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'We are on treatment for depression and scared for the future'

"We are working flat out while facing the prospect of bankruptcy every day"

An anonymous contractor is inspired by C+D’s parliamentary event on pharmacy pressures to describe how tough life has become for her family business

I bought a thriving community pharmacy three years ago in north England with my pharmacist husband using savings, a family loan and a bank loan. Now we both work six days a week, earning way less than minimum wage, with administrative tasks to finish on Sunday. There is no time off as we can't afford a locum. We are working flat out with a skeleton staff. There are enormous pressures from this stressed working environment, resulting in safety concerns. It's intolerable.

It's been four years since our last family holiday. Our personal debts are increasing. The business is in huge difficulties – the bank has put our business under ‘special measures’. We have nothing to offer to reassure it, because the new pharmacy contract means we receive the same funding following the cuts in 2016 for the next five years. Inflation will worsen the outlook further. Our sources of income are down £25,000 per year due to the loss of establishment payments and medicines use reviews with no replacement income. We feel completely trapped, demoralised and despairing. We have zero confidence in the future.

Our clinical commissioning group is in an area of high deprivation, with limited viability for private services. Our pharmacy is overlapped by four primary care networks, but they are not talking to our local pharmaceutical committee or even to each other. Our obstreperous local GPs don't like pharmacist interventions. They bully their patients about flu vaccinations with the threat of removal from their patient list if they go to pharmacies. And they go for whole weeks without issuing electronic prescription service (EPS) prescriptions, forcing patients to collect them from the surgery.

We didn't take on the pharmacy as a cash cow. We bought it just to get a decent income and an investment for the future. My husband is exceptional at doing his job as a pharmacist. He is proud of his role, and has found it satisfying and enjoyable over the 30 years of being qualified. We have never benefited from the alleged over-delivery of category M margin, having opened in 2017, but we have been continually underpaid to provide an NHS service. Reimbursement of medicines does not even cover the wholesale costs.

The reality is working flat out while facing the prospect of bankruptcy every day, instead of being able to spend more time together as a family with our son, who has Duchenne muscular dystrophy. We have no quality time, increasing debt, and instead of making lovely memories as a family, our son has parents who are stressed beyond measure, on treatment for depression and scared of the future. It's no way to live.

No amount of mindfulness, prioritising, delegating, or trying to find ‘me time’ is going to alter the appalling reality of the situation the Department of Health and Social Care (DH) – our only customer, effectively – is putting ours and many other family businesses into deliberately. Is it not concerned about the job losses? We provide eight local jobs. If 3,000 pharmacies close, with an average of five staff each, there would be approximately 15,000 job losses, caused by a deliberate government policy to close down businesses randomly, be they good ones or not so good.

The toll the situation in pharmacy is taking on owners and their families must be devastating. Only a cash injection and fair funding is going to improve our situation – hopefully before the bank foreclose on our debt or something else gives.

C+D takes pharmacy pressures to parliament

On Monday (September 9), C+D and the charity Pharmacist Support brought together MPs, pharmacy representatives and pharmacists to discuss the rise of stress and workplace pressures among pharmacy teams.

The parliamentary event took place in Portcullis House, Westminster, and was hosted by all-party pharmacy group chair Sir Kevin Barron MP.

You can read C+D editor James Waldron’s address to the event – in which he highlighted disturbing data from C+D readers about the extent of pressures in pharmacies – as well as the key points from each speaker.

If you would like to share your experiences, please email [email protected]

20 Comments

Roger Kramer, Senior Management

Who will hold whom accountable for the denials that funding reduction will close a large number of pharmacies eventually, mostly the small ones....and that without taking into account branch closures by multiples by commercial gain not available to independent pharmacies? The deny-ers will have long since left their positions!

What a pity that all governments, including Conservative ones, have allowed throttling of all small businesses and given unfair advantages to large businesses in name of what? There is more and more leakage of wealth away from small business and small man to everything big and not accountable due to constatant outsourcing of government responsibilities so no one is responsible enough to resign or be asked to.

An Anonymous Contractor Independent Pharmacy, Pharmacy owner/ Proprietor

Firstly, Jignesh, I’m overwhelmed by your kindness and generosity. Thank you. It’s amazing how a single act of kindness can lift your world. Unexpected and deeply appreciated.

The sentiments in the article are necessarily negative to highlight the real stress all pharmacy teams must be experiencing so a follow-up piece might be needed now – along the lines of ‘Reasons to Love Community Pharmacy’ starting with the assertion that pharmacists and their teams are the best! There is so much compassion, strength and humanity in the work we do – thousands of acts of kindness every day in pharmacies the length and breadth of the country and our customers love us for it. That’s the value of CP that the government and its advisers are ignoring. First port of call and often last port of call because our loyal customers know their pharmacist will always go the extra mile to help. As a fraternity, pharmacists and their teams have shown determination to keep going in the face of all difficulties for the sake of our colleagues and our customers, undervalued by DHSC but still determined to show our worth and make a contribution.

We are real people and we all have our own stories. We aren’t failing because we haven’t innovated or embraced technology, we’re struggling because the DHSC have been short-changing us for the services we provide.

Respect to all fellow pharmacy colleagues, with such empathy and concern as shown in these comments and which is inherent in community pharmacies everywhere - we’ve got this! We are stronger standing together and the future has got to look different from the one on offer now.

