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Pharmacy Plus fiasco 'exposes care home supply weaknesses'

Representatives have urged both care homes and pharmacy providers to assess supply contracts carefully, following national supplier's unexpected closure

The unexpected closure of Pharmacy Plus has exposed potential weaknesses in medicines supply to care homes, pharmacy and care home bodies have said.

Representatives advised residential homes and community pharmacies to carefully assess any medicines supply arrangements they entered into. The warning followed the collapse earlier this month (May 16) of distance-selling Pharmacy Plus, which supplied hundreds of residential homes across England, Scotland and Wales. Pharmacy bodies suggested it presented an opportunity for contractors to re-evaluate their relationship with the care sector.

The withdrawal of Pharmacy Plus from its community pharmacy contract had a "massive impact" on residential homes, which had turned to local pharmacies to supply them with medicines, said the National Care Association (NCA), which represents care providers.

The care sector was reliant on pharmacies to deliver medication and the closure of Pharmacy Plus had been a "wake up call" for residential homes to make sure they carried out risk assessments of their suppliers, NCA chairman Nadra Ahmed said.

Care homes and their community pharmacy providers should both assess supply contracts carefully, representatives said

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Ms Ahmed told C+D that the closure of a large-scale medicines supplier was "not a common occurrence" but she could not "rule out" it happening again. Boots and Lloydspharmacy were the only two medicines suppliers that worked on a similar scale, she added

Smaller independent pharmacies also supplied care homes and there was "always going to be a worry" about these pharmacies going "bust", she added.

Local Care Home Chemist, a company that offers pharmacy services to residential homes, advised contractors to "plan ahead" when agreeing to supply homes.

"If you take on too many care homes at once without adequate resource, you can easily fall over," clinical director Asim Mirza told C+D.

"Retail pharmacies often lack the space and infrastructure to service large numbers of care homes efficiently and cost effectively but they do provide many services very well – sometimes at a loss," he added.

Pharmacy bodies said the closure of Pharmacy Plus was an opportunity for the sector to re-evaluate its relationship with care homes.

Numark director of pharmacy services Mimi Lau suggested that the Pharmacy Plus business model of "dispensing as many prescriptions as possible" from a central hub to care homes across the UK might not be the best approach.

"Care homes may have found this attractive once, but will they want that again in the future? Perhaps there is a lesson to be learnt here - that it is better to keep it local," she said.

Royal Pharmaceutical Society head of corporate communications Neal Patel said there may be an opportunity for pharmacists to become more involved in "making sure medicines are used safely and effectively in care homes".

Pharmacy Voice chief executive Rob Darracott said the closure of Pharmacy Plus due to cash shortages highlighted how "tight the cashflow of pharmacy businesses can be" and called for the government to simplify its reimbursement system.

"One or two difficult months, allied to a particular business mix, can precipitate a crisis," he told C+D.

Last week, Pharmacy Plus administrator Zolfo Cooper said 240 jobs had been lost when the company 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.

Would you be able to supply care homes in an emergency?
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Meera Sharma, Community pharmacist

May be it's now time to use this opportunity to re-negotiate the standing with care homes - it is a loss making business. So the pharmacists stepping in to sort this out "temporarily", how are you being rewarded?? Or is this just another gesture of goodwill on your part - yet again. Me thinks the NCA and pharmacy bodies need to be sitting round a table to discuss, this is not a viable set-up for the future. As someone mentioned, everyone is charging for deliveries, so why is pharmacy the exception?

A Super-calloused Fragile Mystic Hexed With Halitosis, Other pharmacist

The Car Home owners Aston Martin is parked outside when we pop around to offer the latest helping hand at no charge. I'm surprised he hasn't asked if our driver could just clean it for him when he delivers the monthly meds. Joking aside, there is no margin in Care Homes. With all your investment in equipment and supplies and a perfect performance there is no loyalty. Unfortunately the Pharmacy Plus situation will be repeated.

Chris Pharmacist, Community pharmacist

Care homes are a license to print money. Contractors should rememeber this when losing money dispensing into MDS from monthly Rx's, employing a full-time driver to collect Rx's dotted all over the place and delivering medicines on demand.

