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Pharmacies scramble to help care homes after supplier collapses

Pharmacists battle to ensure care homes receive vital supplies after Pharmacy Plus is closed by "severe cash-flow shortages"

Pharmacies face a "dilemma" about how to supply care homes after a company that provided medicines to hundreds of residential homes unexpectedly closed.

Midlands contractors and LPCs told C+D they were trying to ensure care homes continued to be supplied with medicines after Bristol-based distance selling company Pharmacy Plus withdrew from its community pharmacy contract on May 16.

The company's administrator Zolfo Cooper said "severe cash-flow shortages" had forced the company to close and care home residents would have to find "alternative sources" to obtain their prescriptions.

NHS England said Pharmacy Plus had served "several hundred" care homes in England, Scotland and Wales but neither they nor Zolfo Cooper specified locations.

C+D spoke to LPC representatives from 12 areas of England but only those in Nottinghamshire and Northamptonshire were aware that local care homes would be affected by the closure of Pharmacy Plus.

Nottinghamshire LPC secretary Nick Hunter said one local pharmacy had agreed to supply three care homes affected by the closure. It had been "very difficult" to find out which care homes Pharmacy Plus had supplied, he added.

"We have a good network of pharmacists in Nottinghamshire and they will get patients through in the short term. But it could be quite complicated with a huge care home, especially if they have complex needs," he said.

Contractor Ritesh Gokani, of 3Q Pharmacy in Northamptonshire, said he had agreed to supply a big local care home for a month, which had caused some "extra strain".

Care home residents have had to seek ‘alternative sources' to obtain their prescriptions

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Mr Gokani faced a "dilemma" about whether to commit extra resources to supplying the care home in the long term, he told C+D.

"Luckily we are a 100-hour pharmacy but it does put extra pressure on the existing workload because we're quite busy," he said.

Other contractors told C+D they would not be able to help out. Rizwan Moledina, of Croyland Pharmacy in Northamptonshire, said he would have to employ an extra member of staff in order to supply local care homes.

"We're closed Saturday morning and Wednesday afternoon. If there was an emergency, we can't help out. We have enough workload [from] the local community as it is," he told C+D.

The prescribing and medicines management team for Nene and Corby CCGs in Northamptonshire said it had emailed its local GP practices and pharmacists to encourage close communication between practices and affected care homes.

Head of prescribing Sue Smith said the CCGs had done the best they could to ensure care homes continued to receive their medicines, but it "would have been helpful" if Pharmacy Plus had contacted the CCG directly to confirm which homes would require a new medicines supplier.

NHS England said it had been in contact with CCGs and local area teams in regions with affected care homes to make them aware of the situation and "ensure alternatives are put in place".

Zolfo Cooper said 240 jobs had been lost when the Pharmacy Plus closed due to "a reduction in trading volumes and supplier pressure". The administrator was working closely with the NHS to ensure "minimal disruption" to care homes, it added.

Pharmacy Plus was unavailable for comment.

How will the closure of Pharmacy Plus affect your pharmacy?
We want to hear your views, but please express them in the spirit of a constructive, professional debate. For more information about what this means, please click here to see our community principles and information

Khaled Miah, Other healthcare profession

Explains why a big chain serving only care-homes had just last week made all their staff redundant. Sad

Farmer Cyst, Community pharmacist

I've never understood business models which seem to be based around the supply of MDS/blister packs.

One of the large local multiples had a board up by their counter basically saying - 'Why not have your medicine in a blister pack?'. When I enquired why on earth they'd do this I was told the area manager felt they weren't doing enough.

Rather than the sea of new patients I think they envisaged, they had dozens of exisiting patients asking for their medicine to be popped out of one box into another, resulting in a net loss.

Personally I avoid MDS like the plague. The vast majority of patients requesting them don't really need them, and of the patients who can't manage their medicines a reasonable portion of them wont really be helped by an MDS either.

Peter Dickson, Community pharmacist

The only reason the really big boys make money from care homes is.......they get the drugs for next to nothing-simple as that. lets see them make a profit if they have to buy crestor etc at the list price!

