I’m a firm believer that community pharmacy can provide a lifeline for the NHS. However, there are major issues with being that solution. Let’s imagine we can put to one side the funding cuts and the battles with other primary care providers who feel we’re pinching a slice of their pie. The biggest threat to community pharmacy being the solution to the NHS’s problems is the move towards distance supply, and how this is set to decimate the sector.
Distance supply terrifies me. Whether it’s through expensive advertising or a smart-looking app, distance supply is expanding rapidly. A quick look at the Department of Health and Social Care’s (DH) figures tells you all you need to know.
Boots highlighted “lower prescription volume” as part of the reason for its decreasing sales. Meanwhile, Pharmacy2U is investing in new premises and talking of supplying 7.5 million items a month, which would equate to them potentially cornering an 8% share of the prescription market. Such change will dramatically alter the community pharmacy landscape. This is happening. It is real.
With the current funding arrangements, struggling smaller-volume pharmacies will go under, and the multiples will consolidate their businesses. It’s going to be brutal. You’ll initially see some volume increase for local competitors as others fold, but what’s not to say that the cycle won’t repeat itself again and again, until pharmacies disappear from the high street altogether?
Is this bleak situation what the DH wishes to see? Well, apparently not. Community pharmacy can apparently “lighten the load” of general practice through service delivery. ‘Fantastic news!’ we all cry. However, by the time the bigwigs in London get it together, there will probably no longer be a viable network of pharmacies to deliver the GP practice-saving services it desires.
So, what of this new service-based funding? Will this keep all of us in jobs and keep patients healthy and out of the surgery, instead of visiting A&E or clogging up hospital wards? Are there genuinely long-term solutions on the horizon?
The patients that I see come to get their medicines and, on the whole, they just want to get in and out as fast as possible. They're not really interested in services unless they see instant or financial benefit. I can’t see the situation where service is the sole source of income and draws patients into my supermarket pharmacy.
Any premise whereby services alone could provide enough income to sustain my pharmacy is folly. Unless community pharmacy is more closely integrated into primary care – and the service element my pharmacy provides is a critical element of supply – my role and the benefit I deliver will disappear.
If community pharmacy is to save the NHS, in the interim there needs to be some form of protection from market forces – before it’s too late. I also need to see a positive vision from the chief pharmaceutical officer and the DH about what community pharmacy could do, and how they intend to integrate us into primary care. At the moment it just feels that, as a community pharmacist, I’m an unwanted, unnecessary inconvenience, fit only for the scrap heap.
The Supermarket Pharmacist is a pharmacy manager in a well-known supermarket chain. You can follow him on Twitter @Pharm_Super.