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Xrayser: Independents are best suited to survive the funding deal

"If you’re not already six feet under, maybe it’s reassuring that you should survive"

The new funding contract will force further closures by keeping income on the floor for five years, but at least it won’t fall into the basement, says Xrayser

I hate it when I’m lied to. It happens with patients, it happens with company reps, but it’s worst of all when it happens with NHS England, which lied repeatedly about the official intention of the Department of Health and Social Care to put 3,000 pharmacies out of business. However, it seems enough time has passed that they can now imply the truth of their policy regarding pharmaceutical services.

I know that we’re not the only vocation to have experienced this. Since 2009, the government has obviously thought there are too many police officers, too many nurses and too many service personnel in the armed forces, and reduced their numbers accordingly. Seemingly content to allow the health and security of the country to suffer, they have now moved onto the high street chemist, with a funding freeze that sets out a five-year programme of pharmacy closures.

There’s no denying that there are clusters of pharmacies, many of which are the direct result of the incompetently planned and obviously flawed loophole that was the 100-hour contract. Inherent additional costs of maintaining extended opening hours meant that these pharmacies inevitably opened where it was most financially viable. Consequently, the attrition of the pharmacy cuts is more likely to close the altruistic contractors who are providing a necessary and desirable healthcare service for smaller or more deprived populations.

As happens so often in the NHS, the cart is put before the horse, summed up by Sir Robert Francis QC who chaired the inquiry into scandalous care at Mid-Staffordshire NHS Foundation Trust and said: “The answer is not to get the people to fit in with the service – you need the service to fit in with the people.” Therefore, pharmaceutical needs assessments are now redundant, because NHS England will never restrict funding for pharmaceutical care to only where it’s actually needed, and is too scared to close pharmacies they deem unnecessary or poorly performing for fear of the inevitable legal challenges to any such decisions.

All that being true, I am still optimistic for the future of community pharmacy. A pecuniary natural selection will force us away from loss-making supply into a service-based model, and while the five-year funding agreement retains income on the floor, at least we have surety that it won’t fall through into the basement. If you’re not already six feet under, maybe it’s reassuring that you should survive another 60 months, particularly if you have a degree of autonomy. In contrast with accountant Umesh Modi, I suggest that independents are best suited to survive, being without the overheads of corporate structure or the need to drive shareholder return, and an ability to respond and react more quickly.

But I can only react quickly if I am freed from much superfluous bureaucracy that inevitably accompanies new services demonstrated, for example, by the NHS Urgent Medicine Supply Advanced Service. As never before, pharmacy needs to benefit from the red-tape reductionist promises of Prime Minister Boris Johnson, unless that is yet another government lie.

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


Chemical Mistry, Information Technology

Most people are Leaving  the information technology in pharmacy is in the dark ages when people think the Pharmaoutcomes platform is groundbreaking looks like it made on the BBC micro.


Concerned pharmacist, Community pharmacist

It's the same in Wales with the Common Ailments service and the Emergency supply service both of which can take 20 minutes to provide with all the bureaucracy and inefficiencies, when we could give the same support and advice in 5 minutes over the counter. For every patient that we supply commissioned low value (to the patient- usually target driven) services, a further 2 or 3 patients are denied access to higher value non-commissioned help or advice.

Joan Richardson, Locum pharmacist

NUMSAS = paperwork!  It took me 40 minutes to deal with one request on a Saturday morning - log in to an NHS email so as to access the premises NHS email - talk to patient - access SCR - make supply including putting a new patient onto the PMR - write the prescription including all of the necessary reference numbers - log into Pharm Outcomes and input all of the relevant details - then pray that you have included everything required!

Ranjeev Patel, Non Pharmacist Branch Manager

The problem is caused by mostly bald, middle-aged, non-pharmacist guys in suits making all the decisions. The computer situation is a nightmare, even if every pharmacy had an extra member of staff solely to input data and know all the usernames and passwords, it would still be a disaster. PharmOutcomes is a disgrace, it takes so long to input basic data, that the pharmacist either has to choose between putting in the data (or getting into major trouble for not doing it), or serving customers at the counter who genuinely need help. A complete and utter shambles. Why oh why are so many pharmacists still working under these conditions? Get out and do something else!

Soon-To-Be Ex-Pharmacist, Superintendent Pharmacist

Using bald and middle aged as an insult......not sure how I feel about that.......

Soon-To-Be Ex-Pharmacist, Superintendent Pharmacist

Get a sense of humour Pharmacy......we really are the most po-faced and dull profession. (Just to clarify things for the hard-of-humour - I am a bald, middle aged man and therefore was using irony to (evidently well hidden) comedic effect - dunno why I bother really.)

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