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Contractors are an easy target for disgruntled pharmacists

"Whilst I have sympathy with the oversupply of pharmacists... it is hardly down to contractors"

The director of a 10-branch chain says it is wrong to blame contractors for negative MUR coverage

I have been mortified to see the recent headlines about medicines use reviews (MURs) in the mainstream and pharmacy media.

At a time when planned cuts to pharmacy funding are not far away, infighting is unhelpful, to say the least. If funding is cut, it will invariably hurt all of us in the long term, be it contractor, locum, pharmacy employee or customer. 
 
I therefore find it difficult to believe that many pharmacists are perpetuating fraudulent practices. There may be the odd case of unethical behaviour by an individual here and there, but then we get good, bad and ugly in every industry. Why would any contractor, other than the most stupid, get involved in such fraudulent activity and risk losing their contract? Without specifics it is difficult to respond to the variety of allegations that are being made against contractors.   
 
The money for funding MURs was taken from the global sum. Money – which contractors used to get as a right – was taken off them and can only be claimed back if MURs are undertaken.

Most companies incentivise their staff and, as a result, even if the full complement of MURs are undertaken, the contractor gets less than he or she used to be able to get. Even with incentives in place, some pharmacists just do not want to undertake MURs, as they do not like doing them. 
 
As a director of a company that operates a number of pharmacies, I saw that pharmacists in some of our shops would do no MURs in some months, and in other months do double the 400 target for the year. I was moved to send an email to all our pharmacists in early March – before the Boots article in the Guardian broke – stating that we should be doing MURs when needed, rather than when we feel like it or simply to hit targets.   
 
Whilst I have sympathy with the position pharmacists find themselves in, and the oversupply of pharmacists in the market, it is hardly something that is down to contractors. I think this is the elephant in the room. Pharmacists’ pay has stayed level or gone down over recent years. There are many pharmacists that are disgruntled with the position they are faced with and often the easy target to blame for their woes is the contractors.
 
What I find particularly distasteful is that many are happy to continue collecting their salaries and at the same time anonymously making claims against contractors about dubious practices. 
 
I hope that C+D will consider the opinions of the overwhelming silent number of pharmacists and contractors out there who are united and working hard under difficult financial constraints.

This reader, who wishes to remain anonymous, oversees a chain of 10 pharmacies in England
 


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17 Comments

CAPT FX, Locum pharmacist

I have been trying to suppress my outrage and ignore this article, obviously unsuccessfully. I hope this contractor's opinion is only shared by him only. I also think it is high time Hard working Pharmacy abandon the dignified silence option especially if contactors share this kind of Opinion. 

Do Pharmacists complain about anything at all? The answer is no because if we did this website would have crashed after this article. This is why this article is so miplaced on every aspect. I will answer this contractor, not with academic stratospheric stuff but real shop floor issues. The rest I leave him to digest.

The biggest issue on the Shop floor is untrained staff. I am taking from the Assistant to the Non-Professional Pharmacy Manager. What I have seen in my years of Practice is just too Ghastly to put down on paper. The Pharmacists challenge every day is to deal with issues so basic that how can we even talk about complex issues. These staff members, despite their limited training have far more authority on the shop floor than the Pharmacist of the day. People might not believe it but they wield this authority on anything from Fisherman's friend to Diamorphine. In most cases Pharmacists quietly and respectfully correct issues when the deed is done. This overwhelming authority comes directly from the Contractor.

My experience with Non-Professional Pharmacy Managers is that they are de-facto Pharmacists. They hold the keys, are in early and leave late. The Contractor rarely defines the borderline between admistrative and Professional Boundaries. Pharmacists in reality are effectively checking technicians at the end. Why then is this contractor relating MUR performance to Pharmacists when the Neo-Pharmacists in the form of the Manager has all this authority. In this profession we pander to theoretical models and fit our regulatory apparatus around them without looking what happens on the shop floor.

The Responsible Pharmacist regulation or whatever it is ir virtually moribund. It ends when you stick that certificate on the wall. Noone respects it in real life.

The answer lies in The misfiring General Pharmaceutical or is it Prosecuting Council. If anyone has been to Barbados and seen the legacies of the housing for slaves. Do you think any institution would have been lauded to prosecute a slave for the state of those huts, the quality of tools they used in Plantations and ultimately the output. 

Finally to Duncan Rudkin and his crew at GPHC, real issues are on the shop floor and every day shops open they are too many to count. Go out there and for once take your regulatory role seriously. Review your priorities and dont wait for a BBC expose' to do your job for you. I also think you dont protect the public like you claim by absolving the Contractor all the time and targeting defenceless Pharmacists registrants only. It is high time you act on quality of supporting staff, poor or no Consultation rooms and not sweeping under the carpet those countless issues which leave us wondering how certain contractors are still trading.

To Mr Contractor, please never accuse Pharmacists of Complaining in this manner again. Enjoy your protection form the GPHC quietly. Pharmacists and all the lovely Branch staff we work with work under difficult conditions imposed and sustained by you and condoned by the authorities.

 

Shaun Steren, Pharmaceutical Adviser

The C and D fights back on behalf of contractors with multiple 'contractor authored' headline articles. Employees and locums remain in the comments pages where they supposedly belong. Isn't it revealing how dangerous they consider anonymously posted comments made by employee/locum pharmacists. Once again, if you can't see that you are being used when they call for unity, you deserve everything you get. 

 

P M, Community pharmacist

do you pay and subscribe to the c&d?

Pill Counter, Pharmacy

A completely irrelevant question.

