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Peer: ‘Unrealistic’ to think advance payments solved funding crisis

Lord Grade: £370m in advanced funding isn't enough to keep pharmacies open
Lord Grade: £370m in advanced funding isn't enough to keep pharmacies open

It is “totally unrealistic” for the government to point to recent funding for pharmacies as though it has “solved the problem”, a Conservative peer has said.

The £370 million in advanced funding for pharmacies made available by The Department of Health and Social Care (DH) to help them meet challenges posed by COVID-19 is “nowhere near enough to keep [them] in business, let alone to allow the pharmacists to have a day off or even earn a living,” Lord Grade said in a debate in the House of Lords earlier this week (July 20)

“It just demonstrates that the department fails to understand why independent pharmacists are still in such grave peril,” he added.

Lord Grade was responding to a comment made by Lord Bethell, parliamentary under-secretary for health and social care, in which he highlighted that  the government has “made available £370 million in advance payments to aid cash flow” in the sector, as well as funded the pandemic delivery service and increased drug reimbursement costs.

However, Lord Grade argued that this financial support is not enough to keep independent pharmacies afloat and warned that “when they fold, they will not be replaced”. Lord Bethell added that the government is “talking to the sector about additional funding for COVID-19 costs”.

“Frontline heroes”

Referring to community pharmacy teams as “frontline heroes”, Lord Grade urged Lord Bethell to meet with a delegation from the sector to “hear directly why their businesses continue to hang by a thread”.

Lord Bethell said he would would be “very pleased” to meet with a community pharmacy delegation to discuss the challenges they face.

Last week (July 13), pharmacy minister Jo Churchill said mass pharmacy closures “would not happen” on health secretary Matt Hancock’s “watch”.

During this week’s debate, Conservative peer Baroness Pidding asked what the government would do to “ensure” that pharmacies are able to offer the flu vaccine during the upcoming autumn and winter.

Lord Bethell said the DH is “talking to the sector about the role  community pharmacies can play in the greater administration of vaccines, both of flu and of COVID-19 ”.

“We very much want to see an enhanced role for pharmacies in the delivery of healthcare,” he added.

Lord Bethell also said the government supports initiatives that see pharmacies play an “enhanced role” in the community, such as being commissioned to provide tests for blood pressure or atrial fibrillation.

A transcript of the full debate is available on Hansard.

25 Comments
Question: 
What do you make of Lord Grade's comments?

Axed Locum, Locum pharmacist

A tip for Lord Grade - Visit the companies house and examine the accounts of the organisations under "Dispensing Chemists" - and you will be pleasantly surprised to know that they have done very well from the taxpayer NHS Cash Cow!! Before these pharmacies close, you might see pigs fly!!.
Elementary arithmetic indicate that 2.9BN (with the advanced funding),shared between 11.5K pharmacies yields a payout to a median pharmacy a whopping 250K per annum!!!!. ....and they can only afford to pay their locums a meagre £19.00 p.h.
The whipmasters extract more than those who work at the coalface with full accountability!!!

Alexander The Great, Community pharmacist

2.9bn pharmacy funding in general? You know how much drug costs and employment costs and rates are?

Axed Locum, Locum pharmacist

Drug costs or Net ingredient costs are not included in the global sum!! , but profit on purchases of circa 500k is included.The latter would fluctuate with the purchase profit margin, but is broadly offset with the periodic price concessions.

Check with the PSNC.

C A, Community pharmacist

Purchase profits are capped at £800 million aren't they?

Not-So-Lucky Ex-Locum, Superintendent Pharmacist

Hmmmm......I sense a little bitterness against contractors here (hence the username?). Remember that advance funding has to be paid back (or at the very least, future funding will be reduced by the same sum) so I'm afraid a lot of your maths goes out of the window at that point.

I do agree that the multiples have done very nicely thankyou from squeezing pharmacists til the pips squeak but it's been like that for as long as I've been working, though the last 15 years or so (co-incindentally arriving at the same time as Advanced Services - how strange...)  have been by far the worst. It is a fact though, that pharmacies are closing. A Lloyds near me is now a coffee shop, another is still empty, so that is two contracts gone in a relatively small area and I think there are more that I have missed as well. More will follow as a result of the post-Covid (though planned long before that) restructuring of companies.

