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PDA: Pharmacies should merge to combat funding cuts

Mark Koziol: PDA seeking "protection" for any businesses that want to merge

Merging with nearby businesses will mean pharmacists can deliver more clinical services, says PDA chair Mark Koziol

EXCLUSIVE

Pharmacies should consider merging to combat government funding cuts, the Pharmacists' Defence Association has said. 

The DH said in December that there are “more pharmacies than necessary” in England, with 40% of businesses within a 10-minute walk of three or more others.

PDA chair Mr Koziol told C+D on Tuesday (March 15) that if some pharmacies merge, it would protect the sector from this accusation in the future.

Better clinical services

Combining businesses will also allow pharmacists to focus on clinical services, he said.

“If you maintain the capacity of two or three pharmacists working in one location, you could start to deploy a range of clinical services in a way you’ve never been able to do before because the pharmacist is too busy.”

The PDA discussed how pharmacies that wanted to merge could be “protected” with the Department of Health last week, he said. 

Mr Koziol stressed that none of the PDA’s discussions with the DH contradicted the efforts of other pharmacy bodies to prevent pharmacy closures.

“But they could springboard from what looks like a bad situation into one where pharmacy can deliver more efficiently and a wider range of services,” he said. 

The PDA launched its campaign against the pharmacy funding cuts last month.

It called on the government to examine the finances of companies that own both wholesalers and large multiples to find the money it needs for NHS savings.

 

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23 Comments
Question: 
What do you make of the PDA's comments?

Bal Singh, Locum pharmacist

I think the main driver for this issue when MPs are approached about pharmacy cuts, they point to clusters and say, "there's too many there" then link it to not being necessary and therefore savings.

If there was a patient management contract, would the idea be more viable?

Because THEN.... do they turn round to doctor surgeries in healthcentres and say clustering?

Sami Khaderia, Non healthcare professional

Balkeet.....why are you sooo concerned? contractors dont give a monkeys if locums loose their jobs......its a dog eat dog world...

Harry Tolly, Pharmacist

Guess who has been indoctrinating this into their thinking ??  This has been an agenda item for at least 2 decades and now Ridge, a man with zero community experience, zero patient-pharmacist interaction, has taken the axe. The worst thing is that there is no long term plan which they will share with the profession. How do you redeploy thousand of pharmacists and those that are graduating ? We have a perfect opportunity for pharmacists to provide a whole plethora of services from different premises in one town (manageable workload).

A Hussain, Senior Management

Locally, our three GP surgeries have merged and moved into one building.  The service is ten times worse than it used to be.  Staff aren't happy, GP retention is awful and patients hate it.  But it's now the only choice so the attitude from the practice is 'like it or lump it'.  In my opinion bigger is rarely better.

Sami Khaderia, Non healthcare professional

in 100s of towns across the Uk..there is just one pharmacy and their attitude is the same.....

Chris Mckendrick, Community pharmacist

Why do all our so-called leaders continue to make public statements that suggest an acceptance of the CavendishRidge letter of Dec17th? Mr Koziol I don't want you to suggest I merge with another pharmacy, just to protect me from the accusation that because I am 10 minutes walk away from 3 other pharmacies that makes my pharmacy one that is not "necessary". I don't need protecting from accusations, I need leaders of the profession who will publicly argue against the ill considered mishmash of proposals in that letter that seeks to undermine the pharmacy network. Just saying there are more pharmacies than are necessary doesn't make it so, whether or not you attach it to a spurious statistic such as "40% of all pharmacies are in a cluster". If the PDA really does have the ear of the DH then explain to them how several pharmacies grouped together in close geographical proximity provides the patient with CHOICE, CONVENIENCE and improved service through local COMPETITION. Ask them how, when the patient presents their script at the 4th pharmacy in the "cluster", finally finding a pharmacy that stocks their medicine, that pharmacy is not NECESSARY? Then explain, when all of the innovative competition from small annoying independents has been snuffed out, what a brave new world we'll have, with local monopoly suppliers of pharmaceutical services not having to try because they have a captive audience. Finally, explain how having more than one or two pharmacies in a town or High Street gives the network RESILIENCE, FLEXIBILITY, ADAPTABILITY, CAPACITY and most importantly FUTURE PROOFING because as anyone knows it'll only be a matter of time before another Government will want more pharmacies again (The Herriot-Watt effect). Fight for community pharmacy is my suggestion.

Dodo pharmacist, Community pharmacist

Fantastic post Chris,I couldn't have put it better myself. What I find particularly galling is that Ridge and Cavendish have no experience whatsoever of community pharmacy, yet suddenly they are world experts on it. They should spend a day in my shoes before spouting the drivel they come out with. It would be funny if it wasn't so desperately serious.

Sachin Badiani, Pharmacy owner/ Proprietor

Hi Chris Armstrong, why don't you invite Keith Ridge and Mr Cavendish to visit your pharmacy. Show them the good work you and your staff do for your community.

If and when the pharmacy network is destablised, will these two and Alistair Burt be held accountable? I thought not...

Dodo pharmacist, Community pharmacist

Hi Sachin, I invited Keith Ridge by email on December 23rd to visit my pharmacy. I have not had a reply. What a surprise ! This man is Chief Pharmacist, yet he is hell bent on destroying the community pharmacy network. Is there any way we can get him replaced by a pharmacist who actually has some idea about community pharmacy and  will support it rather than trying to wreck it?

