Léa Legraien talks to All-Party Pharmacy Group (APPG) chair and Rother Valley MP Sir Kevin Barron about his love for pharmacy, its challenges and improving its visibility
Q How would you describe the current state of community pharmacy?
A I think it’s going through a difficult situation, as quite a lot of sections of the public sector are. The funding cuts could have been better planned and better explained. This isn’t the best way to sort anything out.
Q Is pharmacy the answer to the NHS crisis?
A I have no doubt at all that there are a number of areas in primary care that can help keep pressure off the NHS. Pharmacy could play a major role in that – not just in terms of taking pressure off accident and emergency (A&E), but also GPs.
It seems to me that pharmacists and their ability to do more in terms of providing services to people is something that should be built upon.
Q What changes would you like to see?
A The management of people with long-term conditions, even those living at home or in care homes, could be much improved and this would take pressure off the NHS. Overall, over 70% of the NHS expenditure is on long-term conditions.
What we need to look at is the pharmacy contract itself. You’ll be aware that 30 years ago, the income from prescriptions for a pharmacist would be about 50% of the pharmacy's income. It’s over 90% now.
There is a big reliance on prescriptions and it’s well evidenced on occasions that prescriptions are given to people and not used. We must question the case: ‘Why is anybody being prescribed a medicine they’re not using? Is it in the pharmacist’s interest to change the system at the moment if over 90% of income comes from giving out prescription medicines, even if some aren’t used?’
We must change that and I think the pharmacy contract should be looking at a service where pharmacists can actually provide help and advice for people with long-term conditions.
We should also look at population health, which has been written into legislation but never enacted by the NHS. That should be reflected and measured in the pharmacy contract so pharmacists get paid for keeping people away from ill health so they’re not a drain on the NHS.
I don’t think we’ve done enough at all in looking at how pharmacies interact with populations’ needs, not just individuals' needs.
We should be planning health a lot better than we do and potentially pharmacy has a major role to play in that.
Q Should there be nationally commissioned services rather than local ones?
A I think so. Other measures are about population health and long-term conditions, which are areas we should be steadily moving to so pharmacies would still be recognised for what they do in a measured framework while not being a threat to the their income, for example.
A lot of the time when NHS England says something, pharmacy immediately feels it’s under threat from income and we need to move away from that situation.
Q Is the Government doing enough to tackle medicines shortages?
A When you have such a competitive system where you don’t just get your medical needs from community pharmacy but direct from companies, I’m not sure we have good knowledge of the way wholesalers stock community pharmacy products.
It’s quite clear that some pharmacists are spending several hours a day chasing up drugs. It seems to me that pharmacists have got better things to do.
We’ve worked for 70 years with community pharmacy, which isn’t a public sector per say, and we need to get better cooperation.
We should be focussing on issues and the problems pharmacy has in supplying products to people who have needs in a timely way.
Q What issues have you discussed with pharmacists recently?
A A number of pharmacists from my constituency have talked to me about the cuts.
The cuts frightened everybody and were bigger than predicted.
Community pharmacy is the first step for health needs for millions of people, more so than GPs surgeries, walk-in centres and A&E. We shouldn’t be making changes that aren’t predictable.
All changes have unintended consequences. I’m progressive and want change but we need to make sure that change is predictable and not going to do any harm.
Q Do you welcome the move towards decriminalising dispensing errors?
A It’s been on the agenda for a number of years and there’s never been a good time to change anything like that.
We’ve not had any public outcry about the change so I’m quite comfortable about that.
There will be pharmacists who aren’t happy with it but that’s the nature of change – not everybody is happy about change.
Q What recent discussions did you have with the pharmacy minister?
A We [the APPG] wanted to have a word with Steve Brine about the potential changes to the pharmacy contract. We don’t want to lead the negotiations but ask a few questions.
We’ll be doing what we can to get a change in the contract that’s going to bring pharmacy’s income with the needs of the population.
Mr Brine has been quite positive in his attitude to community pharmacy.
Q How do you feel about the success of the petition against the funding cuts in 2016, which garnered two million signatures?
A We got as far as the steps of Number 10 and were expecting change.
I’m afraid that cuts in the public sector – not just in health – aren’t being stopped nor reversed and it’s not had the effect most people who signed the petition were expecting.
Whether it will have an effect on the next Government in terms of funding, let’s wait and see.
It was a good exercise to do and it’s brought to the Government’s attention what people feel about pharmacy, how they want it to be looked after and carry on doing the work it’s doing and hopefully improve in the years to come.
Q What are the APPG’s plans in the near future?
A We’ll be publishing a paper on long-term conditions. We had a good discussion about that and hope we’ll make good recommendations that will be picked up by the Department of Health and Social Care (DHSC) and change the pharmacy contract in managing people long-term conditions.
What we need to do is go a bit further in terms of recognising how pharmacy can help patients with long-term conditions and ease the problems inside the rest of the NHS.
Q What motivates you to support pharmacy?
A Pharmacies are the doorsteps of the NHS. They’re the ones that see 1.2 million people daily. They’re in communities and understand their needs.
My motivation was to see things improving population health and being quite active in public health particularly around anti smoking.
Some pharmacies are very good at smoking cessation but some anti-smoking packages are closing down and I’d like to see more open.
Pharmacy could deliver services that are being closed because of other cutbacks in the public sector. They need to be recognised, paid for and trained to do it. They’re there in the community and that’s what we should be doing, using that resource to improve the health of the public.
Q Are you confident about the future of pharmacy?
A I am. This isn’t all about what the Government and others do. Pharmacy ought to be talking not just to politicians but health and wellbeing boards and local government about what it can and can’t do.
There is a lot of change that’s taking place at local levels in terms of setting different ways of approach in patient needs.
Pharmacy isn’t always part of that partnership. People need to recognise that and pharmacy needs to raise its voice, [showing] that it can play a part in improving the health of people. Community pharmacy should be part of sustainability and transformation partnerships (STPs).
I hope that the people involved in the negotiations on either side of the table with the new pharmacy contract will look at the wider issues. We need to carry on using pharmacy a lot more.