Are we going to allow the slow erosion of high street pharmacy into extinction?
Or, could there be an alternative future?
I am a clinical pharmacist with a passion for community pharmacy, so here’s my point of view.
Listening to the pharmacy press and national pharmacy representatives, it seems that there is a likelihood of more cuts in the future as well as the cuts tht have already happened in community pharmacy.
So what does this mean for high street pharmacy, as we know it?
Will we shrink into dispensing factories reliant on NHS funding, with poor staffing and increasing workloads, or, will we evolve into accessible healthcare professionals on the High Street?
Speaking with contractor colleagues, in both small independents and large multiples, it seems that there is a sense of impending doom. Some are talking about freezing staffing levels and potentially reducing training and wage reductions for their existing staff, whilst others are thinking about cutting free services such as Monitored Dosage Systems (MDS) and prescription delivery.
Is the future of pharmacy really as bleak as this?
It is likely that the cuts are inevitable and high street pharmacy will need to brace itself for what is certain to come. As a pharmacy contractor I completely understand the impact these cuts will have on the existing pharmacy business model, and, I fully support the protests against the cuts.
However, perhaps the initial cuts are a wake-up call for pharmacists. Indeed it could allow us to recognise our own potential and shape the future of our profession before it is shaped for us by those who don’t understand the role of pharmacy at the heart of the community.
We have been protesting for many years that pharmacist’s skills are under-utilised, and, those with clinical and independent prescribing (IP) qualifications don’t have a recognised role in the community. Up until 2015, there was no clear career structure for pharmacist IPs in the community, and the announcement to support pharmacists working alongside GPs was well overdue. Finally, we see that pharmacists are being recognised in primary care as professionals that make a valuable contribution to the clinical care of patients, other than simply supporting medicines optimisation initiatives.
But wait a minute, these pharmacists that are now working in GP practices, are they not the same ones that either worked or indeed continue to work in community pharmacy? Are those in community pharmacy not able to contribute to the clinical care of patients too? The advent of Summary Care Records (SCR) access, can allow pharmacists to play an even more crucial role in the clinical care of patients.
Whilst closure of some community pharmacies may be inevitable as a result of these cuts, I am optimistic, and I believe that pharmacies that are willing to embrace the challenges and re-think their existing model of service will survive, and possibly even thrive in the future.
I fear that the pharmacists who continue to think of their community pharmacy as simply a supplier of medicines and OTC products will have their days well and truly numbered. On the other hand, pharmacists who recognise their ability to deliver enhanced services in the most professional manner, and, are not totally reliant on NHS dispensing volume will indeed survive and could even thrive in the brave new world. This means that waiting for the NHS to commission services from pharmacy is no longer an option.
I believe that we need to take the ‘bull by the horns’ and invest in our high street pharmacies to provide enhanced services that people would be willing to pay for…. I hear what you’re thinking, “…but our patients don’t pay for anything.” That may be true now, but is it possible, that people, who can afford to do so, would pay for a service that offers the convenience and saves them time? Perhaps we need to seriously consider the provision of private services, either as independent prescribers or through patient group directions (PGDs), until such a time that the NHS is ready to fund such services through community pharmacy. We must not forget that high street pharmacy has a significant strength of accessibility. This may mean investing in your pharmacy so that it meets patients’ expectations, but isn’t that an investment worth making?
It is apparent that the government wants to see a change in community pharmacy with a drive to increase efficiency in dispensing so that pharmacist time is freed up to provide patient centred care in the community. Whilst there is no definitive additional funding for services, pharmacists are finally recognised to do more than dispense prescriptions and perhaps this is an opportunity for us to take the reins and demonstrate our value to our patients too.
It would be interesting to see if other pharmacists share my thoughts; or is there another option for high street pharmacy, or indeed community pharmacy in general.
Mohammed Ibrahim is a consultant pharmacist, pharmacy Contractor and clinical services director at RxAdvisor.co.uk