In the first in a series examining the state of community pharmacy across the UK, George Romanes, owner of Romanes Pharmacy with branches in the eastern Scottish Borders, Northumberland and Lothian, speaks to reporter Costanza Pearce about how he sees the sector in Scotland
How would you describe the current state of community pharmacy in Scotland?
I think it’s in a much better place than England at the moment. We’ve got a reasonable dialogue going between our negotiators, Community Pharmacy Scotland (CPS), and the Government.
Our national minor ailments scheme is going very well and taking a bit of pressure off the doctors. We’re going to get a limited formulary come April 2020 to extend the scheme to become a self-limiting conditions service. That will again help take a little bit of pressure off GPs and extend the role of pharmacy in the community, so I think we’re in quite a good place.
Back in 1999 when the Scottish parliament started, I was chairing CPS and we were talking to then labour health minister Susan Deacon, who being a young mother understood the value of pharmacy. That’s when we started discussions about the minor ailments service in Scotland and it’s been a good thing for Scottish pharmacy.
What have been the biggest changes over the past 10 years?
The day-to-day pressure has increased greatly because we’re doing all these extra services like minor ailments and Pharmacy First, where we treat urinary tract infections (UTIs) and impetigo in the pharmacy.
The other thing we’re finding is that while the doctors have got a great new contract and pharmacotherapy has developed, it has taken some valuable pharmacists away from community jobs. It’s now increasingly difficult to recruit into community, certainly in rural areas like mine.
Without being too controversial, practice pharmacy is quite an attractive job. A nice five-days-a-week job, no Saturdays. Pharmacotherapy doesn’t have the same stress levels as it might do dealing with the public all day. But it probably isn’t as interesting because community pharmacy has got a much more interesting position in Scotland than it did ten years ago.
We can do a lot more and the community pharmacy unscheduled supply (CPUS) means that we don’t have to see people stuck on a Saturday when they run out of medication. That patient group direction (PGD) has been a great thing for Scotland too.
What are the particular threats you perceive to independent community pharmacy in Scotland?
The rise of the bigger chains like Boots, Lloyd’s and Well that have got massive resources and locums to spread over the branches, which we don’t always have as independents. We’re back to recruitment and retention unfortunately, which I think is probably the biggest problem facing community pharmacy. As we get more services commissioned and more patients use us as a first port of call, we need to have the resources on the ground.
We have to show we can compete with our personal service and local knowledge – that’s the only way independents can compete, because we don’t have the big budgets to do advertising and so on.
Any particular pharmacy opportunities in Scotland?
The number of us that are qualified as independent prescribers is important and I like to think that with the relaunch of the chronic medication service (CMS), we could do a bit more management of long-term conditions. That would be a good thing for us to do in the future. It’s also something that would make the job in community more attractive and keep people in this sector.
Lastly, it might be a good opportunity for pharmacists to have split roles – three days in community, a couple of days in a surgery. They’d get dual qualifications and dual experience, which would be good.
What would you like to see in the future?
A successful rollout of Medicines Care and Review in Scotland for serial dispensing for long-term conditions. It would make the job interesting and probably make the patient journey better.
If you could ask for one thing from your politicians, what would it be?
Access to patient records.
Scottish community pharmacy funding
- In 2017/18, the Scottish Government invested £12m to encourage more pharmacists and pharmacy technicians to work in general practice, putting a ‘strain’ on community pharmacy
- In April, the global sum was upped by £2.6m, taking it to a total of £183.559m for the 2019/20 funding contract
- Also in April, the national minor ailments service merged with the Pharmacy First Service, which remunerates pharmacies for treating urinary tract infections and impetigo
- Scottish Community pharmacy funding stands at a total of £224.659 for 2019/20, although CPS said it was ‘not quite the deal it wanted’
- Last year, independent pharmacy support group Numark encouraged the rest of the UK to ‘aspire to the Scottish model’