 

 

Altaf Vaiya,

Merging businesses has many cost implications including creating exit strategies if things don't work out. I agree it makes sense to have large volume businesses that maybe more profitable and maybe more able to do extra services but in reality all the extra services have to be commissioned by CCG's and our paymasters...does the Nhs have money to implement new services. In the end I believe there is not much difference between merging businesses and buying out your local competition. One pharmacy will have a greater than another etc a whole system will have to be created to calculate business values and how to share ownership in the end the partnerships may not be of equal value causing more complications in the partnerships especially when you have a lot of individualistic business owners. Pharmacy is in a difficult position at the moment, we have to start understanding our businesses question the ways we work so we can improve our foot flow of customers. The current budget cuts will force pharmacies to be more competitive and will push for higher script volumes to counter act money being lost in the foreseen cut backs. I have created some useful information that might help support your pharmacy business please visit www.pharmacyknowhow.co.uk

Stephen Eggleston, Community pharmacist

How exactly does Mr Koziol suggest these mergers come about? Who decides who mergers with who? And where? Do we merge two (or more) similar pharmacies, or do we form partnerships whose stake in the new business reflects the income from the old? Whose premises are used? Who pays for the unused one? And, as Harry Tolly rightly points out, competition has previously resulted in higher standards and greater cost savings - it would not be unreasonable to expect those drivers to be lost. I am assuming that the "new" pharmacy will generate at least as much income as the respective partners would have recieved if they had not merged, or else why do it?

Of course, since Mr Koziol does not make his money from providing pharmaceutical services, he is quite at liberty to voice an opinion. I only hope in future he thinks it a little further through

Farm Assistant, Community pharmacist

So are we going to be paid for these extra clinical services or will it be the same as the free deliveries, free diabetes checks, free health checks etc? The minute you do something for nothing you are doomed. When was the last time an estate agent, lawyer or optician did something for free? Pharmacy is reaping what it has sown and I am reminded of that everytime I park my old banger next to the estate agents (next door)  new BMW 7 series. I suppose the RPS will tell me I should be grateful I am not riding a bicycle!

Old Timer, Manager

could not agree more re free services why oh why , also the silence from the big boys must mean they think it will be golden for them .

 

Farm Assistant, Community pharmacist

I can remember when an area manager gave me a hard time because I was not doing enough free services. What an ahole. No wonder pharmacy is where it is today. And when I pointed out we could easily make some money by doing something different he was not interested. What a complete ahole.

Clive Hodgson, Community pharmacist

I must agree with you. Whilst the PDA proposal sounds interesting, I do not believe that there is any interest by government in funding new Pharmacy clinical services. The chances of new services providing a reasonable living wage for an individual Pharmacist are zero. I believe it is clear now that that the Government has Pharmacy in its sights only for further cuts. 84 day prescribing and reduction of the dispensing fee are probably on the way. As Farm Assistant says, this is the inevitable result of Pharmacy providing so many free services over the years. We have totally devalued ourselves.

Chris Locum, Locum pharmacist

Sadly I must second that.I remember someone who sent in a letter to the PJ in 1995. He got together with a few competitors to provide home services at a charge (which was costs other than labour) and lost half his business over night. It was astounding that he had subsequently seen a profit for doing this with 2 vans running. I tried to suiggest it to some people I was doing locum work for but they would not hear it. The new owners wanted to cut the wages of the existing staff (who were very well paid at the time) instead. Community pharmacy never had a proper career structure and the 3 levels of dispensing fees, at the timer, supposedly to support a second pharmacist (whether that was really the case or not I don't know - it went in contractor pockets). I wondered if we headed down the wrong road. We have nothing to fall back on in terms of service fees with these cuts and the government has no express intention of ordering any at present. I am just glad my mortgage is paid off and I can slowly cut loose from a profession which is in decay and reward myself elsewhere..

I've always been ambivalent about Koz and the PDA but I think he's spot on with his suggestions for action. Govt. consultation is a farcical paper exercise and the cuts will take place as announced regardless of our protests. Perhaps the RPS could show similar initiative.....

Sami Khaderia, Non healthcare professional

Again shows the lack of intelligence of those pharmacists who thought the PDA works for the good of pharmacy....

Commentator Online,

Sami almost every time you speak it's painful. Right now the government is using figures on pharmacy proximity to justify the closure of pharmacies, so pharmacies do need to be open to relocating or merging (after a local assessment has been done).

Sami Khaderia, Non healthcare professional

didnt daddy show u any love? I was talking about the PDA in general...with regards to merging, if u look at my post in febuary I already said I have merged with an online pharmacy located a mile from my pharmacy...Muppet....

Commentator Online,

So you're 10 years old too? Why should I bother going to look for your 'post in February', it will be as dull as the rest of your posts. The article is called 'PDA: Pharmacies should merge to combat funding cuts' and you were using that as evidence that the PDA don't care about pharmacy.

A Hussain, Senior Management

And you'd need to know which name he was using at the time. 

Harry Tolly, Pharmacist

At least this is thinking out of the box. Well done PDA. ... HOWEVER

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1/ To date, in ANY business environment, it has been shown that competition increases and drives up standards. Having 2 or 3 pharmacies competing against each other drives standards. Gifting monopolies do not. AND YOU CAN BET that the monopoly will ultimately be a multiple. REALLY BAD IDEA and one which we would repent on if it was ever acted upon.

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2/ The DoH will NEVER ringfence pharmacist hours, i.e. if 3 pharmacies merge then workload triples for remaining business therefore 3 X the pharmacist hours. It ain't going to happen. Pie in the sky if you believe that this is possible.

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3/ The only proposal worth looking at and on which there is REAL EVIDENCE of EXCESSIVE MARGINS is :  "it called on the government to examine the finances of companies that own both wholesalers and large multiples to find the money it needs for NHS savings."   ..............IF we redistribute this money then there would be no need for closures.  ITS ONLY EXCESSIVE profits that are being clawed back. Incidentally, Boots would have paid £1 BILLION more in taxes were it domiciled in UK. .............................

http://www.unitetheunion.org/news/alliance-boots-avoids-11-billion-tax/

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