As part of a series examining the state of community pharmacy across the UK, Eoghan O’Brien, contractor at Bannside Pharmacy in County Antrim, speaks to reporter Costanza Pearce about how he sees the sector in Northern Ireland
How would you describe the current state of the sector in Northern Ireland?
Challenging. The funding situation is still very tight and the price of medicines fluctuates on a daily basis, so there are a lot of instances where we’re not getting reimbursed for what the medicines are actually costing us. The payments coming in are being reduced but our overhead costs, such as pension payments and minimum wage, are going up all the time.
Our pharmacy is fortunate in that we’ve got a good counter trade and we specialise in supplements and even some complimentary treatments and quality skincare products. That has become more important now because there’s more of a margin that can help to offset what we’re losing at the supply end.
What have been the biggest changes over the past 10 years?
A very positive change has been the shift towards more services and medicines use reviews (MURs). Another is the Building the Community-Pharmacy Partnership (BCPP) programme, which enables pharmacists to get into the community and connect with different groups. It’s been a real positive.
It’s great to do MURs but one of the downsides is that the payment for them came from a cut in dispensing fees and dispensing still has to be done. It’s not an option without a second pharmacist now but not all community pharmacies are in a position to have one.
At times there’s a feeling that community pharmacy is being undervalued and there have been more resources pumped in towards practice-based pharmacists. I think they’re a real asset to the practices and they’re good for the profession, but when you see the funding being cut in community pharmacy and then funding being found to produce practice-based pharmacists, it just doesn’t look good.
When we look at Scotland, we get a bit envious of their model, which is so proactive in investing in community pharmacy. I’m sure they’ve got their own challenges but there’s a collaborative approach towards moving everything forward. I would love if there was more of that here.
What are the particular threats you perceive to independent community pharmacy in Northern Ireland?
We face the same threats as independent retailers in every sector and that’s from online. Having said that, I don’t see it so much as a threat because our strength is our personal contact with people and that’s where we need to focus. If we start trying to compete with online businesses, we don’t have the resources to do so and it becomes more of a financial model rather than a patient-centred one. We need to keep people coming in the door.
Any particular opportunities?
Connecting with people and getting out into the community more. We have conversations on a daily basis about basic nutrition because it’s a cause for so many long-term conditions.
I’ve been working on an educational programme for the last couple of years with people with type 2 diabetes to help them understand the impacts of certain foods. We’ve had some promising outcomes with good improvements in [average blood sugar levels] and reductions in medication of some cases too. That’s a real positive and there’s a model that we’re working on so it could hopefully be scaled and spread.
What would you like to see in the future?
- Appropriate remuneration for what we’re doing. I really don’t think we should be dispensing at a loss – no business anywhere can survive with that model.
- More enhanced services as an option and again, remuneration for them.
- MURs being evolved so that we’re constantly trying to make services better rather than right.
- More horizontal integration – it’s a term that I’m very happy to hear being used, particularly by our acting chief pharmaceutical officer a few times. We are going to get access to the electronic care record so the ball is finally rolling for that.
- We need to be working smartly and efficiently, but ultimately and most importantly focused on better patient outcomes.
If you could ask for one thing from your politicians, what would it be?
Get back into Government. It’s a scandal.
A sector in crisis
- In 2016, then health minister Michelle O’Neill published a 10-year healthcare plan with pharmacists playing a central role in primary care
- Since the NI assembly collapsed in 2017, the Department of Health (DH) has had no health minister
- The 2017/18 community pharmacy funding package saw a drop of an estimated £20m, according to Community Pharmacy Northern Ireland (CPNI)
- In November 2018, a funding boost of £11m was granted to last until March 2020 but was described as a ‘sticking plaster’ by the CPNI