It’s not every month (indeed we’ve had some barren ones) we get a new pharmacy contract, but April showers became a downpour as CPE finally reached a deal with ministers. We were spoilt.
They say in politics that the devil is in the detail, but I have to be fair and say closer scrutiny of the new pharmacy deal hasn’t yet produced any pharmacy nasties.
Unlike the UK-EU ‘re-set’ announced this week there was detail within and, as I said last month, I do think passing the £3bn figure for funding the Community Pharmacy Contractual Framework in 2025/26 is an achievement.
Whether any of the recent discussions between Keir Starmer’s government and the EU touched on the crippling issue of medicine shortages and the broken supply chain is unclear.
Either way, I’d like to think it’s on the agenda for re-set 2.0 which will surely follow, as the government’s pursues its manifesto aim to ‘seek to deepen ties with our European friends’.
Read more: Pharmacies to ‘play key role’ in NHS 10-year plan, says Starmer
Truth is, there’s a bit of a vacuum in health policy at this time while everyone awaits the Spending Review on June 11 and the Ten Year Plan expected thereafter.
I understand an early draft of the plan was shown to ministers recently and it didn’t exactly receive a thumbs up emoji.
At the same time we have the deckchairs being moved at DHSC as Tom Kibasi (aka Darzi’s pen) gives way to Chris Thomas in pursuit of a plan that will receive a warmer welcome.
Having worked on the Long Term Plan (2019) I know it’s not an easy job.
Ministerial grand ambitions get chipped away at by Treasury, advisors and officials, leaving a finished article that can underwhelm.
My hunch is all those waiting for Godot may need to moderate their expectations.
The plan will be themed around the three shifts, focus on delivering 18-weeks and attempt to draw together the blizzard of health announcements we’ve had since the election into a narrative that works.
There will be plenty of nods to the future – it is after all the start of a ‘ten year health mission’ – and I do expect some extra NHS cash from the chancellor in the CSR.
How much more will determine whether the Ten Year Plan is transformative or a merely a narrative.
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All that said, taken at their word, Wes Streeting’s three shifts alone should spell good news and sunnier uplands for community pharmacy.
I will be watching this watershed moment in health policy to see if a ‘sustainable contract and operational model’ for community pharmacies is taken as read because it is hard to accept the government really believes the network is sustainable as it stands.
Surely it’s much more credible, whatever they may say alongside CPE at a press conference, that the policy ambition continues to be a smaller network altogether?
There is no question in my mind that was the aim of some at NHSE, although never said to me in terms, as far back as 2017 when I was the minister.
Have ministers, taking back control as they have, slayed that dragon? We shall see.
Read more: Political Pills: Abolishing NHSE leaves pharmacy many more questions than answers
What else? I will look behind the Ten Year Plan fanfare and hyperbole for a clear set of policies that support the health of the nation, not just the NHS.
‘Sickness to prevention’ relies on such, given around 80% of the factors that impact our health are beyond the NHS’s control.
Crucially (see my previous point on sustainability) will we get a clear commitment – in pounds and pence not words - to move NHS funding to primary, community and other settings outside of hospitals?
Community pharmacy needs that one to be a honking yes, or shrinkage is all our problem.
Thirdly, look for genuine funding and actions to achieve new models of care – or put another more fashionable way, ‘neighbourhood health’ - which empowers the users in a personalised and holistic way.
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And finally, ministers will want to realise their manifesto commitment to transform the Pharmacy First model I pioneered in government into a ‘Community Pharmacy Prescribing Service’.
If this is left out of the Ten Year Plan it will to my mind be a big missed opportunity. Watch that one carefully.
As someone said recently, everything is politics.
None of this just happens because a minister put it in a speech, a parliamentary debate or even a manifesto.
Only CPE know whether they are pushing ministers on all this and, crucially, have the political edge and experience to get anywhere near it.
Steve Brine is a consultant, podcaster, trustee, former MP for Winchester and chair of the Health Select Committee