Locum rates are unfortunately a case of supply and demand. The reduction stems directly from the 'fallow year' after the course was increased from 3 to 4 years because companies actively over-recruited from abroad to fill the void, more cheaply than using British pharmacists, followed by a big increase in schools of pharmacy flooding the market with newly qualifieds. I worked with a Spaniard who was managing a ridiculously busy shop and I was shocked at how little they were paying him. I think I was on 6 pounds an hour more as a locum. Even at £19 per hour, you are still probably on a better rate than an employed pharmacist with less hassle (I've been manager, locum and superintendent, now back to locum so I know what I'm talking about) But I do agree that for the level of accountability we hold, we should be on a lot more. The GPs have their payrise for doing bugger all through covid though so there aren't even any crumbs left to give to us.

Axed Locum, Locum pharmacist

We have to agree to disagree. The figures are based on the presumption that the 370M advance will be written off, as there are loud pleas from all angles . We have the PSNC, the editorial, NPA etc all harking and lobbying their MP's for a write off of the loan.
As for Lloyds closing the branches, I believe this is mere consolidation, rather than inadequate funding. In all probability this would because of a cluster of branches in the vicinity. The end result would be retention of majority of the business, with a reduction of major costs of fixed overheads and a Pharmacist and an assistant .I have witnesses this after the takeover of the Sainsbury's branches.
The "supply and demand" theory works in a an open free market and not so well in a closed market, such as this because of contract limitation.
It is accepted that there is a glut of pharmacists, for several reasons, but in spite of increased funding from 2005 to 2016, the rate paid to Locum Pharmacist has gone down, and that of the managers kept up and is now on the increase due to the intervention by the PDA!!
In respect of pay differentials between Locums and employed pharmacists you are completely wrong. I have first hand experience of being offered "20.50 ph with 6 weeks holidays, along with other minor perks.You further forget to add the premium that must be applied to "Self Employed" status.The organisation best placed to determine the fair fee for locums is the PDA, as they have huge amount to data to support their argument.
Come on Mr Koziol, lets have your expert opinion on this!!!. It Is well overdue, to dispel the ignorance and myth!!

.

Not-So-Lucky Ex-Locum, Superintendent Pharmacist

I have to say I don't share your optimism that the advance will be written off. It may nominally be, following a lot of lobbying but you can be sure they will find a backhanded way of getting it all back again.

As a Superintendent, with all the baggage that went with it, I was still earning less than my locums. I have worked on both sides of the page and it is FAR easier to be a locum than a manager, therefore it is only right that managers be given more. I agree to totally disagree with you.

Alexander The Great, Community pharmacist

It made me angry they announced that front line heroes got a pay rise. GPs that hid away from patients. Teachers that didnt go to work and prepared classes from home. Then pharmacists.... not a mention. The public are unaware that we are publicly funded, yet we do not get a pay rise or NHS pension (unlike drs and dentists - who are contractors). Come on PSNC.... negotiate us a NHS pension please!!!!!!!!!!!!!!!!!!!!

Leon The Apothecary, Student

To be fair to teachers - that was quite a difficult task. I have a few friends of mine who are teachers of secondary school, and getting together a learning plan for children that is engaging and that can be delivered remotely, and generally had to do this by themselves without support, and had the pressure of still being required to meet learning objective targets with their students, who are all in a variety of different and sometimes difficult situations (some unstable home lives, limited access to internet/technology, learning challenges).

To say that teachers didn't deserve rewarding is disingenuous at best, Alex. You cheapen yourself by attempting to smear one of the most overworked and arguably important professions.

Direct your anger intelligently, towards those who have the power to change it, rather than at the fortune of others.

Benie I, Locum pharmacist

Zero postive public profile due to RPS, GPhC and their cohorts being as useful as a seive for a mask in a covid pandemic. Their efforts seem to be mainly fcused on punishing pharmacists and driving down their pay in cahoots with the multiples.

Not-So-Lucky Ex-Locum, Superintendent Pharmacist

This is precisely why we won't be seeing any funding increases - something has to give to finance the GP pay rise, and pharmacy, lurking around the outside with it's face pressed against the window like a Dickensian urchin, is the perfect target for that.

Axed Locum, Locum pharmacist

Is Pharmacy the sacrificial lamb??. No, i don't think so. Pharmacy will get its share of increase, but any increase in funding will not be passed onto the pharmacists, particularly Locums, as they do not have anyone to plead their case!!

