Cap on Pharmacy Schools

[DavidS]

Ultimately I see something akin to the European model where, in some towns and cities, there is a pharmacy on every street corner!

Bring it on. In the old days, whenever I had a shop within reach of a pharmacy run by or taken over by Boots or Lloyds my turnover used to shoot up. Several entrepreneurs (Allan Lloyd amongst them) made their money by opening as close to multiples as they could get.

The fact is that the multiples cannot compete with the independent in terms of individual services. Counter-intuitive? - well, think about it. If I own a pharmacy and want to spend an hour a day knocking on doors and delivering goods personally, I can do that. I'll be there next year, too. I can choose what I want to stock. I can offer regulars, doctors and nurses a cup of coffee and a chat. (Especially nurses, but that's another story). I can ask them what they want from us, and can sort it out that day. I can have SOPs with lots of discretion built in.

Multiples just can't do that. Multiples compete by using spin and advertising.

Of course, things are changing. Doctors are opening 100hour pharmacies in the belief that they can make money from them. That has got to be a bit ethically unsound and locally divisive, however the paperwork is organised. I don't see that strategy encouraging intra-professional harmony, either. I'm not sure I wouldn't get a bit aggressive if that happened around my shop, my bank-loan.

[looking243]

Since every Pharmacist mistake that comes to court is well documented in the press and these cases are few and far between it seems likely that the number of pharmacists in prison is very low and that those inside are more likely to have committed fraud or theft than making a dispensing error.

I didn't say "only" I said "likely". If you do a geography degree you may at the end get a job utilising your chosen degree subject. There may be many jobs that require a geography degree. However you can't come out of University and make out that your worth £45k a year simply because of your paper qualification.


ALL areas are affected so it includes pharmacy. Pharmacy isn't some sort of special case.

It's not clandestine at all. The introduction of SOP's, changes in regulation and service specifications moves us all towards a more standardised way of working. It's not a secret. If pharmacy as an industry cannot deliver consistent service between outlets then it will not be suitable for commissioning of locally funded services. The multiples already have a standardised way of working so they are favoured by commissioners as they can deliver consistency in a way that lots of competing independents cannot. Is your consultation room clean and tidy or is it filled with stock and DOOP bins?

Pharmacists are not accepting of change no matter how much promulgating they do. New pharmacists with a better understanding of delivering commissioned health services, rather than being geared toward a dispensing volume, will replace the old stick in the muds.

Thank you for your reply. Yes I agree with much of what you say. As you say, all areas are affected, not only pharmacy; therefore why would we want to dilute the pool churning out more pharmacists?

I still disagree with you when you say pharmacists are not accepting change. As you have pointed out with new regulations, pharamcists had to change then? Time for a culture change | PJ Online

[LeftArm]

As you say, all areas are affected, not only pharmacy; therefore why would we want to dilute the pool churning out more pharmacists?

This I'm not too sure about. are there restrictions on entrants to similar degree courses? Dentist, Doctor, etc? The cynic in me would suggest that Universities can see a drop in entrants to non vocational degrees because of their restrictive pricing (9K per year) but can justify the cost for a degree that has a value at the end (whether real or perceived).
If pharmacy can create itself a larger role there will be a need for more pharmacists.

As for the link you supplied:

Pharmacy practice is in need of a culture change which, by taking a more professionally focused approach, will lead to a more just working environment. Do these words sound like gobbledegook or do they resonate at some level?

For many pharmacists, in all sectors of practice, keeping going and managing the current workload is all they can cope with at the moment: they have little time for reflection or change. However, there are indications that life cannot go on as it is. For instance, further increases in prescription numbers are not sustainable in the current model — particularly if pharmacists have to find time, for example, to provide the new medicine service, to offer the chronic medication service or to conduct a discharge medicine review, depending on where they practise in Britain.

Doesn't this suggest that pharmacists are finding it hard to change their practice from pure script volume to one of service provision? "Culture change" will only occur with a radical change in current pharmacy thinking or replacement by pharmacists who already have a different aspect on what pharmacy is about.

Perhaps the extra pharmacists will create a two tier system with some pharmacists continuing in a dispensary role in a shop, or more likely in a warehouse somewhere, while others go on to provide clinical services promoting preventative treatment and managing long term conditions or similar.

[looking243]

^ That is the issue here, how will pharmacy ever create a bigger role when GPs are getting the power of commissioning? They are asking for their 100 hour dispensing doctor surgeries. Furthermore, why would they want to provide finance for some pharmacy down the road for smoking cessation or EHC when they can do it in their own surgery with their own nursing staff?

[Merlyn]

Commissioning will have to be a transparent process, with any willing provider having the opportunity.

That's the official position, and no I don't believe the playing field will be level, either.

[looking243]

^ Transparent and not being a level playing field does not go together

[Merlyn]

Quite.

[sparkybw]

My GP has just opened a pharmacy inside the surgery in spite of the fact there is a Boots pharmacy attached to their building and just five steps from their front door. They claim it is 'to give patients more choice'.

Like the 100 hour pharmacy in Asda, a potential new 100 hours pharmacy in the new Tesco when it opens, a large Boots with a pharmacy, a small Boots pharmacy attached to the surgery, a Co Op pharmacy, and a Lloyds pharmacy all within 100 metres of the surgery aren't sufficient choice!

Funnily enough they managed to get permission to open a new pharmacy where there are already a surplus of pharmacies, yet an independent was refused permission to open a pharmacy on my local housing estate shopping area on the basis that there were already sufficient pharmacies within easy access of the estate. The nearest pharmacy is at least one mile from the proposed new pharmacy.

[looking243]

Well we have seen today that GPs are avoiding the whole new NHS bill BBC News - NHS reform bill: Royal College of GPs urges scrapping

Do we really think they will stand by their backing out?

Who will be the next target to handle the mess of the NHS?

[SolomonQ]

maybe they're looking for promise of more money