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Keith Ridge: These are 'difficult and uncertain' times

Exclusive
Keith Ridge: I am a person who wants to see change

NHS England chiefs have acknowledged the “difficult” and “uncertain” climate community pharmacists are facing as a result of the 12% cut to the sector's funding.

England's chief pharmaceutical officer Keith Ridge wants to reassure the sector "what NHS England’s duty is”, he told C+D in an exclusive interview last week (October 21).

“As a national commissioner of community pharmacy services, I want to ensure the NHS provides safe and effective patient care,” Dr Ridge said.

“I am a person who wants to see change because of all the issues I’ve talked about including medicines use and outcomes. Pharmacists need to be right at the centre of that,” he said.

A pharmacy integration fund, announced by NHS England (October 20) is “designed to make that happen”, he added.

Dr Ridge acknowledged that "some people have some very strong views about me at the moment", and said NHS England "recognises these are difficult and uncertain times".

The commissioner's ongoing review of services, led by King's Fund director of policy Richard Murray, is expected to be published "later in the year" and will "impact on the deployment of the integration fund", he added.

More details to come

"Full details of contractual changes [for community pharmacy are] coming,” Dr Ridge stressed, which will further clarify the government's plans. More details of the pharmacy access scheme will also be published in December, he added.

“Local and regional [NHS England] teams will be working with contractors to keep them informed, supported and prepared for the changes,” he said.

22 Comments
Question: 
How will the cuts affect your pharmacy?

Mr Pharmacist!, Pharmaceutical Adviser

"some people have some very strong views about me at the moment" -

No, Ridge, not at the moment, forever! Your actions will affect patient safety.  What you have advocated is utter nonsense, from a position of not understanding what community pharmacy is all about.  *This comment has been edited to comply with C+D's community principles*

Graham Phillips, Superintendent Pharmacist

My funding will reduce by 16% from December.

Dear Keith what consideration have you given to the patient safety implications of a drastic cut to pharmacy funding combined with ever-increasing Rx volume?

You've previously said "let the market decide" -who should survive. As Head of Profession is that really good enough for patients' safety?

Sue Per, Locum pharmacist

The huge increase in Rx volume is primarily due to 7- day dosette scripts, and 28 day prescribing, for which there is no justification. Volumes can be reduced at a stroke with 56-84 day prescribing where appropriate.

Thre is no evidence that 28 day prescribing leads to an increase in Unused medication wastage!! 

Valentine Trodd, Community pharmacist

Eh, some people on dosettes need one pack weekly - they can't manage 4 at a time. A 28 day Rx must be dispensed in one go i.e. the patient gets 4 weeks at once. I'd also add that 7 day scripts go SOME way towards paying for all the extra overhead in dispensing blister packs. I wouldn't be able to afford to do blister packs on 84 day rx - it's just not financially viable.

Dave Downham, Manager

I think that if you look at the stats, the rate of increase in prescriptions in 2015 was its lowest in the last 10 years while the average cost per item increased for the first time; implies that the average length of prescription is increasing, so no proliferation of 7 day prescribing. As for unused medication wastage, please come and have a look in our bins at what has been dispensed to deceased patients by certain larger chains

Bal Singh, Locum pharmacist

@sue per, really? would LOVE to see the evidence you have to prove that the Rx increase is due to 7 days scripts....especially when alot of CCGs stopped them.....I assume it would have NOTHING to do with an aging population? 56-84 days scripts? they are WONDERFUL when items are stopped/changed/lost etc. Plus There IS evidence that longer prescribing intervals ARE more wasteful, I can recall an assesemnt done in bradford and yorkshire that came to that same conclusion....... FYI there is no evidence that dossette boxes increase compliance. Nor are patients assessed by anyone to see if they are appropriate for them. The GP/carers just demand it, and the less said after the better. These are view from both evidence gathering and plenty of practical experience. Kind of the opposite of Keith Ridge's methodolgy. 

S Morein, Pharmacy Area manager/ Operations Manager

 

 

Mr Phillips, why does your funding reduce by 16% when the headline PSNC figure is 12%? With an actual annual reduction of only 4%?

Are you really suggesting that pharmacy contractors are so cavalier that a small annual reduction will lead to them ignoring their professional responsibilities? You are correct though, the market should certainly decide rather than contractors with a lifetime monopoly due to the outdated last century notion of contract limitation.

 

 

S Morein, Pharmacy Area manager/ Operations Manager

There is no 12% annual reduction in funding. It would be far better if C&D could refrain from hyperbole when reporting. The reduction is 4% for the financial year 2016/17, the late adjustment means that the over payment will be collected during the final quarter of the year, but the net effect is a a 4% reduction in payments to contractors.

