Layer 1

Xrayser: Why the quality payment hurdles are pathetic

"Recently, pharmacy has become more like juggling chainsaws while reciting pi to 20 decimal points"

The Department of Health's lack of planning for pharmacy could be disastrous, says Xrayser

I’m sat in traffic going nowhere fast. This great city of my birth, a once-proud industrial hub, is now an overcrowded car park. I blame the planners.

Time was when you could get from the city’s outskirts into the centre within 10 minutes, thanks to the motorway. But slowly and surely, successive council planners have added bus lanes and metro-routes, and all these little add-on junctions have promised everything but delivered nothing. Then upon arriving at work, I experience the same thing in the pharmacy.

Foolishly, I thought the purpose of pharmacy was to be an advocate for patients – supporting and improving their health, and ensuring they get the most benefit from their medicines. That used to mean my days were hard enough when defined by simple tasks, like begging for an increase of stock quota while fitting in a couple of medicines use reviews (MURs). But recently it’s become more like juggling chainsaws while reciting pi to 20 decimal points.

Don’t get me wrong – for years I’ve argued for both a pharmacy quality and outcomes framework and for additional clinical services. So with the government’s introduction of a Quality Payments Scheme for pharmacy funding and NHS England’s decision to back a sore throat diagnosis scheme, I should be as happy as a billionaire elected president. If only I didn’t feel they were a sop offered to pharmacy to appease our recently acquired political support.

It’s pathetic to be offered a quality payment dependent upon having our NHS Choices entry up to date and using the electronic prescription service, along with some obscure clinical test. The Department of Health might have been rattled by our new-found lobbying power, but it’s not stopped them treating us like whiny kids for whom they’ve reached into a toy box. Out comes a threat of “no pocket money unless you tidy up your pharmacy, and here’s an old game no one else wanted to play with”.

Until someone in NHS England is genuinely converted to the concept of a joined-up primary care service, my working day will continue to resemble one of those multifunction penknives. The prescription queries stack up, while I decide whether to deliver the MUR, emergency hormonal contraception or flu jab first. Meanwhile there’s a queue of people who have been sent in to ‘ask their pharmacist’, including several asking for the sore throat test they had read about before I did.

Then I opened the newspaper to read about the chancellor’s £1.3 billion investment to ease road congestion, proof that there is public money available to invest in infrastructure. If you speak to the chief executives of clinical commissioning groups, they admit there is money that could be moved to more cost- effective areas of service provision – but won’t, as that means removing funds from the GPs or hospitals they have come to depend upon for core income.

I blame the planners.


Uma Patel, Community pharmacist

Dept of Health Pharmacy Policy is run by people who have no experience of current pharmacy environment. None of them would last a day in a dispensary. That is why they come out with these daft policies. Who is going to convey this message to the Minister.

A Hussain, Senior Management

Making sure I don't view SCR now so that I can increase my use next quarter by viewing it once, whether it's needed or not. What a joke.  

Watch a dememtia video.  Do other conditions not matter?  I have a close relative with dementia and I hate this being a #dementiafriend business.  Caring for those with dementia takes many non-clinical skills, which are just as important to the patient.  I'd rather a caring pharmacy deal with my relative rather than one who had watched a video merely to qualify for points.

Kevin Western, Community pharmacist

Think of the scenario in the DOH post 2.2 million signatures... "weve screwed the pooch this time, how can we get out of it?" 

"We could commission lots of services from Pharmacies and pay them for them"

"Dont be stupid! Ill let you tell the BMA that if you like!"

"well we cant back down - they all think we are incompetent, know nothings but that would provide just too much proof that we are.."

"I know, if we have a chat with those nice chaps and chapesses from boots/loyds, and offer them some money back for doing some stupidly simple things, we can get them to quietly forget about the whole thing, after all they run the psnc, dont they?"

"of course they will still make noises  but that will sort it..."


"what about all the extra work involved in Pharmacies? - will the money cover it?"

no but who cares...

Fionn McDonald, Pharmacy Area manager/ Operations Manager

A quality payment based on EPS registration volume, number of dossett box patients and number of advanced services offered would be adequate.

I'm not sure why they would choose NHS choices in their demands. It's a low page-view website with very poor search optimisation when looking for pharmacies. The lack of integration capability to social media also goes to show how out-of-touch this idea is.. Complaints typically go via facebook pages or direct via each pharmacy's own website. 

While I understand the need for an open pharmacy database, we can do much better than something stuck in 2005. 

Paul Knapton, Community pharmacist


Alas not from memory.

Kevin Western, Community pharmacist

who would have thought, when CCGs were set up to be run by GPs that they would keep all the money for doctors and stuff patient service - couldnt see that one coming!

Leon The Apothecary, Student

So would you suggest the CCG needs to be run by a variety of healthcare professionals so that all their interests are being met, including patients?

Kevin Western, Community pharmacist

god no! how would that work - they would want to give patients good service, spend money outside surgeries and generally wreck the gravy train...

Job of the week

Pre-registration Pharmacist
Sheffield, South Yorkshire
Up to £25,000