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'Pharmacists are becoming short-changed and short of patience'

“Our teams will need further training. Who is going to pay for the resources for it all?”

The government is giving us services with one hand while using the other to pull money from our back pockets, says pharmacist Laura Buckley

The pharmacy funding contract needed a shake-up. I think you’d be hard-pressed to find a pharmacist who has been happy with the situation in recent years. And if you think pharmacists are lamenting the loss of medicines use reviews (MURs), you’d be very much mistaken. That being said, where pharmacists are relieved, contractors are left considering their options for recouping £11,200 per year.

From the initial information, new pilots in the pipeline for pharmacists to get involved with – such as identifying undiagnosed cardiovascular disease and point-of-care testing – seem quite exciting. For years our skills have been untapped and we’ve settled for the hand we’ve been dealt. Perhaps in its desperation, the NHS is finally recognising the capability that has been under its nose all this time.

Funding remains at its reduced level and the payments from MURs will be lost in the abyss from 2021, along with the hopes of pharmacists who were anticipating better from the Department of Health and Social Care (DH). Services appear to be a significant focus of the new contract, but with NHS 111 referral payments at a measly £14 per consultation and no funding increases, where does this leave us? And are we expected to be grateful, since the Pharmaceutical Services Negotiating Committee (PSNC) claims we have more funding than was originally intended? PSNC’s ‘success’ in maintaining the same level is a poorly disguised, progressive decline in funding.

It’s a five-year funding settlement for pharmacy. Five years in which we will see the transformation of community pharmacy as we know it, with services galore and a drought of funding required to sustain them. Pharmacists have called for more services; we’ve shouted for the opportunity to put our roles to use in keeping the NHS afloat. But if NHS England thinks it can ask us to provide services without adequate financial backing, it’s an insult to pharmacists everywhere. It would be prudent to forecast a five-year migration of pharmacists into other sectors, as they become increasingly short-changed and short of patience.

Pharmacists are adaptable and amenable folk. We've accepted change and worked through a considerable number of challenges set by the government over the years. An influx of new services means our teams will need further training, our pharmacies might need more hardware and our patients will expect more of their pharmacists. Without the funding, who is going to pay for the time and resources for it all? Certainly, multiples might find the changes suited to their needs, but independents will suffer. It is also likely that pharmacists will feel the pinch, as their salaries could be squeezed.

Health secretary Matt Hancock claims the ‘French model’ is the way forward; he wants to ensure we are reducing the burden on healthcare professionals so they have more time to care for the community. And what of the pharmacy contract? They are giving us more to do and less to do it with. Money made from dispensing will drop as salaries increase and the single activity fee payments remain the same. These so-called 'savings' will be ploughed back into 'value added service delivery'.

Pharmacies can provide a solution to an NHS that can’t cope with its demand. But pharmacist services aren’t just the cheap option to save the NHS. And yet the government continues to exploit us, taking advantage of our determination to provide for our patients. It knowingly gives us services and opportunities with one hand, while using the other to pull money from our back pockets. The contract is disappointing, not because the services look like they’ll make a difference to our patients, but because we'll struggle to provide them.

Laura Buckley is a community pharmacist based in north England

9 Comments

Chemical Mistry, Information Technology

In any other profession if the risk of doing the job increased then the remuneration would increase accordingly only in pharmacy it goes down !  Best to avoid any job where the NHS or the government is the paymaster i.e.go and be a plumber or electrician or like me a gardener bit of cutting a few lawns and trimming hedges lovely old ladies with cup of tea and biscuit and bit of medical advice chucked in happy days and off to warmer climes in a few months when work is slow can't wait,and mental health best it been for years!!!

janet revers, Community pharmacist

 I also am extremely worried also about the movement to diferrential diagnosis in community pharmacy with no extra training. I will be retiring in six years time so I am the old guard that was taught  NO DIAGNOSIS. The younger generattion are moving this way but I find I am having to learn to diagnose by studying this in my spare time.                                                                                                                  The referral system we have is a nightmare as customers expect far more than we can give them

 

 

 

IAN FRASER, Locum pharmacist

Truth be told it’s time to withdraw services and compliance All other healthcare providers push this threat and get recognition and suitable settlements we don’t and get taken for granted like a two year old child - either take what we give or do what? If pharmacy is to have a future it’s time to reshape/disband the PSNC and form an all encompassing pharmacy union 

When I qualified pharmacists got sround £20 per hour nurses around £6-7 and GPS around £30-35

We still get £20 nurses I would guess £15-16 plus NHS pension and GPs £80-100 plus pension so clearly whatever PSNC has done for last 25years hasn’t benefitted us or worked

 

 

 

 

 

Beta Blocker, Primary care pharmacist

When you put it like that.... it gives the argument some perspective. Why would anyone now study pharmacy? Money isn't everything but our salaries haven't increased at all whereas other professions have seen significant rises.

Jenny Etches, Community pharmacist

Is it unfashionable to say that I quite like MURs but not in the current format. I have had some brilliant consultations and interventions as a result of MURs but I don’t do them for the money. I do them for the patients. However I’ve done some appalling tick box ones because they fitted the criteria and the store manager had a target to meet. Once they’ve gone I won’t be given the time to conduct that sort of detailed consultation because the same store manager don’t have a financial incentive for me to deliver them. Just saying. 

Laura Buckley, Community pharmacist

Unfortunately, as long as there is money to be made there will be a push behind it. I totally agree with you, I enjoyed the MURs that felt more genuine than a tick-box exercise.

David Moore, Locum pharmacist

I do recall the mur. Diabetic lady. 1st item, dermovate ointment. Psoriasis on her arm, no problem. Several diabetic items, also no problem. Then I noticed a script for trimethoprim a long time back. "You're lucky, diabetics are prone to UTIs" " No I'm not." She replied. "But I find the dermovate is very good."
I sat there thinking, did I hear that right?

V K P, Community pharmacist

who covers the liabilty when something goes wrong clinically?? the mutiples can bear the lawsuit  financially. The lawsuits will come hard and fast. Moving differential diagnosis to the pharmacy sector without relevant training and upskilling is a train rake waiting to happen. hopefully no independent contractor gets caught with it. PDA are most likely drooling over the new contract as more pharmacists will require insurance cover. so the DMIRS+NUMSAS= CPCS and the aim of  CPCS is to save 20million GP appointments, so a GP appointment costs anything upwards of £35 per appointment. hence the work is diverted to the pharmacy and not even half the £35 is being remunerated. so what was the initial problem to the system?? it was not the cost of the appointments (£700million) that was the problem. the problem was GP burnout. so they decide to divert the workload to the pharmacy but the monies will not follow. DHSC secretly think: "the cheap pharmacy sector will do £700million worth of work for less than half the amount and PSNC will happily bite our hands off for that amount". PSNC  surely obliged. 

Reeyah H, Community pharmacist

Every point you’ve made is perfectly put! I have a feeling, though, the multiples will also suffer and as no pharmacist is going to put up with this nonsense and work for them. 

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