One of the inescapable truths I took into the job of pharmacy minister was that community pharmacy was always the easiest part of the NHS to praise - and one of the hardest to change.
The argument was never whether pharmacists could do more, it was about turning consensus into whole government action.
As a minister, you can have the best ideas. You can have an enthusiastic civil service and even the unwavering support of your secretary of state (as I was fortunate to enjoy from both Jeremy Hunt and Matt Hancock) but unless Number 10 gets behind them and makes it a genuine government priority, progress can be painfully slow.
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That is why the Prime Minister’s recent call for “growth in every postcode” struck a chord with me. Health policy rarely borrows the language of economic policy, but perhaps it should.
If we believe in opportunity in every postcode, we should also believe in access to NHS care in every community.
Community pharmacy is of course the closest thing the NHS has to a clinical service in every neighbourhood. We should be strengthening that network, not quietly allowing it to shrink.
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Against that backdrop, as I wrote last month in this column, this year’s Community Pharmacy Contractual Framework is undoubtedly a step in the right direction.
Compared with much of the rest of primary care, community pharmacy has secured a better settlement than many expected. Ministers deserve credit for recognising that the sector simply could not continue absorbing ever-rising costs without consequence.
Equally important is how the settlement was reached. In stark contrast to so many other parts of today’s NHS, this was an agreed negotiation, not an imposed settlement. That matters.
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Constructive negotiation is almost always preferable to confrontation because it creates stability and lays the foundations for future reform.
But honesty demands we recognise what this agreement is – and what it isn’t.
It does not repair the funding gap that has opened up over many years. At best, it broadly keeps pace with increased activity and inflation. That is welcome, but it is not recovery. I fear it also means pharmacy closures are unlikely to disappear. Slowing decline is not the same thing as securing the future.
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Perhaps, though, we should now be asking a bigger question? The government’s 10-year health plan is now a year old but it needs new energy if it’s not, like many Department of Health strategies before it, to become another worthy document slowly fading in the summer sunshine beating down on Victoria Street.
If ministers are serious about shifting care from hospital to community, as the Plan argues, then community pharmacy must move from the margins to the mainstream and the new PM in-waiting sounds as if he’s firmly on-board.
When we established Primary Care Networks, the ambition was never simply to create larger GP organisations. It was to build genuine neighbourhood health teams.
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As Integrated Care Boards take on greater responsibility for shaping local services, they now have an opportunity to realise that ambition by embracing community pharmacy as a full clinical partner, not simply a tolerated dispenser of medicines.
Now more than ever, it seems the next chapter of NHS reform will not be written in Whitehall. It will be written in neighbourhoods by ever more empowered local leaders.
If we truly believe in care closer to home, then we should start with the NHS’s most local clinical service. Community pharmacy isn’t just part of the future of the NHS, it may be the quickest way of delivering it and put an even bigger smile on the face of the new Prime Minister at the same time.
Steve Brine is a consultant, podcaster, trustee, former MP for Winchester & chair of the Health Select Committee