Prescription direction by distance-selling pharmacies wasn’t the only thing reviewed last month by the Department of Health and Social Care (DH). Its document also recommends the “government conduct a review of 100-hour pharmacies that analyses who uses these services and consider if any amendments to the terms of service for 100-hour pharmacies should be made”.
“Why is this?” you might ask. Because, the DH writes “…some business stakeholders raised a concern about the commercial viability of 100-hour pharmacies”, which will be a surprise to no one.
Even before the cuts to pharmacy funding in England, 100-hour pharmacies needed business well above the average contractor – business that came from existing pharmacies, because the GPs didn’t start writing extra scripts just because another chemist opened nearby. And you don’t have to wait long before an area manager lists their company’s 100-hour contracts that are making a loss, but are kept going in the hope the competition will close down soon.
The DH's review goes on to say: “Evidence was supplied indicating a very low use of early- and late-hour services from this type of pharmacy.” Well, no shit Sherlock. Who’d have guessed that this pointless exemption was neither needed nor used by patients, and consequently was often turned into an extended-hour, monitored-dosage-system sweatshop by many companies?
So how does the DH propose to address this? By considering “options to remove or reduce the requirements of the 100-hour pharmacies as set out at regulation”. In other words, allow 100-hour pharmacies to reduce their contracted core hours.
Now, some pharmacists have used the 100-hour exemption as a way to get into an otherwise unaffordable business sector, where a pharmacy is genuinely needed. They work incredibly long days with very little reward, often providing essential specialist medicine and general palliative care services for desperate patients and carers in their late-night hour of need. They’ve prevented those of us with conventional contracts having to be directed to open over public holidays by NHS England, and in many cases they are our friends and professional colleagues, for whom this could be the light at the end of a very long and bleak tunnel.
But there are many more individuals and companies who have cynically manipulated this exemption to gain a business edge over countless long-established and well-loved pharmacies. They have not won with better quality services or improved patient outcomes, but by having minimal set-up costs in the location of their choice. And they are responsible for the dilution of payment that is the funding cuts, causing the greatest possible damage to the stability of community pharmacy.
If any one of them is now permitted to reap the benefit of their cynical exploitation, there must be such an unholy cry by every contractor that it makes the pharmacy cuts petition look like a ripple on the ocean. You don’t have to be Sherlock Holmes to realise that.
Read C+D's initial coverage of the DH's review – including its references to “strong evidence” of prescription direction by some distance-selling pharmacies – here.