I think community pharmacy now finds itself in a new, normal ‘steady state’ where the medicines counter may be quiet but the phone is anything but.
The pressures that we faced a month ago have gradually ebbed and changed into a new set of demands – picking up the slack from GP practices that have gone dark, operating delivery services at scale and trying to keep up with the shifting sands of professional guidance.
The NHS is going to look very different for the foreseeable future. Huge amounts of pent up demand still need to be cleared and Covid-19 will likely become a chronic problem to add to seasonal flu. There is also the question of how significantly patient behaviours will have changed.
The Government has been promising Covid-19 testing at scale for weeks and, while progress has been made, it is nowhere near the scale that Matt Hancock promised. Don’t be surprised if he ultimately pays the price for this.
Say what you will about Mr Hancock (and I do) but he is a secretary of state who has probably been more pro- pharmacy than any of his predecessors. His problem is that while he likes pharmacy, he has no direct control over the sector because that all rests with NHS England.
I think it is inevitable that the relationship between NHS England and Government will have to change when all this is over. No politician likes carrying the can for other people’s failings and in this case the failings for Covid-19 belong to the senior leadership of NHS England and Public Health England.
The 2010 Lansley reforms are dead and will have to be unwound, so it is essential that if pharmacy is to have any chance of progress, our leadership bodies must lobby hard to see that the necessary changes happen in the post- Covid world.
PSNC simply has to get a fresh deal but is this likely? Not to my mind. Radical but necessary in my view is a creative arrangement that sees Government funding exit payments for smaller contractors to reduce the number of times our funding cake has to get sliced.
No politician likes carrying the can for other people’s failings
Pharmacy should be a critical part of the Government strategy to transition out of lockdown, provided a reliable and simple test can be developed to see who has immunity to Covid-19. I see pharmacies as a network of testing centres that could be rapidly tasked with certifying who is safe to return to work.
It is essential that NHS ‘group think’ does not railroad this activity into general practice. Apart from anything else, GPs won’t be able to cope as mountains of routine
work have been piling up in the background since they switched to Covid-related activity. In the long-term, when a vaccine is eventually identified, I am certain that pharmacy will need to play a big role in getting as many people vaccinated as quickly as possible.
Another thing that must change is community pharmacy’s currently toxic relationship with the NHS that currently exists in England and Northern Ireland. (Wales and Scotland are fortunate to not be in the same league of hurt.)
So what can be done? We must embed into each administration clinical leaders from our sector just as the medics have done. Many of the mistakes of the past five years have been down to a clear lack of front-line voices within the NHSE pharmacy team.
Misunderstandings of a fundamental nature continue to persist and, to put it bluntly, nobody is flying the flag for the tremendous job that community pharmacy teams do every day. This is why we end up with debacles like the CPCS and the pandemic delivery service, doomed to be repeated over and over again.
I would appoint a senior community pharmacist to work two or three days a week at NHSE to give some ‘real world’ experience and understanding, and to raise the profile and perceived value of community pharmacy.
It occurs to me that not one chief pharmaceutical officer has ever come from the largest sector of practice – community pharmacy. This must change.
* Pen name of practising pharmacist