‘Flu is just the start’
Kirit Patel, CEO of Day Lewis and vice-chair of PSNC
“This summer, I celebrated 40 years at the helm of Day Lewis. The occasion made me think about how much pharmacy has changed in that time. There have been challenges – both from outside pharmacy and within – but somehow we and so many others have tackled them all, and we’re continuing to run great businesses.
“At PSNC, there have been difficulties to navigate through. The challenges that came with the restructure of the health service were felt by everyone, and this was particularly frustrating as we tried to negotiate with newly forming organisations. But we are starting to see more than just hints of progress and the flu vaccination service is a huge achievement.
“Let's all play our part in making the flu vaccination a big success”
“It’s vital that we don’t leave our future success to chance. For the first time, we can offer a service on the same terms as other healthcare providers such as GPs, and we can show the very real impact we can have on vaccination numbers working within those terms. We must capitalise on this opportunity.
“The NHS is starting to sit up and take notice of what we can do, but one thing we must learn from the past is that we cannot sit back and wait for things to happen. At PSNC, we have been pushing constantly for developments such as the flu vaccination service. The success this time around reflects the hard work that has been put in both by us and contractors and by LPCs delivering the vaccination locally; this was not just good luck.
“We also need to have an eye to the future and that is why, next week, we at PSNC will be setting out a plan giving commissioners and others a very definite vision of what pharmacy can do. We hope the plan will set the stage for future service developments and give our work in this area a clear direction.
“Pharmacy cannot afford to stop and lose the momentum we have worked so hard to build up, so let’s all play our part in making the flu vaccination a big success and build on that for the future.”
‘The balance is finally tipping in favour of services’
Gary Warner, independent community pharmacy contractor, PSNC regional representative and chair of PSNC’s service development subcommittee
“It’s a topic I’ve been talking about for years: services to support our core supply function. I don’t need to regurgitate the arguments about how services can give us additional income streams, control over our futures, professional satisfaction and a real headstart as we work to cement our position in the reformed NHS. This is because the idea has now gone beyond just talk, and something interesting is really starting to happen, as a quick look at the statistics shows.
“At a national level, we know that the advanced services are continuing at a pace. As of March 2015, pharmacies had claimed for more than 2.3 million new medicine service (NMS) consultations since the introduction of the service in 2011, adding up to a quite impressive £57 million in income. MURs have proved even more popular, with very few pharmacies not offering them and well over 3 million delivered in the last financial year.
“From an analysis of PharmOutcomes data, we can also see the ever-increasing popularity of local services. We now have 182 commissioners using this system and, between them, they have 1,985 live services. Almost 9,000 pharmacies are accredited to offer those services and, in the past 12 months, they have been paid more than £22m to do so.
“Taking flu as an example, we know from LPCs that all but two NHS England regional teams commissioned pharmacy vaccination services last year. PharmOutcomes tells us that, in the 32 of those services that were managed using the system, 114,298 patients were seen in total and 16% of those had not previously received an NHS flu vaccination. The national figure for vaccinations given by pharmacy is more than double this and, although this is a small number when compared to the 10 million or so vaccinations offered by GPs last year, it does show us how far we have come. Ten years ago, we could hardly have dreamed that pharmacists would be offering vaccinations, let alone hitting record figures and helping the NHS to hit immunisation targets.
“I don't need to regurgitate the arguments about how services can give us additional income”
“As a contractor, this is all welcome news. Services can be incredibly difficult to add into working practices and contractors have been right to be sceptical in the past, but I would urge those still having doubts to have a closer look at the figures. My income from advanced services averaged almost £10,000 from each of my two pharmacies last year. For enhanced services, the figure was even higher. So, yes, there are costs associated with services – but we are really starting to push towards figures that justify spending money on some extra pharmacist or staff hours. For the first time, I have this year offered our pre-registration pharmacist a post now she is qualified, albeit in a fixed-term position as I explore what more we can do.
“As I said in C+D almost two years ago, we know that the government will continue to squeeze funding for our supply function, so the more we can do to support that and to offer better care for patients and value for the NHS the better. Flu vaccinations give us yet another opportunity to achieve this aim.
‘It’s something worth getting all fired up about’
Bharat Patel, independent community pharmacy contractor, PSNC regional representative and member of PSNC’s negotiating team
“In the current high-pressure and financially squeezed environment, it is not every day that health professionals up and down the country feel a shared sense of purpose, excitement and enthusiasm. But that is exactly what happened last month when we announced the national flu vaccination service for community pharmacies. We have heard from LPCs and national organisations alike that the news was followed by a real buzz and a feeling that something unusually important and positive had happened.
“And indeed it had. The service is a well‑deserved reward for all the hard work contractors have done in recent years training to deliver vaccinations and then persuading patients and local commissioners of the benefits. As ever, independent contractors have played their part in all of that, and this has really been a concerted effort.
“The service is a well deserved reward for all the hard work done in recent years”
“So what happens now? Well, first we celebrate; we have a new service with a new income stream, and this is no small achievement. But, perhaps more importantly, we also now have a real chance to show patients and the NHS what we can do. So I would ask all contractors to do what they do best and make this service a real success. We know our teams are ready for this – we have the successes of previous years to prove it – and I can’t wait to see us replicate this on a national level.”
‘Let’s show what we can do’
Garry Myers, independent contractor, PSNC regional representative and member of PSNC’s negotiating team
“If the headlines are to be believed, and I think they are, GPs are rapidly approaching breaking point. So you would think that a service designed to help them improve public health for local communities would be welcome news. Yet making the case for this service has been a long battle and it is clear we still have a way to go to convince some of our GP colleagues of its benefits. PSNC has produced a range of resources to help do this and I would encourage anyone encountering negativity to use those to try to win GPs over.
“GPs may be resistant to these ideas but the reality is that their workload is not manageable”
“But we should also remember that their support is not necessary for our success. With negotiations on the GP contract becoming increasingly hostile, the NHS is and will be looking to others for help. If we can show the positive impact we can make on vaccination rates, this will help us make the case for taking the reins on other things such as managing patients with hypertension or offering advice and consultations for minor conditions.
“Some GPs may be resistant to these ideas at first, but the reality is that their workload is not manageable and that pharmacy, if fairly and sustainably remunerated for it, can help. Let’s show just how much we can do.”