We bought the pharmacy last April, but we made the offer in December 2015, when the letter came from the Department of Health – setting out the initial proposals for cuts to pharmacy funding in England – and everybody started panicking.
Personally, I suspected that this was on the cards. Every aspect of primary and secondary care is under huge strain. You could see that the NHS is not really fit for purpose, because of factors like the ageing population and dwindling resources. If you look at how the other public sectors have been affected, you could see that it was only a matter of time. It would have been naïve to think that community pharmacy would be absolved of the cuts.
Not a coherent strategy
For me, the frustrating thing is you hear people in the NHS saying "Don't go to A&E", but at the same time politicians want to cut the numbers of community pharmacies. It's not really a cohesive strategy.
As a sector, we don't know what the severity of the cuts will be. But it’s clear that our bottom line and ability to provide the same level of service could be affected.
Looking at our skill mix
So what have we been doing at our pharmacy to help? Over the last year, we’ve been looking at solutions for ourselves. We're updating our premises to make them different from our competitors. We recognise that it's important that our staff skill mix is adequately trained to provide a quality dispensing service, so we invested in training for our staff, such as the technician course and the dispensary assistant course. We've also got pharmacy apprentices, who we normally recruit from the local community.
We've been looking at technology in the pharmacy, to see if we can find more efficient solutions. We’ve invested quite a lot in premises automation, and we've got a dispensing robot and a dosette robot, which have helped us drive some efficiencies in our production. We're able to take advantage of a small hub-and-spoke model, and so although we are nervous – as every contractor probably is – we've tried to position ourselves in a way that makes us lean and more adaptable to the future, so that we can survive.
Different plans and strategies
How is my pharmacy being affected? I’m not worried about the threat of closure, because I think we are in a good place. Our prescription numbers are doing ok, and we are looking to alternate other income streams: we engage with all the locally commissioned services in the area, and we are looking at doing more private services – such as those to support independent living for elderly people – because we think the demographic is changing in our area.
Contractors picking up the cost
I get that the NHS wants us to do things more efficiently – although there’s a cost attached to this, and we independent contractors are the ones who have to make the investment. But investing in more services and innovation is all we can do. You can either just give up, and let it happen, or you can do something. So we'll find different plans and strategies to offset the cuts, and we'll see how they develop. Across our chain, we have already seen some savings. We will try to be innovative and think differently about how to solve problems.
The author is a contractor at a small independent pharmacy chain in London.