Elements in the Government seem to believe that all community pharmacists do is provide a commodity product with no value added, says the NPA’s Gareth Jones.

A dangerous policy idea circulating in parts of Government right now is that local pharmacies can be replaced by an Amazon-style medicines service.

The cuts to pharmacy funding in England are consistent with a plan to significantly reduce local provision and introduce a superficially cheaper medicines supply service based on centralised, automated dispensing hubs.

This is predicated on the flawed view that pharmacy is just a distribution mechanism for product, rather than a valuable health and social care asset at the heart of local communities.

Ministers will of course deny that there is any intention to close local pharmacies and say that it is common sense to consider how technology can be deployed to improve services and create cost efficiencies. Yet several strands are coming together to create the conditions for a commoditised, de-professionalised service.

This includes moves to remove the pharmacist from the pharmacy setting, proposals for ‘hub and spoke’ dispensing and, of course, cuts to the funding of local pharmacies.

Problematic model

When it comes to hub and spoke, the model the Government has proposed is wrong on many levels. The idea of a handful of huge warehouses to cover the entire country is problematic, first of all because it could take 24 to 48 hours to get medicines from that warehouse to each pharmacy. Neither have they considered that it reduces competition, leaving the larger wholesalers to control the market, which could increase prices, reduce quality and actually increase the price of medicines for the NHS, too.

Could companies like Amazon play in this space? Certainly the Government – notably, as we now know, the Treasury – believes that things can and should look very different in terms of medicines supply routes. You may ask, if the model is so flawed, why not just stand aside and let this steamroller drive on until it falls over a cliff edge? The risk of that approach is that by the time the whole crazy scheme unravels, the damage to the local community pharmacy network will have been done and may be impossible to repair.

The challenge for the sector is to better describe and demon-strate what pharmacies do, and promote the benefits of local, face-to-face care. Another is to continually adapt to meet the changing needs of society and evolving consumer behaviours. Specifically, we should optimise the use of technology to strengthen our locally based service proposition. Independents must be progressive and modern, while being true to the historic values of community pharmacy as a personal, caring profession.

There are two paths the sector could go down. One involves mass automation, centralised dispensing and pharmacists working predominantly from GP practices or remotely. The other sees community pharmacies better integrated with other services, operating efficiently as neighbourhood health and wellbeing centres, and being a front door to the NHS.

There are two paths the sector could go down