Huge thanks and gratitude to Jignesh for shining a light in the darkness and thank you for all the concern and support shown in everyone’s comments. Thank you Lucky Ex-Locum, N Patel & Reeyah for your kind comments.

AJ Smith, Locum pharmacist

Its strange the goodwill values of pharmacies hasnt plummeted. Lots of mid sized chains are still growing their business and acquiring new pharmacies

Charles Whitfield Bott, Pharmacist Director

your wrong, they have dropped unless you are in Scotland or NI, which have jumped up a lot

N patel , Non Pharmacist Branch Manager

All Smith....you must be a bitter locum...thjs atricle is nothing to do with goodwill values.....everyone is encouraged to be entrepreneural and get on in life. But when the odds are stacked against contractors by those who want us to provide services and meds at a loss then there is something very wrong with the system

AJ Smith, Locum pharmacist

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Benie I, Locum pharmacist

Very sad story and I'm sure there are [lenty more. Hindsight is obviously 20/20, however,  It's a very precarious business which essentially has one client(NHS). This was great when the NHS had 'limitless' money but in these constrained times its absolute disaster. Ultimately the government have little or no concern. 

Recently I was told there is no point telling people your problems because 80% do not care and the other 20% want you to have them.

 

N patel , Non Pharmacist Branch Manager

Benie... the government is thrownin money like there is no tomorrow ....look at its recent spending pledges......contractors are the only ones getting reallly really squeezed a... please dont tell me that the NHs hasnt got money even a modest sum to give to pharmacy...show me one profession and i use that term loosely that will willingly supply its services a  loss

 

Dodo pharmacist, Community pharmacist

By the end of 2024 the pharmacy global sum will have been reduced in real terms by over 30% since 2014.How do PSNC expect any pharmacy contractor to be able to continue in those circumstances? The contract they have agreed to is a disaster and can only result in many more closures.

ABC DEF, Primary care pharmacist

No one with a right mind would have purchased a pharmacy in the past 5 years or so. That has to be a wrong business move I'm afraid. But I guess what, sell up to avoid even more loss and open a grocery store instead. Why would one even want to be a pharmacist at the current state of the profession?

Reeyah H, Community pharmacist

HIJ KLM.. that was the only that was certain in 2017, the alphabet. Now please stop being negative to contractors who are now in this mess because they had no idea what would happen. 

Reeyah H, Community pharmacist

C and D please put me in touch with this contractor, if she would like to talk that is. 

Reeyah H, Community pharmacist

This is the most heartbreaking contractor story I have come across! I am a contractor in a similar position. We bought our first pharmacy during my older son’s leukaemia treatment. We thought we were building a future for our children. Here we are, completely broken. For anyone who makes a stupid comment like ‘Why don’t you just pack up?’ .. no you can’t!!! You want the 100s of thousands you’ve invested back!

 

N patel , Non Pharmacist Branch Manager

guys....i feel sooooo sorry for you...perhaps the C&d will forward this article onto the DoH and the PSNC to remind them of the human cost of the DoH's heartless pursuit of savings and the Psnc's inept handling of the negotiatons with the DoH... all this at a time when the government is throwing money around like there is no tomorrow

 

 

jignesh patel, Pharmacy owner/ Proprietor

My late mother had muscular dystrophy and i would happy to pay for a locum for a couple days for this couple to spend a few days with their son... Can the C &D assist with? Put me in touch with them?

Angela Channing, Community pharmacist

Do we know where they are? If they're in the Midlands/Birmingham area I would lend a hand.

Angela Channing, Community pharmacist

Jusr re-read, North England. Pity. Sorry. I love working for independents and do so much more to help them than I do the multiples who don't care. 

Angela Channing, Community pharmacist

If C&D can tell me where they are and how far North I may be able to lend a hand at a reduced rate to do anything to help them for a day or 2 and stay over in a travelodge, etc paid for by myself. I have been on antidepressants many years ago early in my career and I know how hard it is to simply get out of bed in the morning. You have my sympathy and I very very much hope things get better for you in the future. Are you with anyone like Numark or anyone who can give you business planning and development ideas and help? assess your stock holdings and local demographics so that you are stocking the right products in the right price range to suit your area. As for the GPs and the ETP, could you involve someone at the local CCG to go and have a friendly chat with the Drs about how their actions are affecting you. Along with the flu jab issue, could you have discussions with them/practice manager how you can share them out fairly. It seems to me, that you need some outside help from organisations, especially as you say you are in an area of high deprivation, do the surgery know how much you are struggling? what would they do if you did actually close? What would the effect be on them and their patients? I think a meeting the the Senior partner with a CCG person to act as liason/mediator may be one issue to look at? Forgive me, if you have already tried all this.

 

Reeyah H, Community pharmacist

That is an amazingly commendable act of generosity!

Lucky Ex-Locum, Superintendent Pharmacist

I have so much sympathy for you. I too have put 30 years worth of effort into pharmacy and it's too late to retrain as anything else now. My situation is not like yours, nowhere near as bad because I am an employee not a contractor, so I can only imagine how much worse the stress is for you than it is for me (and it feels awful for me). I can only admire that you are still going and I hope the people you help appreciate what they have. Best of British to you. 

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