Stephen Eggleston, Community pharmacist

This is a tricky one to handle well and to everyone's benefit. Contractors shouldn't be suckered in to bailing out the care homes who, as has been mentioned, went to a distance selling contractor because (I presume) they (the home) got more out of that arrangement. Yet pharmacists are obliged to have the best interests of the patients (ie NOT the Care Home owners) at heart when making any decision. It could also turn in to a bit of a PR disaster if not handled carefully

Disillusioned Pharmacist, Community pharmacist

91p dispensing fee to take tablets out of blisters to put into other blisters, racking, MAR sheets, deliveries at any time of the day or night, booking in and meds management service, free meds trollies, free fridges, free scanning technology for safer administration of medicines- it was never going to work I have said for many years now that Care Homes do not pay. Since all the GP's stopped with the weekly scripts there is literally no incentive for having Care Homes as the majority of your business, yes it gives you buying power and of course the multiples absorb these loss making venturea by having minimum staff & maximum pressure for services whereas an Internet Pharmacy cannot provide Advanced Services therefore resulting in the poor remuneration being laid bare for all to say as in this case.
We need to stop doing everything for free! Let's not provide our supply function for just one day and see the health service go into melt down and then we may see what value they place on our service. As I have said in the past, it does not matter what the Dr. (who are treated like little gods and patients wouldn't dream of being on their mobile phone whilst being spoken to by them) writes on the prescription if we do not supply it then the patient will suffer one way or another.
NHS England need to sit up and take notice, if Co-op Pharmacy were making a decent profit do you think it would be up for sale? Xmillion pouds sounds impressive on paper but when you break it down to all the shops it is merely 3.6% profit- the TSB current account offers 5% interest on your money!

John Urwin, Community pharmacist

When MDS first came into care home use a few years ago a large multiple decided "Tee, hee, we'll do this for free, rake in all the business and massive profits will ensue from all the additional sales we get." Soon everyone was emulating hamsters on a wheel and only the care home owners were benefitting as they could use less qualified and therefore cheaper staff. This is nothing to do with the NHS as such.
If there was a care home nearby suddenly looking for a pharmacy to supply their patients due to their existing pharmacy's business model being unsustainable, I would say "Yes, we can supply you. Either in original packs, as supplied to most of our patients, or there will be a monthly charge per patient for use of MDS" I would do this knowing that if they insisted on MDS and would not pay for it I would be no worse off if I declined to provide them with their medication. Perhaps this firm's demise will provide pharmacy with the opportunity to seek payment for an incredible amount of work currently being done for free.

Disillusioned Pharmacist, Community pharmacist

I take your point John however we have to be very careful with regard to the Disability Discrimination Act when refusing to supply in blisters and if you refuse to supply at all then there is the risk of losing your NHS contract.
I know I haven't got the time to go and assess every single care home resident to see if they really need blisters or not and even having done that they would probably go to the nearest multiple and get blisters for all residents for free.
As usual we are stuck between a rock and a hard place, GPhc will jump on us for not putting patient's best interests ahead of profit, CCG could revoke contract for refusing to supply, face a lawsuit for contravening DDA or we take on a labour intensive loss making venture just to keep the doors open.

John Urwin, Community pharmacist

I disagree. We are talking about care homes. The DDA does not apply. The request for MDS is purely for the care home's convenience. A "reasonable adjustment" has already been made when the resident entrusted their care to the home. Either the resident is paying handsomly for their care or the state is via the local authority. Your provision of MDS under the DDA is paid for (badly) by the DH. The state does not expect to pay twice for "reasonable adjustments".
MDS for care homes is a purely private matter between the pharmacy and the care home management.

Disillusioned Pharmacist, Community pharmacist

Ok John Randell no need to SHOUT! I agree entirely with what you say and if you read my first post on page 1 you will see I have said exactly the same thing, I am just pointing out that refusing to do them may bring other consequences to our door.
John Urwin you certainly seem to know what you are talking about when it comes to the law but how the GPhc would view us refusing to supply on the grounds of lack of profit I do not know and to be honest I wouldn't want to be the one to test it with them or legally either.

John Urwin, Community pharmacist

Oh dear DP, are we really living in a world where "professionals" tiptoe around terrified that the GPhC may take an extreme view of a fairly simple matter?

