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NHS chief: We must be 'resolute' about 'controversial' cuts

Simon Stevens: We're spending around £2.8 billion in order to "dole out £8 billion-worth of medicines"

NHS England must be resolute about its “controversial” funding decisions, chief executive Simon Stevens has said when questioned about community pharmacy.

Speaking at a parliamentary Public Accounts Committee oral evidence session last week (September 14), Mr Stevens responded to a question from Labour MP Karin Smyth about pharmacy minister David Mowat's announcement that details of a planned cut to pharmacy funding would be delayed.

Ms Smyth, MP for Bristol South, said: "There has been a reprieve or a delay for cuts that were in the forward budgets for next year. Community pharmacy, we read, has been saved."

After first announcing that the planned 6% cut to pharmacy funding in England is to be delayed beyond October, the Department of Health wrote to pharmacy organisations last week (September 14) to inform them that a funding "package" for the sector will be announced in mid-October – and implemented in December. 

Ms Smyth said the delay to the funding decision does not give confidence that there is an "overall plan [for the health service] that people are sticking to".

Mr Stevens denied Ms Smyth's suggestion that a delay to the £170 million cut to funding amounted to a "raid" by the Department of Health on the NHS. But the delay in implementing the cut is a “further budget pressure”, which he is “having to manage”, he said.

Community pharmacy is “hugely valuable”, but there are “legitimate considerations” that the NHS is spending “something like £2.8 billion” in order to “dole out £8 billion-worth of medicines”, Mr Stevens claimed.

"There are efficiencies to be made in every part of our cost structure," he said. 

"In order to deliver against the funding that we have, we are going to have to be resolute on some often quite controversial decisions," Mr Stevens added.

Royal Pharmaceutical Society fellow and former president Steve Churton told C+D that he hopes Mr Stevens' comments do not reflect that NHS England “fundamentally misunderstands the role and value of community pharmacy”.

Referring specifically to Mr Steven's comment about pharmacists "doling out" medicines, Mr Churton said it "does not bode well".


What action is your pharmacy taking now the funding cut has been delayed?
No action
Investing in the business again
Continuing to make savings in case the funding drop is confirmed
Total votes: 172
What do you make of Mr Steven's comments?

Marc Borson, Community pharmacist


The U.K. Spends the least on health per capita than any other country in the developed world.

The government is trying to poison the beast that is the Nhs so eventually we all turn to the private providers for a consumer lead service. 


Z ZZzzzz, Information Technology

So following Mr Stevens' logic it would be okay to spend something like £2.8b if the cost of drugs was something like £100b.  Someone please buy him an abacus for Christmas.  Big Pharma you now have the go-ahead to increase your drug prices by whatever percentage you can get away with.  He doesn't strike me as someone with any intellectual or communication skills.  Perfect for the position he now finds himself.  Just like his mate Jeremy Hunt who obviously does not think there will be any cost to anyone in the supply chain to implement his stupid idea of medicines cost printed on labels.  I think they should go on tour as the 21st century versions of Laurel and Hardy.

Andrew Low, Community pharmacist

"Doling out medicines" is a tough expression.

Having schizophrenia I am prescribed sulpiride,which has a brand name "Dolmatil",and many a time I have felt like a burden to the NHS,and been called that too.

It is appaling how pharmacy is treated,and staff can be run ragged.

May I suggest Sahaja Yoga meditation.It is my main lifeline.Now there is medical evidence,for example the book "Silence Your Mind" by Dr Ramesh Manocha,GP and researcher at the university of Sydney in Australia.

What do medicines really do for my condition,symptoms being a vulnerability to the sound of coughing and traffic and guilt and voices?Can they help as much as Sahaja Yoga with what psychiatrist Carl Jung called the (painful) birth of collective consciousness.

We need GPs and mental health nurses and psychologists and pharmacists to lead the way.

