Terry Maguire recalls a text message-based explosion of frustration from an exhausted pharmacy sector. But was it merited?

On the evening of the first Friday in June, an impassioned text appeared on the NI contractor pharmacists’ WhatsApp. It asked pointedly what had changed for community pharmacies in the 15 months of the pandemic; we are busier than ever dispensing more medicines and dealing with increased patient queries since GPs had locked themselves away; the work-load is relentless.

The Health Board had just announced that funding for Covid-19 services would be stopped and that a business loan, issued to each pharmacy in March 2020 to ensure service continuity, would now be paid back over 24 months. GPs, it was argued, were still being paid for not providing services and pharmacists needed to unite and stop any money coming out of the sector.

The post got traction; the lack, and cost of locum cover, defunding a service at breaking point with consequences for service delivery, were all aired. A humorous cartoon was posted of a man urinating on the telephone receiver while commenting to his wife that “the doctor wants a sample” was agreed to be a good summation of the situation.

There was reference to the militancy of the local nursing profession who, before the pandemic, came out onto the streets to secure parity funding with GB colleagues. An essential service having money taken out in the middle of a crisis and with a third wave of infection on the doorstep seemed incredulous. Someone was incensed that £1 million of funding was given to a golf club. There was a call to engage with politicians and a suggestion for effective industrial action, such as we stop providing MDSs in September.

By 10.45, there were 12 pharmacy contractors in the discussion and we were all asked to signify support by replying ‘Not Happy’. A dozen more replies of ‘Not happy’ lit up my screen. There was a recap to sustain the discussion. A measured comment from a Contractors Committee member asked that the Situation Report (SITREP) which each pharmacy must submit weekly might reflect the discussion.

CPNI was hearing clearly what was being said, we were told, and would feed it back. And then it all seemed to calm down and the text exchanges went back to normal, complaining about the poor services and if anyone knew of a locum to cover the bank holiday.

Someone was incensed that £1 million of funding was given to a golf club

These discussions were an interesting explosion of frustration from an exhausted sector. But do they reflect the true state of things? CPNI are in a good place with the DoH and the Health Board because of the work the sector did in the early days of the pandemic and ever since. Constructive work is proceeding on service development, with associated investment for the community pharmacy network.

A PwC report, commissioned by CPNI, assesses the additional workload on pharmacies during the pandemic and will offer a dispassionate and objective assessment of what we are due. To enviously cite GP and nurse funding, or a golf club, as sectors that are much better off than community pharmacy is missing the point.

While it is understandable that contractors are aggrieved funding is being removed, there seems to be considerable ignorance of how well community pharmacy funding has improved since March 2020. The long-sought settlement of £132 million for community pharmacy in N Ireland has been achieved after 10 acrimonious years and in no small part due to the pandemic. This has been achieved even after returning the loan and removal of the small amounts linked to delivery services and business continuity payments. For what it’s worth, a medicine delivery service is not my idea of a professional service.

All has changed and for the better. Contractors have had a financially successful year by any measure; we had considerable additional funding onto the baseline. Outside the pharmacy funding, our businesses have paid no business rates, we have had a business injection of £15k, and in some cases £40k.

We are benefiting from the Covid-19 vaccination services and there is a commissioning plan that will see additional funded services added to the profession; a pilot on a UTI service and news of a commissioned compliance service. We need to respect the work ongoing between CPNI and HSCB that brings additional investment. It’s incumbent on all contractors to get behind and understand the detail and stop knee-jerk reactions that in the past caused so much instability that in the end, was not in the interest of any of us.

Terry Maguire
Terry Maguire

Terry Maguire owns two pharmacies in Belfast. He is an honorary senior lecturer at the School of Pharmacy, Queen’s University of Belfast. His research interests include the contribution of community pharmacy to improving public health