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Minister on minor ailments schemes being scrapped: 'Things move on'

Pharmacy minister Steve Brine attended the all-party pharmacy group (APPG) meeting last night
Pharmacy minister Steve Brine attended the all-party pharmacy group (APPG) meeting last night

The pharmacy minister has addressed the decommissioning of minor ailments schemes across England by explaining that “things have moved on”.

Minister Steve Brine was asked by Labour MP Paula Sherriff yesterday (October 30) what the government is doing to “specifically buck the trend” of decommissioning, and reminded him that “in 2016 ministers committed to encouraging every clinical commissioning group (CCG) to have a minor ailments service”.

In response, Mr Brine said: “Things have moved on…The clock has moved on.”

“Traditional” schemes replaced with “digitally-led” initiatives

England’s chief pharmaceutical officer Keith Ridge, who also attended the all-party pharmacy group (APPG) meeting, said: “My impression is that CCGs are beginning – rightly or wrongly – to decommission minor ailments schemes.”

“I think we’re in a transition phase here from the traditional minor ailments scheme, through to something that is much more digitally-led.”

He pointed to NHS 111 directing patients to community pharmacies as an example of the “digital pathway” aimed at managing minor ailments.

“Blinding us with science”

Ms Sherriff – who is also an APPG member – told C+D after the session that Dr Ridge’s references to digital minor ailments schemes replacing “traditional” versions was an attempt to “blind us with science”.

Sandra Gidley, chair of the Royal Pharmaceutical Society's English pharmacy board, also said she did not “have a clue" what Dr Ridge was referring to.

“How can [decommissioning of minor ailments schemes] possibly be a good thing?” she stressed to C+D after the session.

“When people are sick, there are some that are quite happy to [seek help] digitally, but for a lot of people they need face-to-face contact, and a community pharmacist is the best-placed person to do that.”

“I can't see any hope in what was said [at the APPG meeting] for community pharmacy providing clinical services,” she added.

Ensuring NHS England implements the government commitment for every CCG to commission a minor ailments scheme by 2018 was one of the recommendations in the ‘Murray’ review into pharmacy services – which Dr Ridge revealed in the same meeting NHS England will not be responding to.

26 Comments
Question: 
Is a minor ailments scheme commissioned in your area?

Peter Sainsburys, Community pharmacist

Mr Brine. If you do the exact opposite to what Keith Ridge does then you will be very successful.

Sitting around in board rooms never actually achieving anything for the public who need healthcare might be great if you're on a good salary and full benefits.

Please don't follow his lead.

Dilip Shah, Community pharmacist

Interesting that the Minister concerned is ignorant of the work community pharmacists do , further more he does not even understand the costing and expense that would involve by scrapping this scheme. Dr Minister try this costing question.If every pharmacist sends 1 in every 10-15 pateients they see to either a GP or A&E how much would it cost the NHS?

 

 

 

 

Shaun Steren, Pharmaceutical Adviser

To quote Daniel Kahneman:

‘Most successful pundits are selected for being opinionated, because it's interesting, and the penalties for incorrect predictions are negligible. You can make predictions, and a year later people won't remember them’

Within community pharmacy there are few penalties for being found wrong. If presented in a sufficiently beguiling way, an unsound ‘vision’ based on false assumptions can keep a bureaucrat in work for many years. After a period of time, people no longer have the memory or enthusiasm to hold individuals to account for being hopelessly wrong. The slate is wiped clean and they move onto the next gimmick. 

The ‘clinical visionaries’ in pharmacy are such people. They include those from within the RPS, the pharmacy press (including this publication), the government and academia. Or more simply, those people who don’t work in a dispensary. Of course, there were some shop-floor pharmacists who chanted from the services hymn sheet, but then this profession has always (for reasons I have never really understood) contained an unusually large number of genuinely thick people.

To quote Kahneman again:

‘A reliable way to make people believe in falsehoods is frequent repetition, because familiarity is not easily distinguished from truth. Authoritarian institutions and marketers have always known this fact’

It was this technique that was used to deride any pharmacist who was suspicious of the clinical services utopia. The ‘clinical future’ was so repeated as truth, that any sceptic could be nothing more than a small minded Luddite who only wanted to ‘stick labels on boxes’. Of course, it was top-down, the scepticism was bottom-up. As such, it was a bullying authoritarian culture that wanted to silence. 

The sceptics have been proven correct, but ultimately it doesn’t matter. People will be losing jobs, taking pay cuts and existing in a much worse work environment. It is best described by George Carlin:

‘They want obedient workers,­ people who are just smart enough to run the machines and do the paperwork but just dumb enough to passively accept all these increasingly shittier jobs with the lower pay, the longer hours, reduced benefits, the end of overtime and the vanishing pension that disappears the minute you go to collect it’

Ilove Pharmacy, Non Pharmacist Branch Manager

Comments where you rightly charge this 'publication' with being complicit in the current mess will likely lead to future 'edited' posts. 

Amal England, Public Relations

Steve Brine.... Things have moved on... You are the new minister....Keith Ridge..."wrongly or rightly" ? I assume you vetoed the vote/idea of hitting pharmacy yet again. The comment calling Ridge a traitor..... Cannot be more true.

Paul Dishman, Pharmaceutical Adviser

Ridge is a traitor to pharmacy

Sue Per, Locum pharmacist

Scrapped, probably because of fraud and an inadequate professional service!! Maybe we need to shake off our image of chasing $$$$$$ for nothing -Like useless MUR's done for filling the coffers rather than in the interest of the patient/clients...

