There’s a builders van that does the rounds near where I live, which carries a sign that reads: “Patel Brothers, builders. You’ve tried the cowboys – now try the Indians!"
Back in 2014, NHS England led a series of Calls to Action, one of which was to community pharmacy. Typically, instead of a single unified call with a multi-disciplinary, person-centred approach, all the calls were done in individual professional silos.
But even so, it seemed to me that it had finally dawned upon the NHS that they had exhausted the “Cowboys” (doctors and nurses – no offence), and so now it was the turn of the “Indians” (i.e. US!). Finally, community pharmacy and the NHS were on the same page, filed under the heading “clinical”.
The NHS’ consultation document promised to create a virtuous debate about the future of community pharmacy, and gave every indication it would strategically inform the redevelopment of the community pharmacy contract along more clinical lines.
There was even talk of looking afresh at all the primary care contracts and aligning them – so making GPs, optometrists, dentists and community pharmacists one big, happy NHS family.
The original consultation document noted that pharmacies are well-used (14 times per person per year – 11 for health reasons), especially by people with long-term conditions. Our ease-of-access was noted as a key strength, and community pharmacists were recognised as “medicines experts” with a pivotal role in compliance. With beefed-up medicines use reviews and the new medicine service, we looked set to take centre-stage.
It acknowledged that medicines supply was both “safe” and “efficient”, and it was noted that community pharmacists had saved £1.8 billion by driving down the NHS drugs bill. There was even growing dissatisfaction with GP access due to increased general practice workload.
There was an equally positive series of patient stories, which illustrated how community pharmacists were unsung heroes, busily preventing hospitalisations and other life-threatening catastrophes with our fantastic clinical interventions.
The profession, for once, got really engaged and responded magnificently to the call to action challenge, enumerating all the things we were already doing for patients and the public, and imagining a community-pharmacy-led NHS. It really was can-do stuff.
We had gone from being a pivotal clinical and public health resource to, as the NHS chief executive Simon Stevens recently told MPs, an inefficient service that “costs something like £2.8 billion... to dole out £8 billion pounds worth of medicines”.
Despite endless prompting, the NHS has never publicly published the outcome of the Pharmacy Call to Action, and the many hundreds of stakeholder responses, which were universally positive. So why did we go from hero to zero? Maybe we’ll never know, but I suspect foul-play. At some stage someone even took down the link where related documents were hosted on the NHS England website.
It took C+D's intrepid team of investigative journalists and an Freedom of Information enquiry to uncover what I have called “pharmacy-gate”, and get hold of all the documents. It’s a truly revealing read. Even Teresa May’s beloved “JAMs” (people who are just about managing) simply love us.
I think some serious parliamentary questions must surely now be asked, about why the NHS ignored its own consultation, which could have been used to inform an NHS Community Pharmacy Forward View.
Instead, in an act of political vandalism, health secretary Jeremy Hunt decided to irretrievably damage the community pharmacy network.