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Imagine: An interview with Simon Stevens

In the absence of an opportunity to talk to England's NHS chief executive, C+D uses its imagination

C+D first contacted NHS England to set up an interview with its chief executive Simon Stevens last November, seven months after he took up the post. We were expecting him to have a busy schedule, so we weren’t altogether surprised when the NHS England press office said his diary was “fully booked” until the end of the year.

But persistence is usually the key so, in February this year, C+D popped the question again. We were told an interview would not be possible for a few months, but he was “likely to be able to accommodate this around June”.

June came and went. We heard nothing.

In September, C+D pushed for what we hoped would be the final time. The response was even less promising than before. NHS England will not be able to arrange any interview with its higher-ups until at least January, the press office told us, and even then it’s unlikely Mr Stevens will be available. He’s a busy man, you see (if you leave aside the fact that he found time for a full, sit-down interview with GP Online in March, of course).

So, in the absence of a face-to-face opportunity, we’ve gone into an imaginary world – one in which Mr Stevens is prepared to talk to community pharmacy – to ask him the questions pharmacists want answered.

C+D: Mr Stevens, thanks very much for joining us. First off, there was zero mention of community pharmacy at NHS England's annual general meeting earlier this month. Why is that?

Simon Stevens: Community what now? Oh, pharmacy, I see. Pharmacy, pharmacy, pharmacy. Well, no healthcare provider is going to be exempt from efficiencies. So if you’re asking whether we’re looking to make savings in the pharmacy sector then, yes, of course we are. But if you’re asking if pharmacists should be worried, then no, they shouldn’t – we’re on their side. They’re an underutilised profession, and I’m desperate to look at ways that we could possibly use them better.

I’m pretty sure I’ve dropped at least £12 down the back of the sofa at the NHS England offices during the last year, and that’s the going rate for a locum nowadays, right?


You recently said at the King’s Fund summit that you’d fund 50% more practice pharmacists in GP surgeries. How much more money will there be to support that?

Blimey, I said that? I guess it must be true then. I haven’t really thought about the money, to be honest. Let’s come up with great ideas first, and then think about how to fund them later. What I like about pharmacists is they’re – how do I put this – efficient. I’m pretty sure I’ve dropped at least £12 down the back of the sofa at the NHS England offices during the last year, and that’s the going rate for a locum nowadays, right?

Why have you decided to expand the project?

I know that we’re keen to invest in general practice as much as possible, given that they’re none too happy about the prospect of seven-day working. I also know that we’re keen to prove to pharmacists that we know they exist. So then the solution came to us: instead of spending money directly on pharmacy, why not spend money on pharmacists working in general practice? Let’s get as many of them into primary care as possible.

Do you not consider pharmacy part of primary care already?

*Mr Stevens whispers to press officer*

Pharmacists are an essential part of primary care and absolutely central to NHS England’s strategy over the next five years. But pharmacy still has to prove its worth. I’d like to see evidence that the profession is actually making a difference before we go pumping our precious resources into it.

Will you commission a national minor ailments service in the next funding settlement?

I am absolutely, categorically, 110% convinced that pharmacy has some role to play in helping patients to manage minor ailments. Does that involve a national minor ailments scheme? I wouldn’t know. I’m not part of the negotiations, and even if I were, I wouldn’t tell you. There’s a good reason why they’re kept away from the public eye.

NHS England wants to encourage collaboration between GPs and pharmacists. But there has been some tension over the national flu service. Is NHS England planning to release any guidance on working collaboratively?

Now this is a tricky one. We know that the two professions are having a bit of a spat at the moment, which obviously isn’t ideal. But it’s not up to NHS England centrally to do anything about it. It’s one for the GPs and pharmacists to sort out among themselves. If they want to make an official complaint, there are plenty of achingly slow ways they can do that through our regional teams, and potentially get some action taken a year down the line. But when it comes down to it, the professions just need to be nice to each other. Can’t we all just get along?


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