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Letters to the Editor
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Community pharmacy
PSNC is simply out of touch with reality
From Mr M. Griffiths, MRPharmS
While shadow
health secretary Andrew Lansley charged the Pharmaceutical
Services Negotiating Committee with complacency over the regard to purchase
profits in the PJ (9 February 2008, p139) our members have another
charge: that the PSNC is simply out of touch with reality.
As a practising pharmacist, as well as chairman of buying group Cambrian
Alliance, I must warn the PSNC and all concerned politicians that pharmacists
are seriously wondering just how we are going to make ends meet.
We are seeing a huge drop in income from the recent adjustments to Category
M — up to £3,000 a month — at a time when we have been
encouraged, cajoled even, to increase our staff and infrastructure costs.
The PSNC needs urgently to re-evaluate the real costs of running a community
pharmacy in the climate of the new contract, since we are facing the
increasing costs of a more qualified workforce and higher investment
costs in IT, consultation areas and professional- service development.
One
wonders what the PSNC is basing its profits on and what allowance it
has made for inflation eroding the value of the £500m retained
purchase profit cap agreed three years ago.
I often hear my fellow members saying they wished they had the GPs’ negotiating
team. The PSNC needs to be lobby harder and impress on Government the
true running costs of running an independent pharmacy.
It also needs to communicate the shock that such last-minute, lump-sum
settlements have on cash-flow as well as overall profits when all we
are asking for is a stable financial climate.
Independents are struggling to manage their books and their time in this
climate and are doubly challenged on how to look after purchase profit
at a time when they are being urged to focus on service provision.
While buying groups can give them the power of collective purchasing,
it would be nice to know that pharmacy’s main negotiating body
had the power to truly fight pharmacy’s corner. Mark Griffiths
Chairman
Cambrian Alliance
Category M for “muddle”
From Mr M. James
The recent adjustments to Category M are beginning to bite hard with
reports of some pharmacists finding themselves with little or no money
to pay themselves for January.
The situation has not been helped by the Conservative Health Spokesman,
Andrew Lansley, issuing a press release stating that community pharmacists
had been paid £811m more than agreed.
He did not, of course, take
into account the £500m retained purchase profit cap agreed with
the Pharmaceutical Services Negotiating Committee which will ensure any
excess above that figure is clawed back from pharmacy: hence the recent
Category M adjustments combined with reduced practice payments.
The issue Mr Lansley should have highlighted is not the alleged excess
profit, which, as noted above, will be returned to Government coffers;
rather, the impact all this has on the ability of pharmacists to manage
their finances and invest in their business sensibly, although we accept
that he did
subsequently (PJ, 9 February 2008, p139).
Reimbursement ought to be fair, simple and transparent. However, at present,
pharmacists have no advance view if excess profits are being made and
only find out when the Department of Health, in effect, issues a big
bill: around £400m this coming year.
In practice, this makes it difficult for pharmacies to predict their
financial flows as you would expect any business to do. That in turn
makes it difficult to plan for investment in areas such as providing
new professional services, staff training and refits.
Like any other business, in order to succeed, pharmacy needs a stable
financial environment free from turbulent swings and unpredictable outcomes.
It needs to be able to plan sensibly for investment in premises, staff
and services. It needs to be able to develop coherent business plans
when seeking finance from banks or from wholesalers.
One way forward would be for the Department of Health to provide more
funding to pharmacies in England to provide patient services. This would
create a new, more predictable income stream for pharmacies alongside
the less predictable reimbursement flows from dispensing. Scotland has
already made moves along this path.
However, that would mean the Department of Health committing to nationally
agreed, nationally available patient services such as minor ailments,
chlamydia screening and diabetes testing. This is exactly what the PSNC,
the National Pharmacy Association and others have been calling for.
From a wholesaler perspective, the more financially robust our community
pharmacy customers are the better, both for them and for us.
Mark James
Group Managing Director,
AAH Pharmaceuticals Ltd
ETP is one more reason to consider leaving the profession
From Mrs P. Bradshaw, MRPharmS
Surely patients’ safety and interests and clarity of instructions
on how to take medicines are of prime importance to pharmacists.
The
electronic transfer of prescriptions could negate the pharmacists knowledge
of medicines and their insights on how patients interpret labelling
instructions.
Pharmacists possibly having to alter or amplify instructions on up
to one quarter of ETP prescriptions and the alterations not being able
to
be recorded to use again automatically on repeat prescriptions with
this system, as mentioned by Sarah
Roberts (PJ, 2 February 2008,
p118), leads me to find yet one more reason to consider leaving the
profession. Pamela Bradshaw
Derby
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The
Pharmaceutical Journal