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Xrayser: Pharmacies are closing, yet we still owe DH ‘lots of money’?

“What accounting trick means that after years of cuts we are still in debt?”

Xrayser tries to reconcile PSNC’s claim that the sector is still in debt to the government with news that 165 pharmacies have closed in two years

Despite a running joke between Mrs Xrayser and myself that she is “worth far more than rubies and pearls” to me, it’s hard to put a value on people, and harder still to put a value on their work. Should an optician be paid more than a pharmacist? Should a company chairperson be paid more than a Prime Minister? It gets complicated if you start to factor in a chairperson of failing companies or Prime Minister of failing policies, but the point is: do we pay according to capability or outcome?

After hearing that the Pharmaceutical Services Negotiating Committee (PSNC) estimates that 165 pharmacies have closed in the last couple of years, I consider myself fortunate that I can still pay the bills. Yet still the month-end NHS Business Services Authority statement is met with dread, as payments swing wildly, like the political pundit predictions on election night. One month we are elated with the net payment and think all the woes of the pharmacy cuts are behind us, and the next month the sum is 25% less and we are deep into the darkest forest of overdraft.

One little light in my tunnel is the flu vaccination service because, in truth, I love flu jabs. Of all the things we do in the pharmacy, I find them the most rewarding, which is nothing to do with a sadistic streak I’ve yet to disclose in my GPhC revalidation entry. It is so satisfying to provide a quick, easy and simple service that is of value and appreciated by patients – which can’t be said of the Urgent Medicine Supply Advanced Service (NUMSAS) or the vast majority of new medicine service and medicines use reviews – and it always leaves me in a good mood.

So it’s a good job that I’d done lots of jabs before reading the C+D article explaining that PSNC thinks I apparently “owe the government a lot of money”.

Really? How is that possible, PSNC? Two years ago PricewaterhouseCoopers reckoned our services contributed £3 billion a year to the country. That figure can only have grown with the increased diagnosis, triage and over-the-counter prescribing we’ve provided to patients, as clinical commissioning group financial cuts mean fewer GP appointments and fewer prescriptions if you do get one.

So what sort of perverted accounting confidence trick means that after two years of pharmacy cuts we are still in debt to the government? If we have retained more profit than civil servants expected, that’s their problem. I have to guesstimate the number of flu vaccines I need in a year’s time – and can’t reclaim the value of any unused or the lost profit of insufficient stock – so the same must be true for the Department of Health and Social Care (DH).

Another reason I like to administer flu jabs is because patients say it’s such a good experience of services in pharmacy. So if the repeated cost of service inquiries can’t properly value our worth, maybe the DH should ask and listen to patients. According to them and the outcomes we provide, we’re also worth more than rubies and pearls.

A long-running C+D contributor, the identity of Xrayser remains a mystery, but his irreverent views are known by all. Tweet him @Xrayser


Leon The Apothecary, Student

Pharmacy has an identity issue first and foremost, in my opinion. If you eliminated prescriptions from a pharmacy for a moment, what do you have left? Some disjointed amalgamation of incoherent ideas with no clear direction or purpose.

Nalin Shah, Community pharmacist

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