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‘Why do we constantly have to go cap in hand to the Treasury to prove our worth?’


By Ashley Cohen

18 Mar 2021

As pharmacy bodies continue to press the Government to cover the sector’s Covid costs, pharmacist Ashley Cohen asks what more does community pharmacy have to do to prove its value?

One Monday morning two separate patients self-referred to our pharmacies both having an acute mental health crisis. They both needed immediate medical help. Our pharmacist spent a total of four hours with these patients, providing care, first aid, reassurance and trying to access relevant services that they urgently needed. Two weeks later one patient returned with her mother to say thank you for literally saving her life.

There is so much that pharmacy teams do week in, week out that we do not get recognition for, let alone get paid for. We are constantly referred to as the gatekeeper of the NHS, yet this work we do is never fully understood or acknowledged.

How can we capture this workload? How can we ensure that our skills, knowledge and experience is recognised? How can we make sure that the work we do is communicated to relevant stakeholders within the NHS?

A debate took place in the House of Commons last week to discuss the role community pharmacy has played during the Covid-19 pandemic. I use the word debate loosely. What was clear during the session is that every single person who spoke across all sides of the political spectrum were all in full admiration of the role that community pharmacy has played over the last 12 months, and the role they should play moving forward. Key themes that came out from the debate were:

  • Community pharmacy had played its part in fighting the pandemic.
  • The sector was the frontline of services and remained open and visible throughout the last 12 months.
  • Our response as a sector is appreciated by all.
  • The work we do currently saves 0.5 million GP appointments and 57,000 A&E visits every week.
  • We are well-respected members of the NHS family.

We need to be funded appropriately and unanimously MPs wanted the £370m advance loan to be converted to a grant.

MP after MP quoted all the incredible work that goes on within pharmacies nationally and within their own constituencies, and every single MP who spoke, pleaded with the Government to write off the £370m advanced payments and to provide a stable and acceptable funding platform moving forward.

Pharmacy minister Jo Churchill again thanked our sector for all we do, and applauded our passion, hard work and commitment, and recognised that a more sustainable funding mechanism is required.

So, I ask the question again: what more does pharmacy have to do to prove its value?

Our professional bodies have been for many months providing the Department of Health and Social Care (DHSC), Treasury and ministers, with audits, excess Covid costs, analysis, reports as to the work we have done; costs we have incurred over the course of the last 12 months.

However, the only comfort to pharmacy contractors during Ms Churchill’s speech was that she was still talking to PSNC and others about Covid costs, and how these can be calculated and then deducted from the advanced payments.

She did give some comfort by stating “We need to assure ourselves that community pharmacies are financially stable. Without that stability, they cannot deliver those services”.

I know the whole team at PSNC are working literally round the clock, compiling evidence and negotiating for our sector, and I hope that they can continue to convince those relevant individuals, and departments of our Covid costs to date.

Independent contractors – same as general practice

We don’t want to be treated any differently to other professionals – 90% of our funding is through NHS services, and as independent contractors we are no different from GP practices. Yet it was announced only last month that general practice is to receive a national uplift of their global sum of 4.1% in their 2021/22 contract funding.

This uplift is on top of other Covid specific funding. So why do we need to constantly have to go cap in hand to the Treasury to prove our worth and prove the value we make day in day out?

I am fully aware that, although it has and continues to be a tough and challenging environment, there are so many exceptional beacons of good practice up and down the country working innovatively and breaking down barriers.

Phlebotomy services, supporting prisons, supply and medicines management to Community Intermediate Care (CIC) beds, diabetes screening, weight management services, asthma clinics, not to mention the hundreds of pharmacy teams up and down the country involved with pharmacy-led Covid vaccination sites.

NMS, Discharge Medicine Service and CPCS are a start, but the volume of referrals and overall income will not replace a) the lost Medicines Use Review (MUR) income or b) provide any seismic shift from our dispensing and volume-based model.

As a sector we are a profession of innovators and entrepreneurs as well as clinicians. So, we need to continue to innovate and show clinical leadership.

My plea to you all whether you are a contractor, locum or employed is:

  1. Keep in regular dialogue with your MP to make sure they are aware of our plight – template letters are available from NPA/PSNC websites.
  2. Engage with your local PSNC regional representative and your LPC committees. Talk to them, tell them the issues you face so that they can represent you and feed this back.
  3. Ask your patients and local community to shout loud and proud about all the fantastic work you are doing day in and day out. Don’t let all the incredible work that is being done go unheard.
  4. Consider how you provide services and look at what you are currently doing that is not funded? Effort and resources need to be put into areas that are reimbursed nationally/locally. There is no point in us being busy fools. Learn sometimes to say no – other professions do.

But, most of all, be proud of the incredible work we continue to do.


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