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Chief pharmaceutical officer of England ought to be congratulated

From Graham Phillips’s letter about his attendance at the ‘Quality for patients: pharmacy practice now and in the future’ conference (The Pharmaceutical Journal 2017;298:234), I thought he was going to report on the conference but all he offered was a rant at the chief pharmaceutical officer (CPO) for England for, in his view, inadequate praise of community pharmacy.

The CPO for England is well able to defend himself and I note The Pharmaceutical Journal offered Keith Ridge the opportunity but civil servants rightly avoid public professional spats and are limited in what they can and cannot say publicly, particularly at general election time.

It is easy to offer criticism but this should be professional, constructive and courteous, particularly in such challenging and turbulent times. Disappointingly, Phillips failed to offer any evidence of widespread successes in community pharmacy that sit well with the title of this conference, only criticism of (and some rudeness towards) the CPO. I was under the impression that unprofessional behaviour towards or about a colleague was at best frowned upon by our profession. Phillips’s letter certainly skirts with this.

I would draw readers attention to another letter published recently (The Pharmaceutical Journal online, 11 April 2017). This talks of collaboration to achieve cross sector success and highlights the achievement of the CPO in raising the profile of the medicines agenda in NHS England’s ‘Five year forward view’ (the same applies to a number of other NHS England and Department of Health documents).

No one should underestimate the difficulty in getting such profile in government documents against many competing NHS priorities and we should celebrate the resulting opportunity for pharmacy. The scale of pharmacist posts announced for employment in GP surgeries is such an example and is as much a wake up to our profession to get involved in clinical activity as it was to the GP community and public of the role our profession can offer.

The CPO should therefore be congratulated for his successes in the current hostile NHS financial climate and we should be looking forward not backwards. We as members of our profession should be seizing and exploiting the opportunities before us and be shouting about them, not involving ourselves in backstabbing our professional leaders who have fought and succeeded in getting these opportunities for us. Time to be more professional and collaborative I think.

Ron G Pate


West Midlands

Declaration of interest: Ron Pate has undertaken consultancy work for the Department of Health and chief pharmaceutical officer for England with respect to specialist pharmacy services in 2013 and rebalancing legislation in 2014.


The declaration of interest of added retrospectively on 1 June 2017 — Editor.

Citation: The Pharmaceutical Journal DOI: 10.1211/PJ.2017.20202769

Readers' comments (6)

  • So... where to start!

    Reading Mr Phillips' letter, I in no way feel any professional boundaries have been broken and I see no personal insults or unfair accusations made. Mr Phillips is simply pointing out what happened at the conference.

    As a professional, you should be prepared to explain your reasoning and the thought process you used to come to your conclusions. I feel this is the very least Dr Ridge can do, if for no other reason than to explain to the some three quarters of the profession that he seems to feel are superfluous.

    If Dr Ridge is able to defend himself, why has he not done so? This is much more than a "professional spat" and I find it really quite pathetic that this is being used as a reason for the CPhO to avoid defending and/or justifying the actions of the government, which he seems to back, let alone entering a discussion with the profession. What the government plan to do threatens the very viability of the NHS!

    Celebrate the resulting opportunity for Community Pharmacy? You mean the opportunity for the ones that may survive the cull that Dr Ridge seems to advocate? And for those fortunate to survive the blunt and reckless cuts, would those opportunities involve the sales of sandwiches and shampoo?

    I look forward to your response, sir.

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  • The silence is deafening...

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  • I understand the support Dr Ridge enjoys from Hospital pharmacists and I can well understand that young pharmacists who until the events of the last 18 months probably felt obliged to work under, what are reported as being, huge pressures as employees of one of the multiples, would be excited by the plans Dr Ridge. I myself was excited by many of his utterances e.g. . However since December 2015 when the funding cuts were first announced many things have happened that have been the cause of serious disquiet amongst community pharmacists.

    To be absolutely frank, at a time of huge financial pressure, everyone relying on the exchequer to fund their operation should have been looking at efficiencies and new ways of operating that would yield both a more cost effective way of working and better outcomes for those they serve. Both those funding the service and those accessing it. Be it refuse collection, community policing, General practice and, without doubt, community pharmacy. But to be equally frank, Graham Phillips as a community pharmacist has put more of his money where his mouth is than any other community pharmacist currently practicing that I am aware of, and probably, per pound of resource his organisation generates, a lot more than the big "players" in Community Pharmacy currently operating in the pursuit of new ways of working and innovation.

