PharmacyShowTell campaign, and enter the C+D Awards (entries close on February 16).
On behalf of everyone at C+D, thank you for your support over the past 12 months, and we hope you have a Merry Christmas and a Happy New Year.
James Waldron is editor of C+D. Email him at [email protected] or contact him on Twitter at @CandDJamesW