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The impact of Covid-19 will last a lot longer than the virus itself, a community pharmacy contractor has said.

Speaking to Pharmacy Business, Mike Hewitson added that English pharmacy would go to the wall if new money was not found urgently.

Like many pharmacy contractors across England, he is frustrated that despite putting their own personal health and wellbeing on the line, what community pharmacy teams have ended up getting are “warm words and empty promises which frankly are not at all helpful.”

Instead, he said, the sector desperately needed “resources to keep our people safe and keep our services on the road.”

“It’s a really frustrating situation when we have members of our staff getting increasingly worried because their friends and family ask them about their safety and health. They are dealing more and more with people who look infected or contacts of people that are infected with the virus.”

He’s very angry that “NHS England have single-handedly helped to destroy the morale in the sector.”

NHS moving goalposts

Asked how he perceived government’s funding for the community pharmacy pandemic delivery as well as the increased rates of pay for bank holiday hours, he said: “This sort of piecemeal, penny-pinching approach isn’t helpful at all.

“It means we have no certainty and leaves contractors wide open to NHS England moving the goalposts at any time.”

Hewitson argued that it is only fair to ask for the same guarantee for the sector that the rest of the NHS has – that money should not be a barrier to doing the right thing.

“They’ve wiped off £13bn in NHS Trusts debts, why? That doesn’t do anything to help with COVID-19, that’s a political move.”

He lamented that pharmacy “can’t even get basic assurance that they [NHS England] will actually cover any of our costs.”

Funding totally inadequate

Hewiston, who owns two pharmacies in Dorset, said the government’s £300m advance funding to help community pharmacy deal with the cashflow impact of the coronavirus pandemic was “totally inadequate.”

Soon after the announcement, he calculated that his prescription volumes rose by 25 per cent and his average costs climbed up to 66 per cent.

Despite the NHS England cashflow advance of £45,000 in total for his two pharmacies, he had a cumulative shortfall of around £18,000.

“While we are not going to turn down the additional cash they’ve put into the system, it’s nowhere near enough,” he said.

In addition to the massive wholesaler bills, community pharmacy contractors have had to deal with additional costs since the coronavirus contagion.

“You’ve also got these ongoing costs related to Covid-19 – additional staff, additional measures such as PPE or modifications to pharmacy to make everything safe for the staff – these are additional costs.

“I have done my figures and it’s about £9,000 that I have had to spend up until now.”

Complete inequity

Significantly, almost every other part of the NHS has been given a guarantee that their costs related to Covid will be looked after – Health Minister Matt Hancock and Chancellor of the Exchequer Rishi Sunak have both in unequivocal terms stated that the government would leave no stone unturned and “do whatever it takes.”

Yet pharmacy hasn’t had that barring a small instalment here and a little payment there.

“There is a complete inequity from the point of view of how community pharmacy is being treated in England, compared to the A) the rest of the NHS and B) the other countries in the UK,” Hewitson continued.

Relief in Northern Ireland

Community pharmacy in Northern Ireland will receive £6.5m at the end of the month in addition to the £4m they were paid in early April. That’s a sizeable amount to be shared between 535 community pharmacies in the country.

Breathing a sigh of relief, County Antrim pharmacist Eoghan O’Brien said community pharmacies in Northern Ireland – after enduring a lot of financial difficulties in recent times, have also been paid a “temporary special advance of £25m to ease cashflow” which will be recouped at a later date, however.

Glimmers of hope in Scotland 

In Scotland, a country that has by far had the best support for community pharmacy, has just announced a £5.5 million funding package to cover the costs of the pandemic. This money is in addition to the advanced payment promised earlier.

Speaking to Pharmacy Business after a 14-hour marathon shift in her pharmacy, Genrothes contractor Bernadette Brown said she too has the “same worries with reducing margins, cash flow worries and additional staff bills.”

But having seen all the extra income from services vanish overnight, she said “the buying margin and the role of safe supply is my business right now and I have to nail it to survive.”

But she does see “glimmers of hope and a light at the end of the tunnel.”

“I like the way it is going in terms of new ways of working and maybe positive lessons can be shaping the future of the way we operate.”

Sticking plaster over the problem

Ian Dean, chief executive at Community Pharmacy North Yorkshire, said the cash boost is a step in right direction, but added more needs to be done to support pharmacies which he said are the “front door” of the NHS.

Speaking to the Local Democracy Reporting Service, he said: “We welcome the fact the government is recognising the hard work that these frontline staff are doing. But this is not new money – and it is just a sticking plaster over the problem.

“Pharmacies have seen such a massive increase in demand due to people stockpiling medicine ‘just in case’ they need it.

“Some pharmacies have seen their orders double – and even treble – from their normal amount.”

Long-term prospect is bleak

Hewitson understands that the NHS are community pharmacy’s main customers, but leaders of NHS England “need to be contrite and be prepared to build some bridges – they haven’t been doing that since the cutbacks in 2016.”

“I think this needs fresh leadership right at the top and it needs change of direction.”

And he is really worried about the long-term prospect for pharmacies in England.

“Part of the problem is the drug tariff for April, May and June has been published. Given that wholesale prices have risen and essentially the government can’t put back money back into Category M that easily.

“So they’ll have to wait till July to update the drug tariff by which time you have three months of paying out much higher wholesale bill and it may not cover your cost,” he said.

Bottomline is clear – unless money is urgently found to alleviate pharmacy’s cashflow issues, the sector will inevitably end up in a position where it will run out of cash.

(With additional reporting by Jacob Webster, Local Democracy Reporting Service)

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