Johnathan Laird
One of the few certainties in any profession is the fact that things change. Was 2018 just another year in pharmacy or was there a seismic shift?
I don’t think pharmacy changed much in 2018 but there were some interesting developments.
Themes like Brexit, supervision, community pharmacy cuts and elections are the first that come to mind for me. I feel myself being drawn to controversy and this is not why I started blogging years ago. When I began my journey I cared deeply about the potential for pharmacists to do much more to care for patients. I still do and the part of my week I look forward to most are the two days I work in general practice.
I’ll come back to my more general reflections towards the end but first let’s take a rattle through the key developments in UK pharmacy this year.
In Scotland, the well coordinated, pharmaceutical care driven pharmacy juggernaut continues. There have been moves to support pharmacists in general practice in Scotland and most interesting for me is the obvious backing for community pharmacy independent prescribers. I think we will see more of this in 2019. ‘Brand pharmacy’ in Scotland is in safe hands and the foresight and collaborative approach by many means that ideas like ‘Pharmacy First’ are cutting through to the mainstream. In short folks, Scotland continues to lead the way and this is largely down to the leadership vision up here.
I would like to give a nod to those that have gone before because especially in community pharmacy progress would not have been possible without the forward thinking nature of contract negotiations in years gone by. Patient registration in community pharmacy, for example, may seem like an innocuous operational matter but in reality was a critical step in securing the space for a modern transformation of community pharmacy services.
A very under-reported story has been that of the mass exodus of pharmacists out of community pharmacy and into general practice. Now I only have anecdotal evidence for this at present but ask any locum agent or recruitment person working for a multiple and they will tell this well-known truth. Years ago owning a pharmacy and becoming a contractor was a viable option. I wonder was 2018 the year that the tide finally turned with young pharmacists giving up on this idea in favour of the comfort of an NHS GP practice role.
Unannounced GPhC inspection visits are set to happen as a matter of routine this year. This is yet another thing to occupy the mind of thousands of already busy community pharmacists. However, in theory, a well-run community pharmacy should have nothing to fear, should it?
The Falsified Medicines Directive (FMD) is looming. Contractors are to begin scanning on February 9th I believe. Most contractors are not ready. Folk I talk to are predicting a grace period to become compliant but that remains to be seen. Brexit has thrown a potential spanner in the works here though and there have been suggestions in some quarters that the whole concept of FMD may not be workable in the event of a ‘no-deal’ Brexit. Will this lead to a UK incarnation of FMD? That remains to be seen.
Brexit is on the horizon and with it promises of significant drug shortages. I would, however, question if Brexit is solely to blame for the inconsistency of supply of medicine in the UK market. My experience of quite a few years working in community pharmacy has taught me that there is more to the drug shortage story than meets the eye. For example, I was talking to a contractor in December who suggested to me that up to 50% of contractors are engaging in wholesaling and of course some of the multiples limit the number of wholesalers they use for commercial reasons.
The whole Brexit debacle reminds me a little bit of the ‘millennium bug’ episode back in 1999 as we headed into the new millennium. Nothing was certain then and that was the trouble. Brexit will likely boil down to being an expensive folly in my view and pharmacy, probably through the drug shortages issues most immediately, will not be immune.
So what of my life as an editor? Completely untrained and making it up as I go along but editor nonetheless.
I have pondered on many occasions, especially in the back end of 2018 if I am simply being drawn into the great pharmacy echo chamber.
Am I being influenced by a narrow vocal minority?
I think most pharmacy organisations, and goodness knows there are loads of them now, are really struggling to answer this question too. Fragmentation of the traditional pharmacy representation groups has continued throughout 2018. There is little doubt that social media and the resultant flattening of traditional hierarchies have driven this proliferation. Many are opting for a ‘pick and mix’ professional support option. And this could be seen to be tempting.
Say for example you have an interest in a given clinical area there will no doubt be social media groups dedicated to this. So why join a professional support organisation?
I’m beginning to meander and ramble in this blog but actually, I don’t care because that is reflective of how my mind has been travelling of late.
I have, for example, observed this year, at times with horror, how senior leaders in our profession have interacted under the supposed guise of ‘leadership’. Everyone seems to be jostling for position to make sure their profile gets the most attention. It can be quite nauseating.
And then it dawned on me. The future of Pharmacy in Practice must lie outwith the echo chambers. The purpose of Pharmacy in Practice must be about relishing our independence and lack of political agenda. I look forward to the opportunity to publish diametrically opposed views in 2019. Everyone is welcome as long as the contribution is useful and adds to the debate.
You see organisations now are the press. They publish ‘news’ and in 2018 I have come to experience first hand how insular and protectionist the most apparently moderate organisations can be.
Would bullying, sexism or racism ever appear in the newsfeed of such organisations? I think not.
Indeed more than that in 2018 I have been asked to alter quotes of third parties, I have been asked to delete comments, I have had interviewees who refused to answer certain questions and I have had a number of interviewees who have agreed to interviews until they viewed the questions.
It would be easy to become cynical but unfortunately for these good folk (I wonder are they reading), I am not put off. This general situation is a problem. A big problem for our profession and indeed wider society. So what to do about all of this. Well, the only thing I can do is to keep going. That’s what life is all about, isn’t it?
Tell the truth and keep going.
Johnathan Laird is a pharmacist who runs mostly round in circles.