Shaun Steren, Pharmaceutical Adviser

And how is that relevant to any reasoned point being made? Are you trying to put a price on freedom of expression or reasoned argument? 

Sue Per, Locum pharmacist

The author needs to revisit the contract negotiations and will note that the MUR fees did not come out of the "Core" global sum, but was a partial off set from the excessive purchase profit clawback, which the DOH were legally entitled to deduct from the payments made.

Shaun Steren, Pharmaceutical Adviser

Somehow I don't think you will see the C and D doing article on the real changes in net profit over the last 15 years, it is all about contractor propaganda is it not? Sue, I have concerns you will be labelled a troll if continue to post reasoned arguments against contractor claims, please be careful. 

Arun Bains, Community pharmacist

The author has his head in the sand... or another place that I won't mention here. Pharmacy does not have to be entirely about profit. I thought we got into this profession to help people?

 

 

Pill Counter, Pharmacy

Quite the contrary Arun the writer knows exactly what he/she is doing. You can only pity the pharmacists that work in his shops.

Kevin Western, Community pharmacist

I have to agree with Harry. - the Profession has been sold down the river by the v large multiples who will take any deal which means an extra penny today even if it means losing thousands next week. they know they can hang on to the penny and cut staff costs to recoup the thousands.

On the other hand, I do support MURs as a service - done even moderately well, it builds customer loyalty, expands the reputation of the profession AND helps patients. It also tends to tick off GPs which isnt such a bad thing from time to time.

Pill Counter, Pharmacy

Using the rules set by the likes of Hussain and PM your opinion does not count if posted anonymously. So sadly we must discount all the nonsense spouted by this director of a multiple posing as an independent. Interesting to note that this character mentions getting money 'as a right'. Very disturbing indeed. Such words are similar to these used by benefit fraudsters.

P M, Community pharmacist

shame some community pharmacists such as locums want more money for doing less.. typical of people like chauhan always complain that they are hard pushed when reality doing the same job they were doing 10 years ago and adding no real value to the business they work in, sounds a lot like lazyitis - its very disturbing indeed when they think they can carry on doing this and trying to get as much money as they can from their employers - such words sound very similar to words used by fraudsters and benefit cheats....

Yuna Mason, Sales

Typical tired spin - make it about individual pharmacists doing wrong rather than the pressure they're put under by some contractors (not all). At the same time you suggest that it just boils down to people being disgruntled about their pay. And you don't want any infighting at a time when your bottom line profit is threatened, but acknowledge the difficult conditions in the sector - why were contractors not fighting so hard against those before the funding cuts were announced. You unwittingly exemplified some of the major issues - denial and a failure to truly listen to pharmacists.

Harry Tolly, Pharmacist

 

As a 10 shop owner the DoH classifies your business as a multiple. I ask you : How many of these shops have you bought since the wicked DoH introduced MUR's ?

 

Your assertion that MUR  money is just recycled money is just plain wrong. I pity "Directors" such as yourself that have a mindset that you have a divine right to just get more and more at everyone elses expense. This is what your moaning piece sound like.

 

I think you missed this post about why MUR's are merely part of the hugely increased Global Sum :

2005/2006 - 9872 Pharmacies - Global Sum = £1,766,000,000 = £178,000 NHS GP per pharmacy

2014/2015 - 11674 Pharmacies - Global Sum = £2,800,000,000 = £240,000 NHS GP per pharmacy

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You also state that contractors are not to blame for salaries going DOWN in real terms whilst contractors have enjoyed a HUGE increase in renumeration.

 

""There are many pharmacists that are disgruntled with the position they are faced with and often the easy target to blame for their woes is the contractors."

 

How can ANY contractor justify decreasing in REAL terms Pharmacists pay when their own profits have been hugely inflated by the very generous increases to the Global Sum, the virtual abolition of Business Rates and the HUGE decrease in corporation tax ?""

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I appreciate that small one or two shop independents are struggling, but 10 shop chains (which incidentally, the DoH defines as a multiple) and the huge vertically integrated multiples clearly are not.

 

The money IS in the pot and someone is getting it and it sure is NOT the small one/two shop independent nor is it employees or locums. Small Independents, Locums and Employees are on the SAME SIDE. All 3 groups are being looted by the large vertically integrated groups.

 

SO, the real question is : who is being enriched by the huge increases in the Global Sum ?

 

And is THIS not the REAL issue (i.e. the large contractors milking the system at the expense of the WHOLE profession) which the whole profession needs to unite against ??

Harry Tolly, Pharmacist

Looks like the corporate boys in suits are voting down the above post. I wonder why ?

Dave Downham, Manager

Dunno - maybe because you are focussing on just one statistic and not giving a wider view of the picture including increases in volumes not to mention every conceivable overheads, wages etc. Is it me or am I getting deja vu with your posts?

Harry Tolly, Pharmacist

I repeated the statistic to counter the repeated dross that Gross NHS income has gone gone down for contractors whereas the fact is that it has gone up by 35%. Similarly, Business rates have been all but abolished for small shops and corporation tax has seen a huge decrease. This has all benefited CORPORATE contractors handsomely.

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In that same period employee and locum rates have stayed stagnant, and it is employees and locums that have picked up the workload and NOT corporate contractors. I do NOT begrudge the one man/one shop owner who has benefited by the increase as this individual single shop owner has every right to benefit for his hard work.

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If I were you, I would try to undertsand the bigger picture a little more rather than focusing on just stale and false repitition mantra of corporate contractors that they are worse off. THEY ARE NOT. Corporate contractors are doing amazingly well. It is hard working Employee and Locum Pharmacists that have borne the workload increase with zero increases in pay.

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