Disillusioned Pharmacist, Community pharmacist

I freely admit that I am, I have a family to look after and bills to pay. Did you see the case where a Pharmacist of many yrs unblemished record got struck off simply because he didn't tick that he was patient rep and then cross to say he hadn't seen evidence of exemption with his mds & carehome patients?
You only have to look at the various ftp cases to see the GPhc taking an extreme view of a fairly simple matter, in fact that that should be there tag line!

London Locum, Locum pharmacist

The GPhC sure do like a striking off. They almost seem to derive joy from it especially when in cahoots with a certain multiple.

Tim B, Locum pharmacist

That's why the number of pharmacists has been greatly increased; to give those goons plenty to strike off!!

London Locum, Locum pharmacist

It would seem the increase definitely gives them plenty to do

Tim B, Locum pharmacist

Having read what has been posted already, it seems as though the penny ( excuse the pun here) is dropping. If a service is provided then it is reasonable that a fair charge is made for providing it.
A lot of patient benficial services have been given over the last 20 or so years for free eg delivery, mds etc etc. Pharmacy contractors moan about fee cuts, discount clawback , poor contract remuneration. The government sees all this being provided for noot, then think we are making a very tidy profit in the first place to be able to do it!. This isn't rocket science. Why don't you all stop being so naive and have the guts to charge for the services you currently do for nothing.! Perhaps then your profits would improve significantly.

John Randell, Non Pharmacist Branch Manager

BASIC ECONOMICS....MAKE SURE CARE HOMES ARE A VERY SMALL PART OF YOUR PORTFOLIO....THEY ARE A TIME WASTER AND TIME IS MONEY...the effort involved in dispensing and checking a carehome MDS/BLISTER is 2 times greater than whole packs.


Z ZZzzzz, Information Technology

If you take the time and effort to time properly how long it takes to label, dispense, check, pop out from blisters etc etc you will find it takes at least 10X longer to complete the dispensing process for an MDS patient than it does for an non-MDS patient. Time is money and anyone doing MDS in a big way has to be financially incompetent with an accountant that is hopeless and will go the way of Pharmacy Plus.

thepharmacist Forever!, Pharmacist Director

Agree, plus the expensive cost of MDS equipment, plus stationary

Paul badham, Community pharmacist

Gps still prescribing 7 day in Gloucs!

[email protected], Non healthcare professional

Stop having a go at Ozil - he is entitled to his opinion.

P M, Community pharmacist

this post is obviously written by ozils mum....



Ryszard Cygan, Superintendent Pharmacist

I am NOT having a go at Ozil. I absolutely agree with you that he is entitled to his opinion and I have no issues with his opinions, EITHER. In fact, I am totally indifferent. However, I am merely pointing out the inaccuracy of his profile. After all, he IS a healthcare professional, ie he is a pharmacy contractor and his his postings need to be viewed in that context.

Fed Up Pharmacist, Community pharmacist

he says he is, however i'm not sure he is either a healthcare professional or a contractor.

Ryszard Cygan, Superintendent Pharmacist

May quote Mesit Ozil from an article published on 7th May 2014 regarding the HMRC U-turn on £2,000 - "Pharmacy is a job which pays the bills. It's not my life" and "For the record...I am a contractor "

thepharmacist Forever!, Pharmacist Director

May be a contractor, but not a healthcare professional? So has a superintendent employed in limited company?, title may still be right, if so a very informed non healthcare professional, maybe a accountant ?!?! ...... Or dare I say a dispensing doctor ... But I am sure they are healthcare professional ?

thepharmacist Forever!, Pharmacist Director

In regard to Osil..

thepharmacist Forever!, Pharmacist Director

Ozil, Can seem to edit my post


Who rattled your cage...?
We live in a democracy. I am free to call myself whatever I like..

Ryszard Cygan, Superintendent Pharmacist

Clearly, I think the one that is rattled is you Mezit Ozil! HOWEVER, I agree with you, that we live in democracy and clearly you are entitled to call yourself whatever you like. But, in a democracy, anyone who believes in their views, will stand up for them, in your case - as a pharmacy contractor and not hide behind a facade of a "non healthcare professional". After all, we live in democracy and as pharmacy contractor you are perfectly entitled to express your views, and stand by them.


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