Key Summary
- For pharmacy owners, there is constant pressure on how to continue to survive and how long they will last.
- She has two messages for her fellow contractors, "Stop being Mother Teresa" and "Show me the money".
- She advises contractors to have a backup plan B in case things go wrong, "because we cannot continue flogging a dead horse".
During a recent Pharmacy Business panel discussion, "Reflections on Pharmacy Funding", pharmacy entrepreneur Reena Barai laid bare some of the home truths that pharmacy owners across England face on a daily basis.
The owner of Sutton-based S G Barai pharmacy, a family-run concern that has been in existence since 1979, said, "I still can't tell if I'd be able to pay my wholesaler bills in months to come. I still can't tell if I can afford to take on staff. I still can't tell if I will have a pharmacy in a few years."
She said this is an "impossible way to run a business," and the unpredictability of the pharmacy sector often gives her sleepless nights.
Barai says that for pharmacy owners, there is constant pressure on how to continue to survive and how long they will last.
"I have those daily conversations with myself in my daily leadership chat every day.
"Come in in the morning, right? It's going to be a good day, and by the end of the day, I'm walking back to my car, thinking surely there's a better way to earn a living. I have this conversation with myself daily."
Funding model outdated
For her, the biggest positive the recent Community Pharmacy Contractual Framework (CPCF) has brought about is the need to have a conversation regarding reforming the funding model.
"We cannot do today's work with yesterday's ideas, solutions, and funding. Pharmacy has changed drastically from when the funding mechanisms, reimbursement remuneration models were created, and we really need a significant reform conversation, just not a nice conversation, a really tough one, where we do some economic analysis of different funding models, different ways of maybe having different tiers of contracts with different pharmacy models.
"The time has come to have this conversation, because we've seen so many closures, we know that the model isn't working, and something needs to change."
Daily leadership
She said that last year, for her, was financially very tough, and her own stress levels have been high. Barai urged the contractors to take on daily leadership.
"Sometimes it's very easy to turn up to work and just plod along and think, 'I'll worry about this tomorrow', but there is no tomorrow if we don't worry about it today. And I've had to really wake up to that."
She claims that her other favourite mantra is what her accountant told her during a crisis meeting.
"I was in a really bad financial position, and I just couldn't see my way out. He said something that has really stuck with me - 'Reena, stop being Mother Teresa to the pharmacy world', and that really hit me."
She said she has those "Mother Teresa moments" almost every day, where she feels sorry for people. "I will say I'll go deliver for free, I do these things through goodwill, which for many years we could do because the money was flowing."
She often used to provide discretionary services for patients, but now she questions herself by reminding herself - 'Stop being Mother Teresa' line.
'Show me the money'
Another of her favourites is a line from the movie Jerry Maguire, 'Show me the money'.
"I like to shout to myself, 'Show me the money', and I say it to my team if I hear them on the phone call for like 15 minutes with a patient just asking for advice for free.
"I will try and end that conversation with a patient, because there's no money in that."
She and her team member brainstorm on a daily basis on how the money is flowing into our pharmacy, and what they can and cannot afford, and how they have to change.
"It's this tiny little bit of daily leadership that I think is helping my business turn around."
Patient care important
However, she hastened to add that it does not mean having to compromise patient care in any way.
"I will never do anything that crosses my professional boundaries or the level of care that I want to give to my patients, but I can also create healthy boundaries for myself and for my team as well.
"And a lot of that is setting expectations of my patients, who for many years have expected this a lovely service, and I've had to be really honest with them, and say, "Look, we can't do what we used to do."
She pointed out that from their exposure to television and social media they are aware about the challenges faced by pharmacies.
"So, actually, if you're honest with your patients, they'll help me and support me as well. Many will try and get me new patients, many will try to support me.
"But they all say they'll be lost without us. So, I think engaging our patients, who are our biggest advocates, is a real key for our survival."
So, she has two messages for her fellow contractors, "Stop being Mother Teresa" and "Show me the money".
Plan A and B
She also urges them to have a plan in place.
"Because sometimes it feels relentless, sometimes it feels like we're flogging a dead horse, and if we don't have a plan, it just gets harder for us, and it gets more difficult, and we burn out even more."
For her, the plan is to create as many efficiencies as I can, "I've already implemented new software for cascade buying, so that my buying is really sharp and my margins are as high as they can be.
"I've implemented a new software, which includes accuracy checking, barcode scanning technology to free up my time. I've trained up my team to put on dispensers and ACDs, so that my time is very free now, and my time is spent doing things that show me the money, doing more private services."
She claims that for someone like her "who is so NHS and so altruistic," it was hard to start private services.
"But actually, I am loving delivering them. My patients are so grateful I'm offering these services from someone they trust already."
She also claims that she has set two plans for the coming three years.
"In 2029 my pharmacy, the actual building, will have been a pharmacy for 100 years. My family will have run it for 50 years, and I will have run it for 25," she said.
"I'm doing everything I can to create the environment where we should be flourishing, but if I get to 2028/29 and I haven't flourished, and yet I've done everything I can to introduce all these efficiencies, my plan B has to come in place, which is obviously turn myself into a Starbucks."
She advises contractors to have a backup plan B in case things go wrong, "because we cannot continue flogging a dead horse".
