The Pharmacy Show returned at the National Exhibition Centre (NEC) in Birmingham on 7 and 8 October.
Pharmaceutical Services Negotiating Committee (PSNC) chief executive Simon Dukes was present to discuss the challenges community pharmacies are currently faced with.
Here’s the pick of what The Pharmacist learned from him.
- Pharmacy funding is ‘not fit for purpose’
Opening the first day of the conference on Sunday (7 October), Mr Dukes acknowledged that the current pot of funding for community pharmacy is ‘not fit for purpose’, with many pharmacists facing uncertainties about how much they are reimbursed for the services and medicines they provide.
Mr Dukes said: ‘The sector has survived over the years but [the reality is] pharmacies are struggling. We need stability to explore and pilot new funding models.’
He was amazed by the resilience the sector has been showing against the ‘four Cs’ – competition, cuts, clawback and cashflow, he said.
‘Patients are not aware of the just-in-time delivering process, of the amount of time pharmacists spend sourcing medicines and certainly not that this system provides such value for money for the NHS,’ he added.
‘Patients are also being isolated and insulated from the pressures other parts of pharmacy are facing. That’s a testament to the professionalism and passion I’ve seen in the sector because in many cases pharmacies, are dispensing at a loss.’
- Government won’t increase funding for same old services
Although Prime Minister Theresa May said at the Conservative Party in Birmingham last week (3 October) that austerity is ‘over’, Mr Dukes told delegates that the Government is not ‘going to pay more’ for pharmacy, while seeking ‘more for less’.
Mr Dukes highlighted that PSNC has been ‘working hard to keep the show on the road’ following two years of stasis without major negotiations with the Government – placing pharmacy ‘two years behind where we should be’.
He suggested PSNC will make the case for the sector during the next contract negotiations with the Government, with the profession ‘willing to embrace change’.
He said: ‘We’re not going to roll over as a sector. We still have to influence, [come forward] with ideas and push back where we need to but it’s about collaborating with the Government to try and reach some sort of agreed outcomes.’
- Collaboration is the key
According to Mr Dukes, the future of pharmacy depends on collaboration.
As a beekeeper himself, he explained that when a hive becomes too big, the queen disappears with half of the swarm. If not properly managed, the remaining swarm might split again until a very small and weak series of colonies remains.
‘The analogy isn’t that we have to prevent pharmacy representing groups splitting any further but it’s about working together and ensuring the management and collaboration of the pharmacy groups are conjoint,’ Mr Dukes said.
‘The challenge for us is to ensure we speak with one voice as a sector to the Government. Only [through] collaboration will we get what we want and have a more powerful voice with the Government and patients.’
- Moving towards service-based contract
At the moment, the sector is mostly seen as being a ‘medicines supplier’, which is due to the way pharmacists are remunerated based on dispensing volume, Mr Dukes said.
PSNC’s ambition is to change that reputation. ‘You’re going to be reimbursed on the basis of volume, on the fact that people go in and want their medicines – that’s how they see community pharmacy,’ Mr Dukes explained.
‘In order to change and have a more service-based offer, we have to get those messages across.’
Mr Dukes added that we need to unpick the current model, which is ‘hardwired’ into the Government and the NHS, and propose an alternative payment model or at least ‘patch the system’ to provide quicker return.
‘How can we move from a volume-based funding model to a more service-based approach overnight? We can’t. We [need] time, scale and a clear set of objectives in order to do that,’ he said.
How the sector can prepare for the future, according to Mr Duke:
- Improving relationships with the Government by collecting ideas collaboratively. PSNC is the only negotiator but this does not mean that there is only one source of ideas for the future of pharmacy.
- Exploring new funding models by moving towards a service-based contract.
- Embracing change and technology such as the new NHS App.
Mr Dukes concluded: ‘I’m very optimistic for the future of the sector. I’m a strategist and a negotiator and I’m looking at the big picture. I know the devil’s in the detail.
‘I don’t have all the answers but I’m optimistic because we’re already adapting to the changing needs of the NHS.
‘Pharmacists are in general practice, in the community, in care homes and in hospitals. That is potentially incredibly powerful and we need to make more use of that.’