Chris Mckendrick, Community pharmacist

Mr Stevens, you will be pleased to know that I have already started making efficiencies in my cost structure. For 21 years I have subsidised NHS pharmaceutical services locally by opening on Saturdays, however these extra voluntary hours are not sustainable so I now only open for my contracted hours, Monday to Friday. On the plus side I now get to enjoy something I remember fondly from my childhood - a weekend, and also from your point of view, it's one less day per week that I'll be doling medicines like some pathalogical maniac trying to bankrupt the NHS. It's very sad that my "Saturday" customers will have to join the dole queue at the Town Centre Chemist, Green Wally's that is so reminiscent of the 1979 "Labour isn't working" poster, but at least we're well on the way to solving the local problem of pharmacy clusters. Keep up the good work.

hilary cunnane, Locum pharmacist

Well said Chris, enjoy your weekends!!

Dave Downham, Manager

Never mind the dismissive, disrespectful "dole out" comment, if "...we are going to have to be resolute on some often quite controversial decisions" that suggests that they have stubbornly paid no notice whatsoever to all the petitions, PwC reports, negotiation behind closed doors and general warnings of apocolypse..

Graham Phillips, Superintendent Pharmacist

Chris and Barry are both 100% correct.. we cannot continue like this but please don't leave everything to the National Pharmacy Bodies. This is hand-2-hand combat and we must ALL play our part.  Please get right behind the NPA campaign

Barry Pharmacist, Community pharmacist

Mr Stevens claimed...."Community pharmacy is hugely valuable, but there are legitimate considerations that the NHS is spending something like £2.8 billion in order to dole out £8 billion-worth of medicines". This sounds like he doesn't think Comminity pharmacy is worth the money being paid already and therefore our negotiators must focus on this. Without community pharmacies and Cat M the NHS would be spending £10 billion on meds!

S Morein, Pharmacy Area manager/ Operations Manager

Any competant buyer can negotitiate major discounts on products. It is nothing special, supermarkets have been doing it for decades. The difference is that supermarkets pass the majority of the savings on to their customers whereas contractors pocket vast amounts of savings that fail to be reclaimed through Cat M.

Dave Downham, Manager

Quite right - my local 7,000 independent pharmacy has the negotiating power of Tesco, Walmart et al to bully suppliers into giving me a massive discount. It was just the other day that I had AAH and Unichem giving me massive backhanders just so that I would buy from them having taken us out for a big lunch. I was able to get the pharmacist to do this because he spent 5 years learning how to be a buyer and so is a specially trained negotiator who has nothing better to do all day than thrash out deals with massive corporates who are very generous with their straightforward, uncomplicated buying schemes that enables us to have a transparent enormous profit on every single line we dole out. We make 76.3% buying margin on every line and never ever dispense anything for less than cost. Also, we can be confident that the amount we receive will be the same month on month, so we have not bothered to look at the costs of the business and are in fact looking to recruit extra staff while giving existing ones a big payrise.

S Morein, Pharmacy Area manager/ Operations Manager

The facts clearly demonstrate the fiction of your reply. Pharmacy goodwills are at an all time high. Gross margins are vastly in excess of those possible under the contractual framework. Contractors profits are out of all proportion to the risk to capital employed in a controlled market.   And gaming of prchase profits to fund these excess rewards remains the key driver, profits that should be used for patient care not contractors cars.


Simon MEDLEY, Community pharmacist

funny, I reckon i couldn't sell my pharmacy if I tried at the moment- well not for more tha I paid for it in 1996.  The excess massive profits you imagine are being made by the vertically integrated companies, not the small contractor....  ( just broken one of my rules my responding to your inane and provoctive comments- but hey ho ! )

Dave Downham, Manager

I know the feeling Simon - responding to him made me feel dirty.

Dodo pharmacist, Community pharmacist

This just shows that those at the top of the NHS have no idea about what community pharmacy does. If that is their attitude then we are surely doomed.

Locum from yorkshire Pharmacist, Community pharmacist

It does astound me that someone with the intellectual and communication skills to 'rise' to such high ranks in the govt. Can use such ignorant and humiliating language about us and our beloved profession. Come on representattive bodies. This guy deserves a broadside. !

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