Just 1,000 pharmacies could survive cuts, APPG hears

Left to right: Keith Vaz MP, Mark Burdon, Olivier Picard, Sir Kevin Barron
Left to right: Keith Vaz MP, Mark Burdon, Olivier Picard, Sir Kevin Barron

England could be left with just 1,000 pharmacies as a result of government cuts to the sector's funding, the all-party pharmacy group (APPG) heard this week.

“It’s terrifying how bad the situation could be," Mark Burdon, owner of The Burdon Pharmacy Group and a Pharmaceutical Services Negotiating Committee (PSNC) representative, told politicians on Monday (March 13). 

"We could quite easily end up with 1,000 pharmacies in the country; all posting prescriptions to patients through Royal Mail in the 'Amazonised' model, completely ignoring pharmacy's role beyond dispensing," he warned.

Mr Burdon was responding to a question from APPG chair Sir Kevin Barron about the impact of government reforms to pharmacy, during an APPG evidence session.

The PSNC representative claimed that "a lot of untruthful reporting within the government” means the "real ramifications" of the funding cuts "are not apparent to most people".

"[It could] mean the loss of huge numbers [of pharmacies], not just the 1,000-3,000 [Alistair Burt] spoke about, but a hell of a lot more than that," he stressed.

The Pharmacy Access Scheme (PhAS) is “only a politically expedient tool used by the government to make it seem like they're not cutting every single pharmacy – to appease patients," Mr Burdon continued.

"In 12 months’ time [the PhAS] won’t exist," he pointed out.

"The market will eat you up"

Labour MP for Leicester East Keith Vaz (pictured above, right) acknowledged the benefit of face-to-face interactions in the pharmacy.

“My mum thought her pharmacist was a god. That’s the kind of personalised service which GPs – even to some extent which MPs – can't give," he said.

However, Mr Vaz admitted that when the government's plans were announced, it was "pointed out" that there were 12 pharmacies on one road in Leicester.

"The market will take care of it," he said. "It will eat you up if you are not able to survive."

Mr Vaz asked whether contractors now feel a “responsibility” to discuss locally whether their businesses are viable, as a result of government concerns about pharmacy "clusters".

Mr Burdon argued that the current regulatory system around pharmacy mergers "has driven this glut of pharmacies, preventing [them] from merging where they should do so”.

"For years we've asked to be allowed to merge pharmacies where there's two nearby. Until the end of 2016, if you closed one of the pharmacies, it would have created a need for a new one," he said.

PSNC chief executive Sue Sharpe said last November that changes to regulations around mergers – which came into force in December – could help contractors “survive” in future.

Read C+D's live reporting to see what else was discussed: 
23 Comments
Question: 
How has the drop in funding affected your pharmacy?

Farm Assistant, Community pharmacist

Should have sold Keith Vaz a line! Listen everybody, pharmacy hit the iceberg a long time ago and just like in "Titanic" we are all hanging on to the last floating piece looking down into that cold dark water. It's just a question of time. And remember it was the captain who would not listen that caused the disaster not the iceberg.

Shaun Steren, Pharmaceutical Adviser

Don't you just love it when politicians show off by throwing about the term 'the market' as if it in some way shows them to be hard-nosed pragmatists.  I think he is talking about a 'free market', community pharmacy certainly isn't that. The government have created a monster in community pharmacy. It is a system that has few of the strengths of a 'free market' but most of its weaknesses and most of the disadvantages of a state run bureaucracy but few of the advantages. A hybrid that takes the worst of both worlds and the best of neither. 

Of course it requires the incompetence of the British ruling class to create such a farcical situation, but what is the responsibility of pharmacists in all this? Well, this can be traced back to the new contract just over ten years ago and the support it garnered amongst the 'clinical visionaries' within the profession. These imbecilic morons were unable to see a blatant 'fast shuffle' in which you got paid less for doing the same things but in a more bureaucratic way. This bureaucracy justified under the guise of a move to a new 'clinical future'. 

