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Pharmacy Voice: Cuts are destructive and 'unexplained'

Claire Ward: Cuts imposed with little notice and with scant regard for the consequences

Sector is still "reeling from the shock" of the funding announcement two months ago, says chair Claire Ward

Pharmacy Voice has issued a stinging response to the government's planned funding cuts, claiming they are unevidenced and arrived "out of the blue".

The impending 6% cut to the global sum in England is driven by the Treasury's desire to save money, rather than what the Department of Health considers “efficient or safe”, Pharmacy Voice chair Claire Ward said yesterday (February 15).

The lobbying group is eager to work with the government in a “constructive way” and sees the cuts as an opportunity to change the sector for the better, Ms Ward said.

Letter to Keith Ridge

In an open letter to England's chief pharmaceutical officer Keith Ridge published yesterday (February 15), Ms Ward said the sector is still "reeling from the shock" of the cuts.

"We are very concerned that if the cuts are implemented as proposed there will be a diminishment of quality, safety and access to care for patients.

"[Pharmacy services] will simply not be viable with the proposed reduction of core funding," she added.

Official response

The government's decision to announce the cuts in December with "no impact assessment" and "no route for public comment" had "severely undermined" engagement from pharmacy bodies, Pharmacy Voice stressed in its official response to government proposals.

Slashing pharmacy funding endangers patients, risks job losses, and "destroys the long-term potential" of the sector, it warned.

"[The cuts were] imposed with little notice and with scant regard for the consequences,” it said.

On hub and spoke

Pharmacy Voice criticised the government for assuming hub-and-spoke dispensing would save money for the sector. The model was not a "game-changer", it said.

"We have significant concerns about the potential unintended consequences of moving to industrial-scale centralised dispensing, [including] the loss of interaction between patients and healthcare professionals," it said.

Plans for the future

In its response, Pharmacy Voice called on the government to make the following five commitments:

  1. Stop the planned disinvestment in community pharmacy in 2016/17
  2. Agree a sustainable long-term settlement with the sector
  3. Invest in service transformation in the same way as for other parts of the NHS
  4. Put in place a joint, coordinated approach to planning investment and implementing change, in partnership with national community pharmacy bodies
  5.  Deliver the reforms that are required to enable community pharmacy to play its full role

Without these commitments, the government will be risking the continuity of the supply chain, the motivation of pharmacists, and the potential for the sector to reduce demand on GPs and urgent care services, Pharmacy Voice warned.

Pharmacists' positive response

Pharmacists on Twitter applauded the "excellent" response to the cuts.

 



What do you think of Pharmacy Voice's response?

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17 Comments

Shaun Steren, Pharmaceutical Adviser

In Northern Ireland we have precedent - pharmacists working for £15/hour as the norm. If you combine the graduates who are about to be unloaded onto the market from the new pharmacy schools, the cumulative growth of those graduates every year, EU immigration and the large number of pharmacy closures the government are adamant must happen, then your have a colossal oversupply on your hands. With well paid graduate jobs few and far between, I'm quite confident £15/hour could be normalised. The multiples are banking on this development to maintain net profit. I am still surprised how well wages have held up, getting £20/hour is remarkable in context. However, as many locums will be able to tell you, a well known multiple has just mass cancelled a huge number of bookings, replacing them with their own relief pharmacists. I think 2016 is the year when the great unravelling will truly begin. Can we run a quick end of year competition? Jan 2017 average locum rate - I'm in at £18/hour. 

Sami Khaderia, Non healthcare professional

LOL NOTHING about openig the market.....just the say old [email protected] from contractors..!! who are just interesteed in their own jobs...

Chris Pharmacist, Community pharmacist

On the contrary Sami, the same old [email protected] from yourself.,.keep on trollin'...

Sami Khaderia, Non healthcare professional

Another contractor who thinks the world revolves around them..!!!!

Peter Marshall, Community pharmacist

There are many locations where there is an obvious need for pharmacies to merge, so perhaps incentives could be put in place to make this beneficial. There are many places where 2 pharmacies would provide a better service if they formed one decent sized pharmacy , perhaps with the added advantageof having 2 pharmacists in a pharmacy to deliver a better all round service.

It also seems like a good time to ask why  so many services are provided free of charge. Everytime  pharmacies provide free services- deliveries and MDs for a starter- the department of health must think there is so much profit in the system, that pharmacists can offer a free service on the back of excess profits in the contract. Well I guess at some point it is no longer possible to offer free services. Who will be the first to start charging ? Can't blame the Dept if you keep offering free services.

