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Community pharmacy in England at the precipice

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THE 6 per cent cut in the community pharmacy global sum, announced in open letter to the Pharmaceutical Services Negotiating Committee’s (PSNC’s) chief executive, Sue Sharpe, from the Department of Health, has opened a chasm of despair between pharmacy contractors and NHS England, which asserts that there is more scope for efficiency savings on top of those that have already been made.
In a split from reality, the Government believes that these efficiencies can be made “without compromising the quality of services or public access to them” [cue raucous laughter from people who have actually worked in community pharmacy]. The imposed cuts, which amount to an average of around £14,500 per pharmacy, have served to further exasperate those who are questioning the very existence of an increasingly beleaguered PSNC, and demoralise pharmacists at the busiest time of the year.
And don’t forget it’s not really just a 6 per cent cut, as prescription volume increases annually by around 5 per cent, community pharmacy will be working 5 per cent harder for 6 per cent less in 2016/17 – a real terms cut of 11%. More worrying, however, is that this 6 per cent is a minimum cut; there may be more to come.
It’s understandable that non-community pharmacy employees see this announcement as an opportunity, as it does mention a Pharmacy Integration Fund to “help transform how pharmacists and community pharmacy will operate in the NHS, bringing clear benefits to patients and the public”. There will also be a Pharmacy Access Scheme which will provide more funds to certain pharmacies depending on the health needs of local population. Both sound great (if a bit nebulous), but there are a few things to note here: the Integration Fund isn’t ring-fenced for community pharmacy, we have no idea how much money is available, and the Access Scheme will mean some pharmacies receive reduced payments. Show me an employee with a guaranteed known monthly income who would relish an ‘opportunity’ that involved a 6 per cent salary cut and an increased workload of 5 per cent.
Community pharmacy does need to change and I have argued for that change, but for it to work, and for community pharmacy to reach its potential, at the very minimum we need a stabilised income that keeps pace with the increasing workload. Inevitably when we look back, perhaps we’ll wonder why that change wasn’t wholeheartedly driven by the profession before now and reflect on missed opportunities. My feeling is that the pharmacists in GP practices initiative may be a Pyrrhic victory and that focusing on the bigger picture would have been better, although it’s likely that these events were out-with our control anyway.
But we are where we are, and now is the time to fight. The profession needs to unite as never before, and this is the part I worry about. It’s not about contractors versus employees; our fortunes are bound together and pharmacy organisations must divest themselves of historical acrimony and combine their resources to fight these cuts or we will all suffer.
The community pharmacy precipice is here: we need to get our house in order, come out fighting or make the mistake of grimly clinging to an ever crumbling edifice. I’m no longer a contractor and I don’t work in England, but I wholeheartedly support my colleagues at this crucial time. Make no mistake, we are now fighting for the very existence of community pharmacy.

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