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Community pharmacy is currently in limbo somewhere between being rewarded for supply and being rewarded for services. The confusion this generates isn't good for the profession.
Progress away from this limbo demands an argument to be articulated. It goes something like this: we are pharmacists, this is what we do, this is the value we add, we deserve to be rewarded for it. We're able to make the first and last points well, but the bit in between - the real substance - we're not so good at.
It's still the case that other health care professionals and the public don't understand what pharmacists do. The favoured line of "experts in medicines" only goes so far. It should be the beginning of a sentence, not the entirety. And we're even worse at proving the value we add. It was with disbelief I read that the first study on community pharmacy's day-to-day contribution had only recently been completed.
Being rewarded for supply is a concept that deserves to have long ago been gathering dust. That's why I don't understand the commotion made about category M. The scheme provides £500 million of ‘purchase profit'. This is profit from buying a medicine for less than gets reimbursed. It isn't a professional activity, it's the work of shopkeepers and even The Apprentice hopefuls. Why do we seek to be rewarded for it?
Yes, a contribution to the costs involved with the supply function is deserved, but to want to make reward for supply the lifeblood of a community pharmacy as it has been in the past, well, that's embarrassing.
We should be rewarded for the real value we add. That isn't simply for supplying medicines with perfectly aligned labels wrapped neatly in paper bags. It's for clinically screening prescriptions, dealing with patient enquiries, treating minor ailments and any of the other activities it takes five years of training to be able to competently undertake.
Developing a pharmacy contract which reflects that would be a significant challenge no doubt, but it could be the grit that yields the pearl. Scotland appears to have made good progress in the right direction.
A redeveloped contract should also provide an opportunity to change the current model of working to address the workload problem. Pharmacists needn't dispense or check - we're fortunate to have highly trained technicians more than competent enough to do that. Pharmacists need only clinically check prescriptions, freeing them to provide professional services which have greater impact and add more value.
Currently community pharmacy seems to be in that tentative limbo hover where it could either fall to the ground or make it to the other side. Let's hope it makes it to the other side where the applause awaits. The profession, the NHS and patients will be the better for it.