Not-So-Lucky Ex-Locum, Superintendent Pharmacist

Again I disagree. Pharmacy is not considered a genuine part of the NHS so whatever NHS budgetary increases there are will only filter very slowly, if at all down to pharmacy. However, any budgetary CUTS, now there's a different story. We have to take our fair share then! I think we also have different views on the future of Pharmacy. You believe it has one, I don't. Ah well, I'm out at the end of the year at the latest so I hope for your sake and all the rest of 'pharmacydom' that I'm wrong and you are right.

Are you old enough to remember the heyday of locuming, about 20 years ago? I made an absolute MINT (twice what I was getting as a manager for only four days a week working) up until the fallow year effect as I mentioned above kicked in which for a brief period meant we were in extreme demand and could name our price, but ultimately was the downfall of locum rates because I think that was the point that the multiples particularly, realised that they could slice our rates with impunity because we had little choice other than to suck it up , work extra or see our houses repossessed. In the end I had to work five and a half days a week just to keep my head above water.

Axed Locum, Locum pharmacist

Co-incidentally, i have as much experience as you, and our opinions are polarised!!
Beggars belief!!
Pharmacy will be here to stay in some shape or form. They are universal, and part of the healthcare system throughout the world, operating as per their local laws, by-laws, rules and regulations if any!

Not-So-Lucky Ex-Locum, Superintendent Pharmacist

I agree that PHARMACY will stay. However, maybe I should have changed the word and said PHARMACISTS have no future. The future is remote dispensing, hub and spoke, ACTs, Techs and not us, with just a minor change in legislation to remove the need for pharmacist supervision. Ah well. This particular pharmacist has no future in the profession after 31st December at the outside so I'm doing my bit to help the rest of you!

Not-So-Lucky Ex-Locum, Superintendent Pharmacist

Perhaps we should trade user names? I don't consider myslef lucky any more because the job I gave up locuming for turned out to be FAR more stressful but C+D won't let you change any details now without basically telling them your bank details and mothers maiden name so I haven't bothered to swap my name.

It may be down to the areas we work. You aren't London by any chance are you?

Axed Locum, Locum pharmacist

Perhaps not, with our polarised views. We will probably continually argue till the "cows come home" . But I must say, that i have a wide experience in Pharmacy and understand balance sheets and P & L accounts to arrive at a sound judgment. Applying that .i have been lucky enough to buy non pharmacy businesses and turn them around and sell them on for good profits. But now, i am not so lucky!!. Pharmacy will become a Four "horse" cartel, and become too big to fail. like the banks. There are already the beginnings of tentative threats to the government, and in all probability the government will capitulate to the demands of these asset strippers simply to honour their pledge to the citizens.Watch this space- the 370M will be written off., and when it happens don't forget to salute me!

Not-So-Lucky Ex-Locum, Superintendent Pharmacist

Actually, in many ways we agree. I agree with you over the evil of multiples, crap locum rates, crap pharmacist rates generally, I just think we differ on our views when it comes to how devious Government can be when it comes to money.

Axed Locum, Locum pharmacist

The one thing i cannot accept, and will not accept under any circumstances is my professional independence being compromised, particularly by persons who do not have qualifications beyond "A" levels. This happens too often and hence the title "Axed Locum". They all like to have me, but when i asset my authority, which i am entitled to as the R.P., that is when we start to part company.There is a very simple rule: as an R.P., I am not accountable for my professional duties/performance/standards to anyone other then the FTP of the GPHC. We are in this predicament because GPDC refuses to enforce the RP regulations against those who breach it!!

Not-So-Lucky Ex-Locum, Superintendent Pharmacist

Agreement is reached!!

Benie I, Locum pharmacist

Tell them to Foxtrot Oscar. No amount of money can be placed on peace of mind. I only feel sorry for the students sleep walking into this slow train wreck of a 'profession'. I could pay off my mortgage tomorrow so don't shed any tears.

Not-So-Lucky Ex-Locum, Superintendent Pharmacist

You're the lucky one then Benie. I'm having to downsize to get out.

Leon The Apothecary, Student

Healthy and respectful discourse is important in pushing forward pharmacy.

Benie I, Locum pharmacist

I wish you all the best. Stay well.

Kevin Western, Community pharmacist

Good on him

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