Pharmacy driven at local or national level? PSNC and Celesio chiefs offer contrasting views
By Neil Trainis
PUBLISHED: October 11, 2017 | UPDATED: October 11, 2017
PSNC chief executive Sue Sharpe and Celesio managing director Cormac Tobin exchanged contrasting views during the Pharmacy Business conference over whether the future of pharmacy and the services it provides should be locally or nationally driven.
The two exchanged opinions during a panel discussion alongside Julian Mount, the managing director of Alliance Healthcare, who agreed with Sharpe that the commissioning of pharmacy services is, and would remain for the foreseeable future, at a local level.
“A national contract overwhelmingly driven towards remunerating dispensing has allowed people to become quite passive without developing their own businesses and being energetic, innovative, individual about it,” said Sharpe, who will step down from her post at the end of the year.
“The status quo with the NHS and the state it is in and the mindset it is in is just not geared up to people allowing themselves to just be driven by a national contract. We’ve got a big job to do to get people to wake up to the reality that it is going to be very individual efforts that are going to be the determinant between success and failure in the long-term.”
Sharpe added: “The NHS is starving, it’s got no resource, general practice is under immense pressure, A&E services are under immense pressure and it hasn’t got the ways to find a system level to push the services, to increase their capacity through getting money to fund community pharmacies to do it.
“The best way of doing it is by pharmacies demonstrating at local level to general practice just what they can do. I don’t think you’re going to see a national framework insisting on a transfer of care.”
Concurring with Sharpe’s view, Mount said: “I would agree with that. If you’re waiting for a commission and you’re waiting for it to be given to you, the situation we have now is not going to be permissive.
“Actually grabbing that, demonstrating that, doing something about that, to me exemplars in what pharmacy can do. I think it’s going to be very illustrative in shaping the political dynamic and shaping the conversations we have going forward.”
Tobin, however, did not accept the views of Sharpe and Mount on the direction of pharmacy and insisted the profession needed to be nationally and locally-driven if it is to survive in the long term.
“I disagree wholeheartedly. The work (pharmacists do) resonates locally. They’re doing exceptional jobs there. But nationally, if the government doesn’t see pharmacy as part of the solution, they don’t. Simon Stevens’ report mentions us…reasons for dialogue…doesn’t mention us at all,” Tobin said.
“And if we do not solve that engagement and relationship problem at the top and change the way we do things phenomenally, there’s no world order. Number one, we don’t have the resources to do it because most stores are flat out.
“Secondly, there’s been a lack of investment. We haven’t invested in our infrastructures. There’s still a movement out there to deliberately make it look as if people try to use technology to dispense is bad and wrong. It’s not.
“Pharmacists go to school for a long, long time and continue to evolve and learn their skill set. Taking away mundane, not-needed-skilled jobs and doing it another way is exactly what we need to do to release the talent because we cannot do it in the capacity we have today.
“So I disagree. It’s a combination of a nationally-driven, properly represented body who articulates what they want to do plus local initiatives that can feed right (into that). It’s both. Businesses operate that way, why shouldn’t this operate that way?”
Sharpe responded: “I don’t actually think the two are inconsistent. What I’m saying about how we can get these services transferred from general practice into community pharmacy is that is something that will happen locally.
“In terms of building the framework (for) the national infrastructure evolution, revolution that is needed to take pharmacy practice into the 21st century, yes it would be brilliant if we could persuade a health department or an NHS England that is bankrupt to invest in this, it would be great.
“What I’m saying is community pharmacy cannot afford to wait. The current policies of NHS England are to decentralise and not to push much more from the national level. They are looking at a much more locally created health delivery network.”