Mike Hewitson, Superintendent Pharmacist

Suggest actually reading the sentence before you decide what it means! It says 12% cut, which it is, for four months from Dec 1st - March 31st, pro-rata. You would have to be particualarly sardonic to suggest it as an annual cut of 4%. 

It is easy to make sweeping, unevidenced generalisations based on prejudice or self interest from behind your cloak of anonymity. For all we know you could be Keith Ridge himself, trying to justify his own unevidenced proposals based on sweeping generalisations and prejudice. 

 

S Morein, Pharmacy Area manager/ Operations Manager

The sweeping generalisations you claim that I make are in fact figures quoted by the PSNC. Yes the 4 months from December are a headline 12% but this is due to the delay in implementing the 2016/17 settlement so on an annualised basis it is only a 4% reduction. Again NOT my figures but those of PSNC. 

Jupo Patel, Production & Technical

Yes I've noticed the tablod type scare tactics in favour of the corporates and contractors.

Marc Borson, Community pharmacist

once the activity fee kicks in and establishment paymnet is irradicated altogether then there will be no reason for control entry, any one that wishes to meet the standards and open up a shop can do --- thats the future.

 

Jay Badenhorst, Superintendent Pharmacist

Blah blah blah blah blah blah blah.......

The cause of the cuts finally comes out from the hole he had been hiding in. Next he'll say again that we all need to remain professional in our remarks...

It may be uncertain times for pharmacies but MORE uncertain where patients will go once their pharmacy closes.

If Keith is so passionate about the PHARMACIST integration fund, why is there NO Community Pharmacist representation on the Oversight Board?!

'The governance of the fund is overseen by an NHS England Pharmacy Integration Oversight Group including representation from CCGs, NHS England regions, General Practice, Patients and Carers, Department of Health, Health Education England and Public Health England.'

Sorry Keith, you've lost the (community pharmacy) dressing room....

Dodo pharmacist, Community pharmacist

Yes Ridge, these are difficult and uncertain times for community pharmacy- and YOU HAVE CAUSED THEM! *This comment has been edited to comply with C+D's community principles*. I have had to make redundancies for the first time ever in 30 years, as a direct result of your comments about too many pharmacies and acheievable efficiencies. Tell that to the trained staff members I have just had to make redundant. 

Ian Kemp, Community pharmacist

Of course Mr Ridge is not remotely interested in prescription delivery or MDS provision at the request of carers as these are not strictly NHS services and so he's not responsible for their provision but what outcomes does he expect if it becomes uneconomic for community pharmacy to continue to provide these 'free' services. I'm sure he'll happily pass the buck, maybe to Social Services as he'll say technically it's their remit not the NHS . Sure some big name logistic company [ G4S? ] will offer to do it for peanuts initially but increasingly expensive over the next 30yrs with no escape clause [ PFI anyone ] but as long as Mr Ridge looks good who cares ? Besides, he's probably confident contractors will just moan a bit more and carry on as before as we'd rarther be seen as bankrupt than morally bankrupt.

Simon MEDLEY, Community pharmacist

Is he getting a 12.5% funding cut ? No - probably getting performance bonus - he can just keep quiet if he's got nothing constructive to say

Grumpy Pharm, Community pharmacist

So we can expect all of the other details at 1730 on December 23rd then!

Hackney Drug Dealer, Community pharmacist

Keith Ridge: Not a community pharmacist or practising pharmacist. 

And boy does it show. Best option: give him a locum duty for a week. Might not be 'just another day at the office'. Chief Pharmaceutical Officer with no idea of daily practice. Patronising condescending sound-bites. No change there then. His priority is to safeguard his seat, that will have nothing to do with safeguarding community pharmacy and the benefits of pharmacy to the community. Yet another Hospital Pharmacist risen to the dizzy ranks of the DoH. Clueless. Community pharmacy serving the community. Keith Ridge: serving his paymasters. So, in the spirit of constructive criticism, lets get someone who knows about community pharmacy to make positive decisions & measurable outcomes for the community. Perhaps someone from commuinty pharmacy even.

Bal Singh, Locum pharmacist

Am I wrong in thinking he was an ACT who became a pharmacist?

Anonymous Anonymous, Information Technology

I can think of a few words that begin with A, C and T to describe him that's for sure!

Simon MEDLEY, Community pharmacist

he did a PhD in 1998- so its very unlikely

 

P M, Community pharmacist

what about lps pharmacies - are these being considered ?

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