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Sector-based prejudice against community pharmacy

I recently attended the ‘Quality for patients: pharmacy practice now and in the future’ conference on 22 March 2017, hosted by NHS England. I was looking forward to a positive, constructive day celebrating and showcasing all that is best among our profession, but I came away appalled by the attitude of the chief pharmaceutical officer for England, Keith Ridge.

During his 20-minute presentation he praised, one-by-one, every sector of pharmacy for its clinical excellence barring any mention whatsoever of community pharmacy. He continued in the same vein on the crucial subject of antimicrobial resistance: again community pharmacy was conspicuous by its absence. But, at long last, community pharmacy did feature: he reminded us that only four community pharmacies were deemed “excellent” by the General Pharmaceutical Council (GPhC).

Such distortion of facts might come as no surprise given the current political climate but surely we can expect better than that from the head of our profession? Although it is true that only four pharmacies were found to be “excellent”, the fact is that the GPhC had not defined “excellence” in its standards. Quite simply, the demarcation “excellent” was not achievable; indeed, almost every pharmacy was merely “satisfactory”.

But this is not the first time Ridge has failed to give the full clear picture to make a point. Let us not forget that, when addressing the All-Party Pharmacy Group (APPG), he overstated the rate of dispensing errors made in community pharmacy in an attempt to bolster his argument for automated dispensing (Pharmaceutical Journal 2016;296:263). Albeit, he eventually half-apologised for misleading the APPG with this “inadvertent” error.

The GPhC has gone out of its way to assure us that there is no intention to publish the results of its community pharmacy inspection scheme anytime soon precisely because it is still in its early testing phase. Yet no less a figure than the chief pharmaceutical officer for England chooses to make such inaccurate and morale-deflating statements in a further attempt to undermine community pharmacy. Can anyone imagine the chief medical officer doing the same to GPs?

Ridge must finally be held to account. I perceive this as professional (sector-based) prejudice and it must be challenged.

Graham Phillips

Wheathampstead,

Hertfordshire

NHS England has declined to comment on the letter. — EDITOR

Citation: The Pharmaceutical Journal DOI: 10.1211/PJ.2017.20202515

Readers' comments (2)

  • Some of the evidence submitted during the judicial review made dreadful reading. It's not opinion based it's factual. Who persuaded the chancellor that on line pharmacy is a viable substitute for bricks and mortar face to face consultation? Who persuaded Simon Stevens that pharmacists do nothing more than "dole out drugs"? Why does Jeremy Hunt have such a low opinion of us?

    Stand in your pharmacy and just listen to what is going on. The phone queries, the patients coming in full of anxiety, the GPs, nurses support staff all requiring advice and the solving of problems. Some can be done on line but most can't. Why do senior politicians not understand that? Who is giving them the "evidence "?

    Why were delegates at a recent conference told that a prescribing qualification has no use in a community pharmacy despite roles identified in the (buried?) Murray review?

    With 500 ambulances being turned away from busy A&E departments this year, GP surgeries closing as partners can't wait to get out, how were the health secretary and chancellor persuaded that closing pharmacies and moving towards a "virtual" presence was a good idea?

    We have already had misleading figures about error rates in pharmacies as well as misleading figures about the salvation by automation using systems unavailable in the U.K. I mentor pharmacy students, I also have pre-reg students. I do my best to inspire and enthuse. We want motivated committed talented people in pharmacy. But so vicious and prolonged is the assault on community pharmacy I wonder why I waste my time.

    The future of pharmacists as autonomous professionals is not in a "Doctor's handmaiden" role in a surgery despite David Mowat thinking he's invented the wheel when announcing it at the PSNC conference. Practice pharmacists have been around for over 20 years and yes they've done excellent work. But the network of pharmacies is surely worth exploiting to help relieve the intolerable pressures on primary care?

    Community pharmacists have long talked about using their skills. We have taken on new skills. I personally was a first wave prescriber. Young pharmacists I encounter can't wait to show what they can do in their communities. But the language from the top of government is about "subsidy", "over provision" (despite a policy of only granting dispensing contracts when demonstrated to be necessary or desirable for nearly 20 years) and retailing.

    How has this come to pass? Why are we now treated as pariahs? How can the chancellor of the exchequer allay the prime minister's fears about tearing down the community pharmacy infrastructure in a dangerous experiment which has no evidence base to support it's design?

    Who told the Health secretary or the chancellor that community pharmacy is as valueless as they currently believe?

    It wasn't a junior clerk.

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  • Altaf Vaiya

    Having read your article Graham, seeing first hand the difficulties the community sector has faced, I too find it difficult to see how Keith Ridge has actually supported community pharmacy sector.
    I can quote from a newspaper extract I have read ' In a letter sent to Sue Sharpe, chief executive of the Pharmaceutical Services Negotiating Committee, NHS England’s chief pharmaceutical officer Keith Ridge set out the plan alongside details of the proposed cuts. He said: “In future, patients should be able to choose to order their prescriptions online and have them delivered to their home if they wish, or to ‘click and collect’ if they prefer. We will also be looking at steps to encourage the optimisation of prescription duration, balancing clinical need, patient safety, avoidance of medicine waste and greater convenience for patients.” 
    This clearly states the objectives Keith Ridge has for the future of the community pharmacy sector, automation in the community sector does not create jobs it helps destroy jobs unless the government changes the way community pharmacy is funded.
    I believe that Keith Ridge should be supporting pharmacy as a profession, to do this he has to look at ways to work with the current stake holders. Pharmacy needs strong leadership, it needs inspiration and it needs change, the future of our profession lies in the people we trust to lead us. The community pharmacy sector needs dialogue and it needs to address its concerns. Leaders like Keith Ridge need to understand the valid concerns the community sector faces and should be able to support the sector and bring in robust systems that protects our profession. Initiatives should be encouraged but not at the expense of future generations of pharmacists hoping to make a career in community pharmacy. I think the leadership in England can learn from Rose Marie Parr, the CPO for Scotland. who is investing in the future and planning to have all pharmacists trained to become independent prescribers by 2023.

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