Ben Merriman
What is the best thing about being a pharmacist?
Just one? I love lots about pharmacy! Being in a position to make a positive contribution to patients health and wellbeing; being the person patients turn to in their hour of need, being at the forefront of medical technology; being an important part of the community; there are many reasons to love this job.
Do you own your own pharmacy?
I don’t, unfortunately. However, I’m lucky to be employed by a family run company and do have an active say in lots of the day-to-day running of the business. As well as being a patient-facing pharmacist, I’m involved with creating and reviewing SOPs, our dispensary stock buying and IT administration. I like to think I have the best of both worlds!
What aspects of the job do find a drag?
Chasing stock! Since the introduction of quotas several years ago, I’m struggling to remember the last working day when I didn’t have to spend time on the phone pleading to an operator that I really do need that box of whatever medicine that I happen to have dispensed more of this month. This is time that I could be spending with patients.
What will community pharmacy look like in England in 2027?
If David Mowat and Jeremy Hunt have their way, it will be nothing like it is now. We currently have a 14,000 strong network of healthcare sites, offering free advice early in the morning, late at night and up to seven days a week. How will this network, seeing some 1.6 million people a day, survive if centralised dispensing becomes the norm?
What can community pharmacists bring to the table right now?
We are a diverse and under-appreciated part of the profession. With a range of clinical and management skills, we could be saving the NHS money with medicines management interventions like medicines optimisation.
Any one of 14,000 pharmacies could be taking pressure off already stretched parts of the NHS by being referred to as the first port of call for minor ailments and triaging patients to the most appropriate part of the health service according to their needs.
What future activities should community pharmacists be doing?
My ideal scenario for community pharmacy would involve community pharmacists managing long-term conditions. The basic difference between a physician and a pharmacist is that a physician is the expert in the human body, disease and diagnosis and the pharmacist the expert in medicines and prescribing.
Let’s say a patient had been diagnosed by their GP as being a non insulin dependent type 2 diabetic. I would like the GP to write a clinical management plan with the diagnosis and list of treatment options. These could be pre-prepared as templates for the most common conditions.
The patient is then asked to visit a pharmacy of their choice for treatment. The pharmacist (as a supplementary prescriber) would choose and monitor the treatment, referring the patient back to their GP only if there is a worsening of the condition, or treatment failure, or treatment outside of the management plan was considered necessary.
The pharmacy would be paid for prescribing and dispensing, and decide upon duration of treatment based upon the individual patient’s needs and situation. This would utilise pharmacists’ skills and allow them to become an integrated part of the NHS, it would free up the GP to deal with patients that only they could help, and it would lead to a more patient-centred approach to care.
Should community pharmacy be paid by volume of prescriptions or by patient outcomes?
The million dollar question! As it stands, I think the NHS gets a pretty good deal from community pharmacy.
Assuming a pharmacy receives 90% of its income from dispensing NHS prescriptions, I think the Department of Health and the taxpayer get fantastic value from community pharmacies across the UK. We give out countless amounts of expert healthcare advice free everyday: from reassuring a young mother that her child doesn’t have a rash indicative of meningitis, to making sure an elderly gentleman knows which inhaler is which.
The government simply can’t separate the two functions without spending more money, which we all know they don’t have. You can’t take dispensing away from pharmacies without losing the accessible healthcare professional on the high street.
Does the recent investment in GP pharmacists mean the Government has no intention of expanding clinical services in community pharmacy?
I don’t think the government honestly has a clue how we work! On the face of it, they do make positive noises about how they want to make the most out of our clinical skills and help reduce the pressures elsewhere on the NHS. But, in the same breath, insists on removing thousands of pounds from our funding, threatening the viability of a huge number of pharmacies. How can we be expected to see patients if we’re not where they need us?
Has money been diverted from community to support GP pharmacists?
Who knows! I believe the only reason this could be suggested as an issue is the lack of understanding of community pharmacy and what it actually does from those high up both at NHS England and in government.
David Mowat has repeatedly used the practice pharmacist scheme as a positive for community pharmacy, but the two are unrelated. Both have a role to play, and both are important, but to talk of the two as if they were interchangeable is simply wrong.
Have our pharmacy leaders let us down?
Community pharmacy may not be in a great position but I don’t think any more could have been asked of those representing us. The government have ignored what is the largest petition in the history of the healthcare in the UK when the NPA and PSNC presented over two million signatures opposing the plan to close up to 3,000 pharmacies with the shockingly blunt cost cutting measures first announced in December 2015.
If the government pay no attention whatsoever to the very people they are representing, how can our pharmacy leaders be expected to persuade the government to change their course?
Do you think independent prescribing has a place in community pharmacy practice?
Absolutely. As experts in medicines it is only right that suitably trained and qualified pharmacists should be able to prescribe medicines.
A whole host of minor ailments can be treated (and therefore patients kept away from accident and emergency or general practice) with POMs. For example, it’s crazy that there is no OTC treatment for impetigo, or simple UTIs in women.
I am a pharmacist and proud of my role and my profession. If I wanted to be a GP, I would have studied medicine and, similarly, I don’t want to become a ‘GP lite’ or cheaper alternative to a medic.
Our professions have lots of common ground, but expertise in different areas. To me, it’s common sense that pharmacists should be able to use their skills and training to recommend medicines for conditions, regardless of whether they are manufactured as an OTC medicine or not.
If I am unable to resolve an issue, I should be able to refer the patient to the most appropriate healthcare professional. We all know about the financial constraints placed upon the NHS. Any money that is spent should be spent as cost-effectively as possible and community pharmacists are ideally placed to do more to benefit patient care and reduce costs borne by the NHS.
Are you an RPS member?
I am and proud of it!
If you could change one thing about the RPS what would it be?
A professional body should represent its members. I would encourage the RPS to be as proactive as possible in getting all pharmacists to firstly, join their professional body and, more importantly, engage as to how the profession should be moving forward.