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Xrayser: Vision docs are everywhere – but can we see the wood for the trees?

It seems there’s always a new vision document for community pharmacy these days – but are we losing sight of what’s important, ponders Xrayser

Let’s talk about the vision for the future of community pharmacy – or, I should say, the numerous visions.

This year has brought us visions from Community Pharmacy England (CPE) via the Nuffield Trust and the King's Fund, the National Pharmacy Association (NPA), the Company Chemists’ Association (CCA) and a vision from The Royal Pharmaceutical Society (RPS).

The RPS’s document talks about pharmacy professional practice in England and the pharmacy profession as a whole – which feeds into pharmacists and pharmacy technicians working in community pharmacy, so it’s still another vision for us. All of the reports make great reading materials and have the right buzz words – albeit the same buzz words we see time and time again.

Read more: These are tough times for community pharmacy – so tell us your experiences

To have a vision is to think about or plan for the future using imagination or wisdom. I’d think that the vision we would have had for years, acquired through wisdom, is that we all need to work together to achieve one voice (in fact, did we not have one in the past, Rob Darracott?).

Although I am aware that everyone has their own challenges and opportunities, I think that if we want fair funding, we should all see each other as winners and come up with something simple for stakeholders like the Department of Health and Social Care (DH) and NHS England (NHSE) to buy into. Ultimately, we need the vison to be simple and achievable.

After The King's Fund and The Nuffield Trust vision, commissioned by CPE, was published, I heard and read many comments from people stating: “Well it’s nothing new, what’s changed?” Or: “It’s not very visionary.” But I think that sometimes, surely, the best ideas are the ones that are simple and straightforward. They are the ideas that seem achievable. A good vision may be pointing out the obvious, but that’s what we need. Community pharmacy is under a lot of pressure at the moment, and we need someone to say: “Stop, reflect and let’s get back to what we are here to do for our local communities.”

Read more: Pharmacy First negotiations ‘concluded’, CPE chief announces

The NPA has been bold and is looking at the next 10 years, which is brave considering that pharmacy is moving quicker each year and changing constantly. It’s asking for a lot from NHSE; some of which our negotiators have already asked and been turned down for and time again. Being ambitious is great but we need every sector to work together to achieve that ambition.

On the other hand, the CCA’s vision document uses the 2019 NHS long-term plan to consider how it can be implemented in community pharmacy, and what needs to happen to transform patient care in community pharmacy.

Read more: Overcoming challenges to achieve the Pharmacy First vision

As for the RPS’s vision for professional practice, many individuals and organisations contributed to it – even The King’s Fund was involved in writing the document. It’s had a busy year!

I believe that a successful vision for our future needs to engage stakeholders and the people who will deliver its objectives on the frontline. My question is, have most community pharmacy teams actually read any of these documents? Or are they too busy firefighting the increasing workload, looking after patients who can’t get appointments elsewhere in the NHS, or trying to source stock, given we are currently facing stock shortages like never before, on top of dealing with a dwindling workforce?

How many community pharmacy owners are hoping for things to return to how they used to be back in the good old days? Those days, my friend, have long gone.

I know that the document drafters care, because they all talk about it when they get together. But being in the thick of it, it’s hard to see the wood for the trees. Mind you, it’s a good thing the visions were all electronic documents and not printed as that would have used up lots of trees.

Read more: ‘Not unnoticed’: Sunak issues letter of support to community pharmacy

Stakeholders will glance at the vison documents, but do we have good, strong local representation like local pharmaceutical committees (LPCs) to negotiate funding and ensure that we can do what is being asked from us? Do integrated care boards (ICBs) even have funding, because a lot of them seem to be planning for a deficit?

Nationally, as we come to the end of 2023, we are all waiting for CPE to negotiate a deal that will allow community pharmacy to be the best that it can be and to deliver above and beyond the visions. Even when CPE does secure good funding – such as £645 million earmarked for clinical services – the delay in implementation is frustrating for those on the ground.

With all of these organisations representing and fighting for the best for community pharmacy, we must also be mindful that 2024 brings with it a general election that could be a game changer…or not.

I guess we’ll just have to wait and see, if you’ll excuse the pun.

The identity of Xrayser remains a mystery, but their irreverent views are known by all. You can Tweet them @Xrayserpharmacy

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