Opinion: Stop complaining, these ads are a bonus
NHS adverts are encouraging people to visit their local community pharmacy for common ailments. They certainly have an impact so why have some in the sector been complaining about them, wonders our columnist Liam Stapleton
The message to encourage people to use their community pharmacy as the first port of call for common conditions is not new.
It is something that the sector has encouraged for many years. The NHS is currently providing a free marketing campaign that is designed to drive footfall into community pharmacies to get advice and purchase medicines, increasing sales and profit. So why the complaints?
The argument is that there is currently a lack of capacity to cope with the influx of patients asking for advice and products for low acuity conditions. There is no national minor ailments scheme, so how can pharmacies hope to provide a service to these patients?
Supporting self-care is something that has never been funded through the NHS and has always been seen as a commercial activity. We have called for pharmacy to be the first port of call and, in previous years, have collaborated with the NHS to promote this message. If this isn’t working now, we need to examine our identity and business model.
Pharmacy has been seen, by itself and the public, as an important source of advice about health; healthcare on the high street is an oft used trope. We have promoted ourselves as a health hub within the community, more accessible than GP practices, that can help people to improve their health, from health promotion to managing common ailments to supporting patients with long-term conditions.
Whether we call it responding to symptoms, managing minor ailments or treating low acuity conditions, this activity has been a traditional part of community pharmacy from well before the formation of the NHS.
It’s free publicity, stop complaining
Members of the public are able to walk into a pharmacy without an appointment, ask for advice and purchase a product that will meet their needs. If we want to maintain this activity as part of our identify, why complain when we receive free marketing? Perhaps we need to examine the business model for it more closely.
Let’s take an OTC medicine with an assumed average cost of £6. If we remove the VAT and assume a markup of 50 per cent, that’s a profit of £1.70. Take off some allowance for costs (like rent, rates, heating and lighting) and the net profit before staff costs starts to look very thin.
“Things have changed around us buy pharmacy is fundamentally based on models from the past”
It could be argued that this activity is one where a pharmacist should actually have a much greater role, diagnosing the cause of symptoms and providing the most effective treatment.
It can certainly be described as a highly professional activity when done effectively and comes with a reasonable element of risk. Perhaps it shouldn’t be routinely delegated – but if a pharmacist is to regularly be involved in providing this service, the profit margin looks even more inadequate.
What defines our value?
This should force us to think about how we value our time, knowledge and skills. What is the intervention of a pharmacist worth when giving advice about low acuity conditions and purchasing a medicine?
What is the value to patients and what is the value to the NHS? One thing is true; if we don’t value ourselves, no one else will. And, if a pharmacist is undertaking this activity, it should be delivered to a demonstrably higher level than if it is provided by a medicine counter assistant. However, there are dangers in valuing our time and charging appropriately.
If we were to reflect the value of a pharmacist’s involvement in the cost of medicines, will customers be happy to pay the increased prices? They could be driven to the GP practice to get a free prescription or rely on GSL medicines bought in outlets without any advice. And could this approach be maintained in an environment where medicines are treated as commercial items, subject to price competition in retailers?
The main problem is that things have changed around us but pharmacy is fundamentally based on models from the past. Technology, methods of communication and the expectations of patients and the NHS have transformed – but pharmacy itself is slow to change.
We need a clear, holistic identity that we can easily articulate, demonstrating the value that pharmacy provides to the NHS and local communities, with a business model that integrates income from public and private sources. Evolution is not working. We need revolution.
• Liam Stapleton is director of Metaphor Development Limited and an associate clinical lecturer at the University of Lincoln.