    He would be the first to admit he is not alone and many of us have also played our part. I was a first wave prescriber and I have been fortunate enough to have been part of a social enterprise I helped found, providing drug treatment services. I, like Mr Phillips, am a previous winner of the Pharmaceutical Journal "Pharmaceutical Care award". We are both passionate believers in community pharmacy being part of the solution as opposed to part of the problems confronting primary care at the moment. Not out of attempting to hang onto our income but from having invested our own money, time and effort in working with other primary care providers and seeing sustainable outcomes. And let's not forget, earning the thanks and respect of our patients in the process.

    Whilst recoiling at the description of "clinical pharmacists" working in GP surgeries I welcome the move to get more pharmacists into such positions. I first performed such a role in 1994 and met my own increased indemnity insurance costs. I am well aware of the value a pharmacist adds to general practice and pharmacists were subsequently employed by FHSAs then PCGs and then PCTs before, in the main, the role was taken over by private companies who employed such pharmacists. There are significant providers of such pharmacists to general practice and their roles are in general co-ordinated by private companies and the third sector under competitive tendering arrangements. Contracts being renewed every 3-5 years. So forgive me for not standing back in awe at what David Mowat has been taking credit for.

    The disquiet I refer to has been the way in which the DOH proposals ended up being imposed in a bullying and ill considered way. The judicial review opened the lid on the tactics the DOH employed and their callous disregard for the work done by pharmacists working in primary care and the outcomes they have been achieving.

    Initially the announcement of a £300m pharmacy integration fund was good news. However, at the last count it had shrunk to £42m and details were expected in April. Before the announcement of the general election so I won't accept that election "purdah" prevented that announcement. However, if it does remain post election, it should prove an opportunity for community pharmacy to demonstrate that which it has been claiming.

    It is not my intention to start a war of words with Mr Pate, a man who has practised with such distinction he has been awarded an MBE. However, as I have previously stated, hospital pharmacists, with their own pressures, have much to be grateful to Dr Ridge for. The implementation of the cuts has been done in a savage and meaningless way. The JR demonstrated that the 4% cut was as high as 20% for some contractors and will be higher this year. That is a much higher burden than any business, seeking to invest and change, should be expected to bear. Particularly when DOH sentiment seems so anti community pharmacy and the CPhO himself seems to say so little in support of community pharmacy. I am as hurt as Mr Phillips by the comment at a well publicised conference that seemed to rubbish the requirement for a community pharmacist to seek a prescribing qualification. The comments about GPhC inspection outcomes etc have been dealt with elsewhere.

    I believe the time has come for Dr. Ridge to clarify his remarks as reported by Graham Phillips. If he does it would be the beginning of a welcome engagement with community pharmacy. In Scotland, with it's similar health problems and identical recruitment problems there is significant investment in and development of pharmacy's role in managing minor ailments and long term conditions. The data has been collated since 2005 and is available as a matter of public record. Why is England hell bent on a dangerous experiment with no precedent? Distance selling pharmacies are declining in the USA, the only major example of such a phenomenon. Why is Philip Hammond so sure it will be a success here? Who advised him?

    If Dr Ridge is prepared to engage and explain his apparent antipathy towards community pharmacy it will do him great credit. In a private conversation with him at my pharmacy in January he was very encouraging. However public utterances have been at odds with what he said. If he does not engage, or, continues to be responsible for quotes (which he doesn't refute) that undermine community pharmacy the English National Board of RPS should be engaging in a process that demonstrates a lack of confidence in Dr Ridge. It is well known that many ENB members are disturbed by his attitude towards community pharmacy but also pharmacy academia and the time may be coming when they need to justify their own pleas for votes.

    I speak, not just as a pharmacy proprietor but on behalf of employed pharmacists and locums who have contributed so much to their local patients that a petition of 2m signatures was achieved in opposition to these cuts.

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  • I would agree with Mr Pate's view that Keith Ridge should not engage in public professional spats, where it not that Mr Ridge had instigated this by his use of biased and inaccurate comments in a public arena. It is an old lawyers trick to ask a question which the judge deems inappropriate but the question - or, in this case, comment - has been made and cannot be "unsaid". As the manager of a pharmacy where our inspection rated us as "good", it is personally offensive that Mr Ridge should comment that "only 4 pharmacies rated excellent", as this places inappropriate emphasis on the top result while ignoring others who score above the, if I am honest, frustrating label of "satisfactory". I should be interested to hear what Mr Ridge has to say in response

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  • I think the late addition of the Declaration of Interest on 1st June 2017 says everything you need to know about the purpose of this letter....

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  • Indeed Mr Merriman. What a shame I wasted time formulating a response. Had the conflict of interest been noted at the time the letter was published it would have been seen as a defence by a consultant who had benefited previously and saved a lot of unnecessary effort.

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