Part of The Pharmacist’s series of case studies on how the funding cuts are affecting ordinary pharmacists, a Bristol contractor explains what effect they are having on his business

Ade Williams, superintendent pharmacy at Bedminster Pharmacy

‘As with many other pharmacy contractors, the funding cuts have put enormous strain on our business and our ambitions to be the local NHS outpost in our community

‘We’re seeing funding losses in keeping with the Pharmaceutical Services Negotiating Committee (PSNC) projections.

‘We are also facing challenges in obtaining medicines due to shortages and price variations due to monthly price concession arrangements. This has made financial planning and cash flow projections very difficult.

‘It means that, rather than investing our energy and innovation into tackling the various health challenges in our community, we’re channelling all our endeavours into ensure we remain commercially viable and thinking up plans to cope if the situation deteriorates.

Making savings

‘We’ve had to undertake a painstaking efficiency exercise looking at all parts of the business. We undertook this as a team, ensuring key things were protected.

‘Patient care and safety were the most important. Our team has been excellent as we continue to work together to ensure patient care isn’t compromised and our ambitions, although scaled back, aren’t shelved.

‘Our team is highly motivated, very effective and multi-skilled. We support each other admirably. Cutting staff hours wasn’t something to consider, as the team, much to their credit, and many other pharmacies across the country, already do much more than their job specifications demand.

‘We had a pipeline of programmes to help improve health outcomes locally, reduce the pressure on primary care providers, such as GP surgeries, whilst also pioneering some new medicines optimisation initiatives to reduce medicines wastage. Sadly, we’ve had to slow our rollout of such programmes much to the disappointment of our third sector partners and primary care colleagues.

‘We’ve also had to present a new business plan to our financiers who need more reassurance in the present environment. Daily, it’s certainly hard going.

‘As many colleagues have already highlighted, the cuts are evidently deeper and impact much more difficult to manage. Cash flow pressures have meant extra caution with all financial decisions.

‘I also note that it’s had an impact on the team’s morale. The message the cuts have sent is that, in the Government's thinking, community pharmacy teams are extrinsic to the workings of the NHS and evidently expandable when cost considerations come into play.  The body of evidence showing our health, social and financial value is disregarded.

Government rethink needed

‘We didn’t benefit from the Pharmacy Access Scheme (PhAS) but were able to fulfill all the criteria for the Quality Payment Scheme. This is due to the great support we received from the Avon LPC team. They left no stone unturned to support contractors.

‘I remain confident about the future. I do however believe a major change of policy direction with regards to the sector is desperately needed.

‘I don’t think the policymakers fully understand the potential that community pharmacy offers to radically deliver cost-effective health and wellbeing outcomes. The lost of trust and confidence, as a result of this indiscriminate cost-cutting exercise, may yet only make future collaborative engagement less enthusiastically available in future.

‘I have no doubt community pharmacy will continue to be called upon to support the NHS. I am most confident in my fellow pharmacy professionals who, in the face of all this, continue to daily create a narrative of the indisputable value of the work they do in their communities.

'We'll never let patients down'

‘We looked at things such as charging for deliveries. But about 80% of our delivery patients struggle to pay their energy bills. This service, far from being a luxury or service of convenience, serves as an enabler, allowing them to live independently. This lifeline reduces the pressure on families and social care.

‘I had a patient come in recently to offer to start paying for her husband’s delivery. Explaining that we weren’t looking to start charging for deliveries presently moved her to tears. She explained that her actions resulted from her concerns after reading about the pharmacy cuts and decisions being made to cope with it. She agonised over how to ensure we could continue to deliver to her elderly neighbours, who cannot afford to pay.

‘I reassured her that we’ll never let our patients down.’