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Most pharmacists get a bit stuck in a rut when they've been in one place for any length of time...

Until last week it had been a while since I had worked in a different pharmacy, so I found the first day at my new pharmacy a bit strange. You don't know the staff or the patients but, depressingly, the problems are all too familiar: supply chain, surgeries, staffing levels stretched to breaking point, and the ever growing demands of the general public.

We're working off a financial settlement that is goodness knows how old, while the NHS is dragging its feet on a workable funding package. Meanwhile GPs are moaning in the press about their patients having to wait a week for an appointment. Excuse me while I buff my crystal ball... could the answer perhaps be more GPs and more money for GPs?

€Somehow I need to avoid the same fate€

The new pharmacy is a firm favourite with the local community and a much-loved asset to the town. Even though the business is held in high regard, I could tell, even within a few hours, that there was a lot of work to do to, especially on the NHS business, bring it up to the required standard. The previous pharmacist is someone I and the patients have great respect for but he was burnt out by the demands on his time. Somehow I need to avoid the same fate, while moving the business forward.

Embarrassing

I must confess I was amazed at how low the stock levels were. Even high volume generics were run to the bone. While this might look efficient to the accountants, it doesn't make life comfortable for the pharmacist. Spending a whole day apologising that you can't fulfill a prescription is embarrassing and bad PR, especially when you're new in town. So my first mission is to restock the dispensary, which is more difficult than it sounds, given the state of play in the supply chain.

The Government has buried its head in the sand on stock shortages, consistently ignoring the problem and refusing to do anything about it. There are many reasons for the shortage of branded medicines, but for generics the reason is price, which the Government controls.

Day in, day out, we have to fight on behalf of our patients to get their medicines amid so much uncertainty. Has a concessionary price been granted? What is the concessionary price? What is the current wholesale price? I'm sorry but the current system just is not good enough.

I'm halfway through the month and I have no idea if mebeverine will get its concessionary price despite buying it at more than £18 a pack. How is this system fair?

Contempt

The Department of Health treats pharmacists with contempt, as it appears that we are no longer trusted to use the old NCSO system. When it comes to the concessionary price adjustments, these have to be in place at the start of the month, or else we are being asked to assume unfair financial risks on behalf of the NHS, with contractors ending up out of pocket because they are trying to do the right thing by their patients. The Department of Health has to start playing fair on stock shortages. Refusing to pay a concessionary price because one wholesaler in the Outer Hebrides has three packets isn't acceptable; neither are retrospective price adjustments and late announcements that make it impossible for businesses to plan. The department can't have its cake and eat it.

Good team work

Fortunately I have inherited a very capable team of staff. In the short space of time I've worked with them I've been surprised at how easily the business runs without any major input from me.

The prospect of fine-tuning and developing the team further is an exciting one, but I am acutely aware that pharmacy has a really low glass ceiling. There are only a few different job roles and it is really difficult to pay people what they are worth because the money is simply not in the contract. Why is it that a NVQ3 registered technician can earn more in hospital and have better employment benefits and prospects?

That said, I find resolving problems, developing people, systems and services really rewarding. Already in the short space of time I've spent in the new pharmacy I feel enthusiastic about going to work and the challenge ahead of me. It's true what they say €“ a change is as good as a rest.

In pharmacy we've got a lot to feel happy about: the public's perception and goodwill towards us being foremost, but there are always going to be bugbears. For me, the frustrations come from the remote decisions of civil servants and policymakers, which bear no resemblance to the issues I face every day.