The Pharmaceutical Journal
Vol 280 No 7503 p636
24 May 2008

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Numark

Success in pharmacy requires more teamwork and less focus on supply

If you are a community pharmacist who feels overworked, confused, stressed or unsure of the direction in which your business is heading, you are not alone.

This was the message from John D’Arcy, managing director of Numark, who believes that while the overall direction that community pharmacy is heading has been established by the White Paper (Pharmacy in England — Building on strength, delivering the future) and the community pharmacy contract, how the profession gets there is not yet clear.

Although he believes this can be challenging and threatening, it also creates many opportunities: “When things aren’t set in stone, they are easier to influence.”

For many years, the pharmacy service has been focused on what the pharmacist can offer, but the role of the whole pharmacy team is now becoming increasingly important. “The pharmacist cannot do everything in the pharmacy,” said Mr D’Arcy. Investment must be made in staff training and development so that some tasks, traditionally carried out by pharmacists, can be delegated.

When the current community pharmacy contract was first implemented in England and Wales, 50 per cent of the money given to pharmacies by the Government was paid to reimburse the cost of drugs issued on prescription, said Mr D’Arcy. The other 50 per cent was paid as professional service fees.

Now, since the Government announced its clawback of drug costs on category M products, pharmacies receive around 38 per cent of this Government funding from reimbursement. “This provides a clear indication of the direction of travel, said Mr D’Arcy. “We cannot simply rely on reimbursement income in the future.”

He believes that supply must remain a core component of the community pharmacy service, because this “brings customers in”. However, he acknowledged that fees for clinical services, such as those paid for completing medicines use reviews, are now becoming increasingly important.

He said that although MURs have received some negative press coverage, they still represent a significant income stream for community pharmacy. He encouraged community pharmacists to continue to raise any issues they have regarding MURs, but such issues should not stop pharmacists from doing MURs.

He also stressed the importance of completing MURs from a strategic point of view. “If you are a primary care organisation, and you have [to choose between] two pharmacies to commission a service from … who are you going to pick: the one that has done 400 MURs, or the one that hasn’t done any? It’s a no-brainer,” he said.

Let go of dispensing to deliver a greater range of clinical services

Many community pharmacists must move away from the “sticking and labelling role” that they have become comfortable with, and spend more time with patients. According to Mimi Lau, Numark’s director of professional services, this will be one of the many challenges associated with implementing the recent pharmacy White Paper.

Pharmacists will need to review their pharmacy’s staffing level and skill mix to allow new services to be delivered. “Are you making best use of your team?” Ms Lau asked attendees. Work will have to be delegated to allow pharmacists to deliver new services.

She also urged pharmacists to employ accredited checking technicians (ACTs), and make sure their skills are used efficiently. She suggested that repeat prescriptions, which contribute around 60–70 per cent of a typical pharmacy’s dispensing workload, rarely require intervention from the pharmacist.

ACTs could be given the responsibility for checking these prescriptions, which would free pharmacists’ time. Therefore, pharmacists could focus on delivering new services and talking to patients who are prescribed new medicines.

New staff may need to be employed and existing staff may require additional training, but Ms Lau emphasised the importance of not underestimating other pharmacy staff: “They are your biggest asset,” she said.

Pharmacists should ensure that their premises are suitable to deliver new services, said Ms Lau. They will need to check whether their shop or dispensary is set-up correctly to cope with different ways of working, such as repeat dispensing and electronic prescriptions.

Market research suggests there is little public awareness of the new services being offered by pharmacies, added Ms Lau. She urged conference attendees: “You are champions for the pharmacy cause in the community. Go out and tell [the public] what you can do, and be proud of it.”