Consequently, some might argue that Whitehall have played a clever hand over the last decade, but I would disagree. If you are playing against a profession in which the smartest people in that profession are silenced and the least intelligent dominate loudly, you have merely scammed a collection of fools. Indeed, those fools still speak loudly today, often on this website. So how did that 'clinical utopia' turn out so badly? Well, I have a simple suggestion - much of this 'profession' is made up of people who were just not clever enough to get into medicine and dentistry. These people dilute/suppress the ideas and voices of the genuinely clever people within community pharmacy (and there are many of those). We carry an intellectual/educational underclass that doctors and dentists simply do not. 

With the proliferation of academically questionable pharmacy schools, it is a burden we will continue to carry. So what if only a 1000 pharmacies remain? Well, the clever and creative pharmacists will move on and have their talents truly appreciated elsewhere, it is the others who need to worry. 

Paul Dishman, Community pharmacist

The biggest problem with the mid-noughties contract was the paperwork shufflers that the various PCTs employed to administer it. The ones I had dealings with appeared to be unable to understand the responsibilties and standards that pharmacists had when running their own pharmacies. As a consequence of this, there were various attempts to micromanage pharmacy practice and create paperwork to justify their own existence. A prime example of this was an attempt for the PCT to create and maintain a register at the PCT of a named person responsible in each pharmacy for monitoring dispensary fridge temperatures. I refused point blank to co-operate with that and never heard about it again.

Valentine Trodd, Community pharmacist

Very acutely perceived Shaun. I have observed this in the independent group I work for. There is no reward for any independent thinking - those that 'prosper' (very loose definition) are the ones that keep their heads down, their MUR and NMS numbers up and do what they are told. Your opinion is never canvassed and you are treated like a mug. Now is the time to get out - it's only going to get worse!

Shaun Steren, Pharmaceutical Adviser

Maybe some people are just keeping their heads down and hold private antipathy, but my experience tells me that many community pharmacists rather like the culture of practice within community pharmacy. 

For a start many see community pharmacy as a source of convenient part-time work. They have no deep intellectual interest in the practice of pharmacy, it is just a way to supplement their partners wage and so maintain a middle-class lifestyle whilst they bring up their children.

Many community pharmacists actually enjoy the rules, regulations and bureaucracy. They prefer top-down decision making. They don't want to expend the mental energy required to question central orders, to scrutinise data, to experiment with new ideas, to construct tightly reasoned arguments, to constantly challenge their own conformational bias. They are petty rule followers by preference. These are all signs of an intellectually and educationally deficient profession. 

Community pharmacy has not innovated for decades. For sure, the government, RPSGB and corporate owners have played a large role in this. But there is another side to this story which involves pharmacists themselves. For whatever reason the 'profession' has attracted petty minded rule followers. They would be the students who always elected to avoid mathematics and physical science, prefering derivative coursework to broad private study and original thought. They are the people who always judge on intentions rather than outcomes. They are people who obsess over what is rule compliant rather than what is optimal. They are the people which truly innovative industries would reject out of hand.

The chaos that you find in most dispensaries, the mismanagement of pharmacy staff and the pseudo-clinical activity that is so ubiquitous are all indicative of a profession that does not attract people who wish to develop intelligent solutions to what are quite simple problems. Quite frankly, this is not what brought them to this profession. 

 

Valentine Trodd, Community pharmacist

But isn't a lot of this just built into the system? SOPs dictate the ways things must be done, innane GPhC inspection guidlines dictate you have rotas and schedules for everything from cleaning the lav to checking the fridge temp, pointless NHS audits that must be completed every year, etc. I've come to pharmacy from an entirely different career and have found the last few years some of the most demoralisng I've ever had!

Shaun Steren, Pharmaceutical Adviser

Yes, the bureaucracy has been imposed from above, but from my experience as a locum and as a manager, not everybody is as demoralised by this as yourself. I have been in branch managers meetings and seen how complicit many pharmacists are with this culture. I have worked as a locum and experienced the enthusiasm for petty bureaucracy. 