Community pharmacy should work together to agree standard fees for providing care home services instead of undercutting each other to make what they think is a quick buck. Perhaps care homes may start to realise their excessive demands and expectations are unrealistic. Yes I know, it will never happen.

My experience of care homes is that they are a pain in the backside and not worth the hassle, leave them to the multiples who seem happy subsidising losses with other parts of their business.

Hayley Johnson, Community pharmacist

I agree with this, and with many of the comments above. I found setting up and maintaining a care home contract an enormously stressful and pretty thankless task in my community pharmacy days. The demands from the care home get more and more Herculean as time goes on, but at the end of the day we know a patient will suffer if we refuse them so we end up bent so far backwards our spines nearly break.

A more joined up approach, with community pharmacy bodies working together, would be brilliant. Yes, we need to be profitable and competitive, but at the moment the current system appears to be on the whole a whopping amount of stress for not a huge amount of gain.

Leon The Apothecary, Student

Nursing Homes have a lot of choice in regards to Pharmacies, so why shouldn't they shop around? As much as it pains me to say it ~

John Randell, Non Pharmacist Branch Manager

"Retail pharmacies often lack the space and infrastructure to service large numbers of care homes efficiently and cost effectively but they do provide many services very well – sometimes at a loss," he added


Tim B, Locum pharmacist

Here, here!!

Mike Hewitson, Superintendent Pharmacist

Perhaps the care home sector should re-evaluate its attitude towards community pharmacy?
Who hasn't heard of care homes demanding free drug trolleys, MDS, medication rooms, daily deliveries….How sustainable is that business model? Look at some of the innovative work that Pharmacy Plus was actually doing around medication safety in care homes, computerised drug trolleys, etc; didn't do them much good.

Why shouldn't care homes pay for MDS, staff medication training, facilities or additional deliveries?

There is a real question about the desirability of the prescription hub, which the Chief Pharmaceutical Officers seems to be a fan of. What happens when a single enormous provider hits problems? Chaos it seems.

Anant Bhogaita, Locum pharmacist

We are too competitive within our own profession and others including the NHS, government and service users play on this. They know that we are too bendable to their wishes. Until we all unite and stand up together to say enough is enough, we will see the profession go down the pan even more. Which other profession would allow this to happen?

Tim B, Locum pharmacist

Said this 30 years ago!!

Mike Jarrett, Community pharmacist


London Locum, Locum pharmacist

Ahead of your time but |'m sure you were shouted down for it and castigated.
Pharmacy is NOT a profession, just an occupation. But you sound like you knew that already.

Tim B, Locum pharmacist

I sure was shouted down etc. Basically ,in the community setting, we are little more than shopkeepers with degrees. Thought I had entered a profession - how wrong and naive I was- and now I'm stuck with it. Who are these loonies who insist doing things for nothing??


Anaant - This is business. Community pharmacy is about making money. Anyone who says it isnt is a liar.

Stephen Eggleston, Community pharmacist

Mike, you are quite correct - many care homes make all sorts of demands and once you satisfy the, they may only stay with you for a short while. It is time for pharmacists to stop giving away their margin - or is it not small enough already? Homes only have a bargaining tool up to the point the pharmacy walks away - maybe more pharmacies should do that? Why provide a service that costs you?



Again you seem to be passing the blame to others.

Carehomes can make all the demands in the world but it's the Pharamacist that accepts the conditions. So its the profession to blame not the carehome managers.

Until you wake up and smell the coffee, and stop blaming others, nothing will change.

I recently gave up a home cause another Pharmacy opted to do blisters on monthly scripts when I recieved weeklys. So now Micky and stephen who is to blame? The carehome? the pharmacy or MR wenger or my pet rabbit Roger?

Tim B, Locum pharmacist

You are all to blame for not charging for the service in the first place. Even Tesco charges for delivering!!

London Locum, Locum pharmacist

Therein lies in the problem - NO unity. There is always another contractor down the road prepared to demean the entire profession providing a service for free.

This in a nutshell is why Pharmacy has no right calling itself a profession.

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