John Sargeant
IN December, the Department of Health (DH) dropped a bombshell for pharmacists in Derbyshire and elsewhere. It announced a £170 million funding cut for community pharmacy and radical changes to the way the sector operates.
Yet, the Government doesn’t seem to have any idea what the full impact will be. But, I believe, the fallout could be catastrophic for a service that is a key part of the social capital of this country – the ‘glue’ that helps to hold communities together.
Every day, 130,000 people visit Derbyshire’s 217 pharmacies, making them the county’s most accessible health locations. The Government, however, believes the sector could be more efficient without comprising service quality or public access. Chief Pharmaceutical Officer, Dr Keith Ridge, has even said there may be 3,000 too many pharmacies (which equates to a loss of more than 50 pharmacies in Derbyshire alone). We cannot allow that to happen.
The last ten years have seen a 48 per cent rise in the volume of prescriptions dispensed, while the number of pharmacies has only risen by 18 per cent. So, the huge extra workload is being met very efficiently and pharmacies already operate a lean business model.
In announcing the cuts, the DH talked of developing large-scale automated dispensing, to provide opportunities for efficiencies. This would include more ‘hub and spoke’ arrangements, and even a worrying ‘click and collect’ option with, at first sight, limited opportunities for patient counselling. These proposed changes to the existing network can only be a long-term ambition because the technology and infrastructure aren’t in place.
In any case, community pharmacies are not impersonal remote dispensing factories. In many communities the facilities that have traditionally provided elements of social capital (post offices, banks, pubs, etc.) are being lost. Increasingly, the pharmacy is the last establishment left to fulfil this role. Even the DH admits that access to a pharmacy is even more important in areas of deprivation (i.e. pharmacies are located where they are needed).
Here are just a few of the ways that community pharmacy contributes to social capital:
- Advocacy, advice (not just health-related), and signposting to other services
- Access for medicines – including additional support with compliance aids
- Home deliveries – free of charge
- Helping to reduce GP workload and improve access to healthcare services – handling patient medication queries, dealing with minor ailments, etc.
- Hospital discharge – making sure medication is ‘right’ after a hospital stay
- Local Authority services – delivering public health services and supporting vulnerable people (e.g. MAR sheets)
- Local staff talking to local people – shared values and beliefs
- A ‘shoulder to cry on’
- Friendly and usually familiar faces behind the counter to just chat with!
- A human alternative to internet services – vital for patients not comfortable with computers and modern technology
Social capital is difficult to quantify, but thousands of people will feel it if it’s lost. The Government’s proposals are a real threat to the network of community pharmacies. If the network is damaged then no amount of glue will put it back together again…
John Sargeant is Chairman of Community Pharmacy Derbyshire Local
Follow John @john_sarge