Shaun Steren, Pharmaceutical Adviser

As a matter of net profit, nothing is being done for 'free'. Even MDS and no charge delivery services are profitable - the income from the acquired prescriptions more than covering the costs (marginally in some cases). Ultimately certain activities within the pharmacy subsidise other activities. Obviously there is no rational basis for the specific allocation of payments, the insanity of the Drug Tariff empirically proves this claim........... .. Net profits have been somewhat maintained by the slashing of the wage bill and massively increasing workload. Items have increased by over 50% with a simultaneous decrease in staff hours, my estimate being a reduction of about 16 to 24 hours per week over the last ten years. Pharmacists wages are about 15% less than they were 10 years ago with plenty more to go. So you have people doing 50% more items for lower wages and with reduced number of staff hours. I still think a further increase in workload (same staff hours - more items/services) combined with a further reduction in wages (pharmacist) will be tolerated by employees. I am very confident this is how the 'cuts' will be managed in order to maintain net profit. What is the limit to this? I will make some guesses - £15/16hour average wage will be tolerated by most employee/locum pharmacists. I would guess this wage would be tolerated with an associated increase in workload of an extra 100 items a day plus an expected service delivery of a minimum of 400 MURs/100+ NMS and no increase in staff hours. I think once you drop to £14/hour people will begin to walk and you will no longer be able to maintain net profit using this mechanism - at this point the multiples will break their silence and start refusing things. 

 

Barry Pharmacist, Community pharmacist

At that rate people really would be stupid not to apply as a trainee paramedic.

 

Angela Channing, Community pharmacist

I think people will walk before £14.  Most 6th formers/students still seem to think pharmacy is a well paid and stable profession.

I think people will start to walk away when rates fall below 17/18. For all the stress and responsibility it just isn't worth it! £16 is awful, I was earning that in 1999! Can you imagine telling a GP they are set to go back to those levels of pay?!

 

 

 

Clive Hodgson, Community pharmacist

Angela, I would suspect that in the period 1999 to today not only has pay hardly risen but workload has probably more than doubled with increased script numbers, reduced staffing and of course MURs and NMSs. If you consider this in conjunction with the almost total lack of career progression in Community it is incredible that the Universities can continue to expand their intake. Those students are in for a nasty shock.

 

Rajnikant Hindocha, Community pharmacist

Excellent response however Government listens to the users of Pharmacy services and the message that this journey of attrition would impact service users has not fully reached patients to have real impact on reconsidering Government's own position.Users of the pharmacy service are voters.

Gerry Diamond, Primary care pharmacist

From the point of view of a GP practice pharmacist my experience on the ground makes the 6% cut deterimental to adult and elderly social care. Primarily, all the deliveries, medicine changes, discharges and weekly blister packs make a significant comtribution to keeping vulnerable groups independent in the community, positively contribute to patient care in care and nursing homes in very tangible ways. These cuts will impact on these people when these services delivered at a near loss should be greatly appreciated by central and local government. Hope it works out for the best.

Chris Pharmacist, Community pharmacist

Excellent point, elderly and social care is already on its knees. The impact of ending free weekly blister packs and/or deliveries would be significant. I think these services and the support community pharmacy give to these groups is underestimated yet how longer can both independents and multiples continue delivering these services at, as the funding cuts continue to bite, a loss...the govt needs to be very careful.

Arun Bains, Community pharmacist

Two pharmacies from the same multiple within a stones throw of each other, multiple pharmacies on the same street, unnecessary and target driven MURs/NMSs, short staffing to increase profits, hub-and-spoke to increase profits, no career progession, over promising and under providing, lack of effective clinical knowledge.... Have we as a profession bought this upon ourselves?

Paul Miyagi, Information Technology

Pharmacy seemed to work better when there were many more independent pharmacies and you were paid a " proper professional fee" for dispensing each item and you didn't have all these non sense MUR and NMS which  most patients don't really want anyway ( & lets face it most pharmacists don't like them either ) . Now its dominated by Boots and Loyds ,et al, and I don't hear them objecting to cuts  - not a murmur of descent- discraceful. 

Stephen Thomas, Community pharmacist

Given that the CCA, AIMp and NPA make up Pharmacy Voice it is safe to assume that the response submitted by PV reflects the opinions of all three organisations and therefore the multiples and independents are all in agreement on this.

Dave Downham, Manager

Reasoned response.

Harry Tolly, Pharmacist

Boots used to pay £150 million in corporation tax in 2006. Since being taken over by Passina and KKR it has paid virtually nothing in Corporation Tax. Yup virtually nothing.

 

This is what ultimately happens when multi BILLION corporates pay less Corporation tax than many small contractors

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