Gary Paragpuri

By Gary Paragpuri

Having sat in many job interviews throughout my career, for me, one of the most illuminating moments is when an interviewee answers the age-old question of where they see themselves in five or ten years’ time.

There is often a slight pause and then the tension is punctuated with a response that ranges somewhere between modest ambition and a detailed plan to jump in the boss’ chair.

The truth is, it’s a difficult one to get right. When it comes to imagining the future, we humans are notoriously bad at it. Studies have found that we are naturally drawn to prioritise the present, and when we try to project further forward, the medial prefrontal cortex loses interest to the extent that we may as well be thinking about someone else entirely.

Thanks to these neurological impulses, we are hardwired to never really meet our future selves. They will always remain strangers in a tomorrow that never really comes.

Unimaginable change everywhere

Today, given the unsettling situation we all find ourselves in, our already flimsy ability to picture the future is seriously being put to the test. The COVID-19 pandemic has thrown whole countries and communities into crisis, presenting most of us – and more-so those working on the frontline of community pharmacy – with the most challenging situation we have ever had to face in our lifetimes.

We know there is light at the end of the tunnel but, right now, it remains distant and it’s failing to illuminate a clear picture of what life will look like at the other end.

For frontline pharmacists, it would have been impossible to foresee many of the changes that have been enforced over the past month as the sector has adapted to battle against this invisible killer.

The initial pre-lockdown period was characterised by stockpiling and panic buying, leading to overwhelming levels of demand. Unscheduled closures were needed in some cases to give staff the chance to catch up.

As the scale and severity of the outbreak became clear, this phase gave way to the introduction of longer-term measures to maintain social distancing. Perspex counter screens, floor markings and controlled queuing are all now commonplace.

However, in seeking to keep some distance between themselves and patients – for the good of both parties – pharmacy teams have met with verbal threats and even physical abuse.

Maintaining social distancing rules

For my own customers, the experience has been a little different as they have been able to use their Pharmaself24 (PS24) automated collection points to let patients pick up their medicines from outside the building.

This has brought significant benefits at a trying time, easing the number of people looking to enter the premises and reducing the risk of infection – something that has been an all-too-real concern among staff given the limited availability of suitable personal protective equipment (PPE).

Many of our customers have, understandably, seen a huge increase among their existing patients wanting to collect their medicines from their PS24s, as well as new patients flocking to use the service as word spreads.

One pharmacy contractor has had over 2,000 patients collect their medicines via their automated units in the past fortnight. That’s 2,000 people who didn’t queue and 2,000 people who managed to avoid contact with other patients or staff members in the current pandemic.

Replicate that scenario across the pharmacy network and it transforms the sector’s level of resilience in the face of the current onslaught.

Ability to adapt

In truth, pharmacy was already being squeezed on several fronts. From stagnant funding and inflexible quotas to demanding patients and rising workloads, the sad truth is that the additional pressure of the pandemic could well see many pharmacies closing their doors for good.

Those that survive will need to adapt in the short term and become more resilient in the medium to long term as they get to grips with coronavirus and whatever new challenges come over the horizon.

Change is never easy, and especially so when pharmacy’s main income stream – dispensing fees – is in long term decline.

Income from clinical care may well provide compensation, but coming up with plans to increase efficiencies in dispensing is now imperative.

Whether it’s through automating all but the provision of clinical care or partnering with competitors to build capacity, we can be sure the future will not be a return to the past that we knew – and that applies equally to pharmacy, grocery, medical services or pretty much any other industry.

Catalyst for change

The science from Imperial College London that prompted the move to suppression rather than mitigation of COVID-19 clearly indicates the need for intervention measures to continue in some form in the absence of being able to develop herd immunity and on the assumption that a vaccine will not be available until 2021.

Even with intensive testing, high-tech contact tracing and a greater understanding of this new virus, it’s likely that our socially distanced ‘new normal’ will simply become our normal.

For pharmacies already grappling with how to reshape themselves for a more efficient, digitally-driven future, perhaps this disruptive period will present an opportunity to consider their offering and act as a catalyst for answering that difficult question about where they want to be in five or ten years’ time.

Gary Paragpuri is CEO of Hub & Spoke Innovations Ltd.

This feature also appears in the May issue of Pharmacy Business magazine.

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