Chandra Nathwani, Community pharmacist

CORRECTION:

Scrapped because there is no money! As always its the poor in our society who end up suffering.

Ask the people who have to chose between treating head lice on their kids head or feeding them for their views. 

A B, Community pharmacist

I agree with the general consensus that a MAS should exist in every area. However, poor implementation and lack of published evidence supporting the schemes has meant it is an easy target for the government to cut. Ministers need to be told "if you cut this service it will cost you £X in the long run". Unfortunately, what I'm guessing they get told is "this service is costing £X, the general public don't really know much about it, so we won't get much bad press if we cut it". 

I've also found one of the problems with current schemes is that they include too many very cheap products on their formularies. Items such as paracetamol and loperamide. I know of pharmacies that are making up to £10.000 per month from the scheme because they would rather get the MAS consulting fee (the consultation is sometimes is just a quick glance at the patient) than sell the product OTC. I'm not saying this is wide spread practice as I'm sure many pharmacies provide the service appropriately. It may the case in some areas though, that there has been money put into the scheme but the benefits to patients have not been documented properly and passed onto the commissioners.

It will be a big shame if a nationwide MAS never materialises, but not a big surprise to me.

Amal England, Public Relations

What evidence do you need when a pharmacist can give a bottle of Calpol via MAS yet that same patient going to the GP costs the NHS ten times more and that of even before the patient has got their hands on the bottle of Calpol. MAS is a no brainer.... It is going out because the pharmacy leadership is a bunch of dummies, too many pharmacists have their heads in the sand, GPs are pulling the strings and the GP has a few toys- the pharmacy leadership dummies. In legal terms the GP and the pharmacist are equal- private contractors hired by the NHS.

Marc Borson, Community pharmacist

 

 

MAS ARE 90% cheaper than a gp MAS consultation this is just wrong. I have never heard of digital MAS what the heck is that?

 

 

BIPIN PATEL, Community pharmacist

MAS is to be scrapped . As pharmacist will no doubt refer patient to the over worked GP's.

Shaun Steren, Pharmaceutical Adviser

Where are those moronic ‘visionaries’ who promised a ‘bright clinical future’? 

Where are those cringeworthy management b*ll*cks talking idiots who talked of ‘skilling up’? 

Where are those condescending bigots who derided service sceptics as ‘Luddites’ who would find themselves ‘unemployable’?

Where are those insufferable blowhards who claimed new funding would follow once we gave up ’sticking labels on boxes’? 

Where have all those people gone? Come on, step forward, speak to those hundreds of workers who now face unemployment, wages cuts and ever worsening work conditions. Speak to those pharmacists who now work in environments that make clinical excellence all but impossible. Have you moved on to other parts of the bureaucracy? Have you sold up and retired? Where you just armchair pharmacists with no skin in the game?  Or are you just too embarrassed by your own gross stupidity? 

 

Valentine Trodd, Community pharmacist

Well said Shaun. The great clinical white hope was smoke and mirrors. How could it be anything else when MURs were the highlight?! I'm interested to see how the 'clinical' pharmacist role in GP surgeries develops over the next few years as funding dries up.

Ilove Pharmacy, Non Pharmacist Branch Manager

Surely you never believed those lies. These are the same sort of people who advocated attacking Iraq and colonising Afghanistan after some Saudis brought down the twin towers 9/11.

Chris Locum, Locum pharmacist

They are a myth. Always have been. Unfortunately, these useful idiots have dealt community pharmacy a mortal blow. The kind of people not getting their hands dirty at the coal face, issuing various edicts which now prove to be very hollow indeed. There will be a high price exacted on pharmacists and support staff in the coming years. It may not be immediate, but it will happen. Amazon has applied for licenses in several states in the USA. The sand clock is pouring.

Clive Hodgson, Community pharmacist

Some of our “leaders” may indeed be “useful idiots” however I can think of a couple of very vocal and very opinionated “leaders”, whilst under the pretence of advancing (community) Pharmacy, would appear to be attempting to steer Pharmacy for the advantage of the large Corporates.

Chemical Mistry, Information Technology

Good to have you back Shaun say it like it is ? Ridge must be most unpopular pharmacy person ever!

A Hussain, Senior Management

We've had our battles on here but 100% agree with you on this.

Honest Pharmacist, Community pharmacist

Couldn't have said it any better Mr. Steren! Wish you were an MP rather than a Pharmaceutical Adviser - you'd get my vote! :-)

Sue Per, Locum pharmacist

Mur's  and NMS' should have been decomissioned instead. A complete waste of tax payers money, as very few are of benefit to the patients. 

Dave Downham, Manager

Ridge is an utter disgrace to the pharmacy profession. He refers to NHS 111 referrals - how many pharmacies when verifying their details for quality payments - more wind and water - found the data held to be utter bobbins? Surely the cost of a referral is going to be much greater than simply walking into a branch?

Chemical Mistry, Information Technology

Good money better use maybe towards pharmacy prescribing

Ben Merriman, Community pharmacist

Move on. Now, where have I heard that before? Has the Minister been speaking to our esteemed CPhO Dr Ridge, per chance?

Barry Pharmacist, Community pharmacist

Yes things have sure moved on but the stupidity of the DOH continues.

This government will not commit to a free National MAS and we will no doubt see medicine boxes at food banks before long. Sad, very sad.

Rich S, Community pharmacist

Should we be surprised...really? 

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