Dispensing has been devalued in monetary terms over the last three years and it will continue to go down: Patel

Secretary of North East London Local Pharmaceutical Committee, Hemant Patel, says 30 per cent pharmacists across six London boroughs are struggling to make more than one per cent net profit.

According to his estimate around a hundred out of the 328 pharmacists in North East London LPC “are not making one per cent net profit.”

Addressing around 260 independent pharmacists at Sigma Pharmaceutical’s second UK seminar in London on Sunday, he warned that pharmacy contractors need to understand what business they were really in and what kind of competition they faced in order not to become redundant.

Otherwise, he added that they will run the risk of losing it out to someone else who will have a better understanding of what the customer really wants.

Stating that a lot of community pharmacists were “under the cosh,” Patel said it was indeed “a precarious situation” for the sector, but they would need to decide if they were in the business as “a supplier of medicine or something a bit more than that?”

In the new pharmacy landscape, despite being in direct competition with other healthcare providers within a primary care network (PCN), Patel said: “Our sector can do things which we have never done before and some of them better than ever before.”

“In 2021, there are likely to be 21,000 GP vacancies, 42,000 nurse vacancies – there will be opportunities but we need to siege them properly,” he said, adding that a “collaborative chap” would be better suited to do this as the days of “the lone wolf” were numbered.

Adding ‘value’

Stating that money has dried up in some areas due to the £200m cut in public health funding since 2015, he asked pharmacists to ask themselves what “value” they were actually “adding to the system” to make a difference to people’s lives.

“The more we consider that, the more options we will have. We already have an opportunity in CPCS (Community Pharmacy Consultation Service). We are going to be providing more services than ever before. Dispensing has been devalued in monetary terms over the last three years and it will continue to go down because CPCF (Community Pharmacy Contractual Framework) is very clear that dispensing fee might go down. Prescription volume in my opinion will go down too.”

Vital for contractors to understand what is on local medicine optimisation dashboard

He said there will be money available around government’s prevention strategy which pharmacists can benefit from.

It will involve predictive prevention – which means the ability “to predict from one drop of blood how many diseases” a patient has had and what they are “likely to have.” He added that in the future this will involve “genomics and artificial intelligence” which pharmacists need to “take into account”.

According to Patel, it is vital that pharmacy understood the ambitions of the government and how the profession could add value by being part of the solution to the issues around healthcare.

Digital enablement, he said, was one such area which could allow the pharmacy workforce to work differently and more efficiently.

He said there was a major government push on a range of clinical priority areas which will include services around children and young people, cancer, cardiovascular disease, stroke, diabetes, respiratory disease and mental health.

The ‘golden thread’ of medicine optimisation

“There is a golden thread running through all this – it’s called medicine optimisation” but pharmacists will need “a much broader understanding of what causes these long-term conditions… how do we optimise the treatment, what happens when there is a failure to optimise? What are the urgent care needs of all these people? How do we support them to live independently in our community instead of going into a care home or hospital?”

Expanding on the role of the new Sustainability and Transformation Partnerships (STPs), which were initially formed to bring local health and care leaders together to plan around the long-term needs of local communities, he said each of 44 STPs in England now have a chief pharmacist who would be reporting to Chief Pharmaceutical Officer, Keith Ridge.

“Suddenly now at the national level they have got a very clear understanding about what is going to happen locally, and they are going to be driving it through the chief pharmacist at the local level.

“Now the microscope is going to be on the PCN area. How many people need smoking cessation, who are the providers, what is the performance, is it good enough, what can be done to improve it?

“That kind of microscope will mean that we will have to ourselves understand if we are going to be a reliable party to a contract.”

Therefore, he told the seminar audience, it was important to understand what was on the local medicine optimisation dashboard “so that we can proactively influence it” and “start delivering in the area where there is focus.”

Going forward, the bottom line, according to Patel, will be for every pharmacy contractor to align themselves to their local PCNs because there is money attached to it in the CPCF and the network is a platform for future commissioning of local services.

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