There may well be many pharmacists who are appalled by the lack of independence and autonomy, but there are also a significant number who are not. Pharmacists are so resistant to this culture that the majority have actively got involved with their trade union? Pharmacists are so resistant to this culture that the majority actively involve themselves in online discussion? Pharmacists are so resistant to this culture that they support one another at a branch level instead of reporting each other? 

I take your point, but there is an unnaturally high level of enthusiastic complicity for what is a supposedly stifled profession. 

Paul Dishman, Community pharmacist

 

One of the reasons that I enjoyed having my own business was because of the independence from the petty bureaucracy and the general level of B.S. found in multiple management.

 

ajaz akhtar, Student

l

Have a free for all 

Opportunities for all and not a select few

Let the public choose the winners and Looser's 

Tom Kennedy, Pharmacy Area manager/ Operations Manager

and so it begins... all you other pharmacies best stay away from my customers.  Who wants to ally with me to take on the local Boots?  I'm offering a 70:30 split of their teritory.

Fasial Sheikh, Locum pharmacist

this is the end of neighbourhood pharmacies!!

S Morein, Pharmacy Area manager/ Operations Manager

1000 pharmacies left. Really??? But then the same people have been trumpeting the urgent collapse of the so-called network ever since the contractual framework was introduced in 2005. Whereas in reality there are more pharmacies, each more profitable than ever, benefiting from a record level of goodwill values. 

Farm Assistant, Community pharmacist

Not on the crack pipe again?

Farm Assistant, Community pharmacist

Not on the crack pipe again?

ajaz akhtar, Student

Pharmacy2U is the future 

Lucky Ex-Locum, Superintendent Pharmacist

Pharmacy2U is the death of pharmacy.

ajaz akhtar, Student

The Death of pharmacy is due to endless free services not pharmacy2u

Simon MEDLEY, Community pharmacist

are you the same guy who likes windimng people up on this site under the name of variousn sporting personalities ? or is it as coincidence .....

Andy Burrells, Pre-reg Pharmacist

The death of pharmacy is ultimately reliant on which political body is spending the cash. Unfortunately for us, it's a clueless Conservative government with no opposition.

As we say up my way...

... We're F#£&£d!

Chandra Nathwani, Community pharmacist

The largest online pharmacy dispenses around 1.5 million prescriptions per year. That is 130,000 per month equivalent to around 15-16 high street average pharmacies volume. And they have been around for many years. The country dispenses 1 billion scripts per year! You really think that ANY online setup can match that in a year or two that it will take to decimate the existing distribution of pharmacies in neighbourhoods? And the reason for a low take up is because the patients prefer to use the face to face product.

Please think again before it is too late!

Valentine Trodd, Community pharmacist

Bit of exaggeration perhaps?!

How come we're not hearing about the real news:

http://www.telegraph.co.uk/news/2017/03/13/blind-raf-veteran-died-boots-sent-pills-meant-different-patient/

Can't believe C+D haven't covered this!

Marc Borson, Community pharmacist

 

 

I am so frustrated with C and D, you have not covered errors enough its a major problem. Partly caused by a lack of resources. My hypothesis is that using the same resource to dispenses 10% more items, and trying to cut cost by encouraging distance selling and delivery is going to kill people.

Infact it is already happening. The current resource can not cope.

How can we invest in service delivery if we are told that any money we invest will never be capitalised and returnable on exit.

 

 

Benjamin Leon D'Montigny, Non Pharmacist Branch Manager

That certainly makes sense. We are going to see some big shifts in pharmacy this year. With those closures, the remaining locals are going to see an increase in workload, but will they be able to handle it? Examplex of the 180,000 patients displaced from GPS closures in the Brighton area, and the exponential difficulty is accessing remaining GPS this has caused, my thoughts are very much towards the negative. Not as pharmacy is now.

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