Core Belief: Supply and service belong together

01 Aug 2017

The link between supply and service is our history and our future. This link is a crucial element of the established, trusted service model of community pharmacy – namely convenient, face-to-face care from health care professionals, locally responsive and community based.

Mark Burdon has been a practicing pharmacist since 1999, and a committee member of the Pharmaceutical Services Negotiating Committee since 2006. In addition to running a group of five pharmacies in the north east of England, Mark is a fellow of the Royal Pharmaceutical Society and has recently been appointed Treasurer of the World Pharmacy Council.

There have been attempts recently to break the link between service and supply; facilitated primarily by the ill-conceived “hub and spoke” consultation. Large automated warehouse dispensing is thought to be more efficient (i.e cheaper) than dispensing in community pharmacies, yet no evidence of the economic benefits has been put forward. Neither has the effect on patient safety been properly assessed. Despite this, the government proposals predicted that half of all medicines could be supplied in this way

Promoted as a capacity releasing measure, this transformation is said to make community pharmacy more clinical, by removing the pharmacist from dispensing. Proposals to remove the requirement for pharmacist supervision of dispensing will supposedly allow pharmacists to leave the premises to perform these (yet unspecified) clinical tasks.

Meetings of the so-called ‘Rebalancing Board’ have been discussing just this.

Others may think this is all new. It is not. The Civil War from 1642 to 1649 as well as the Great Plague of 1665 and the Great Fire of London (1666) amounted to chaos in London. Most physicians left town but the majority of apothecaries stayed behind to treat the sick. The apothecaries took the opportunity to enhance their reputation as medical men for the ordinary citizen, being the first port of call for medical treatment.

Turf wars between the apothecaries and physicians ensued once normal service had resumed in London. In 1701, an apothecary called William Rose unsuccessfully treated a man and a complaint was made to the College of Physicians. The case went to the House of Lords, who found in favour of Rose. They found that Rose had not illegally practiced medicine (which was prohibited in law), as what he was doing was custom and practice. In addition, apothecaries, unlike physicians, could not charge for their services – only for drugs.

As they were more expensive than the “chemist and druggists”, which became popular due to consumerism of that time, most (but not all) apothecaries left their premises and became part of the medical profession. The general practitioner came into being.

Will the latest attempts to price pharmacists out of the supply market drive community pharmacists towards new roles, as with the apothecaries? Or is this the road to oblivion

For my part, I believe that service and supply belong together and that maintaining this link is key to a sustainable future for the sector.  The model is safe and convenient for patients, fundamentally cost-effective for the NHS, and plump with potential for service development within the bricks & mortar community pharmacy network.

Author: Mark Burdon, Burdon Pharmacy Group