How much we can have to look forward to really is as clear as mud. Operating in a vacuum without a vision and strategy for community pharmacy … the optimist and the pessimist could have some fun here with their glass of water, writes Ultan Molloy
As I write this, the Irish Pharmacy Union (IPU)conference is looming next weekend on 26-27 April. We’ll no doubt have any amount of words of praise from our special guest, the Minister for Health Stephen Donnelly. We can feel good about ourselves and pat ourselves on the back, having being recognised as valuable healthcare professionals in every community, countrywide, providing accessible and affordable care on a walk-in basis, up to seven days a week in many cases.
There will be talk of extending the role of pharmacists, personal experience of pharmacists and pharmacies, and a photocall to use for press releases, advertising, and political propaganda. The shining light – that is, the now not so recently established pharmacy task force – will be lauded, and there will be promises of talks about talks of extending services through community pharmacies, and utilising the pharmacy network to its greatest potential.
What we will not hear about is a vision for community pharmacy into the future, involvement of a chief pharmaceutical officer at top tiers of government when the primary care budget is often being divided up by medics-turned-administrators, and we will not hear about any pay restoration to pharmacies or unwinding of FEMPI (Financial Emergency Measures in the Public Interest).
Negotiation with a bully, with one arm tied behind one’s back, is not a negotiation, although we know our IPU colleagues are doing their best to influence a win-win-win (patients-State-pharmacy) as our profession again looks to a vague and opaque future. How much we can have to look forward to really is as clear as mud. Operating in a vacuum without a vision and strategy for community pharmacy, we continue to do our best, with our dedicated teams, cross our fingers, and hope for the best! The optimist and the pessimist could have some fun here with their glass of water.
We do know that we have an ageing population, and increased medical care will be needed, while rising numbers of medicines are likely to be dispensed. What we also know is that this is happening in neighbouring countries, at the same time that pharmacy is being decimated with crude and shortsighted government cuts and policies. What our fate will be is no clearer to me now than it was when I started writing these pieces many years back. We can reflect on what we do know, and aim to control the controllable for now, in tandem with perhaps returning to a practice engaged in acceptance and uncertainty. Nothing is permanent, and change is inevitable, as has become abundantly clear more recently, although change for the sake of change is tantamount to folly. Are there any change-makers and can they be trusted to represent everybody’s interests?
Meanwhile, my wife’s friend asked me today, why the next available appointment with her GP is in two weeks’ time? I don’t know. For busy people, GPs have taken on an amount of additional work over the past 10 years through embracing a chronic ailments scheme and involvement in Sláintecare, and the significant payments that have come in tandem with these. Nobody is saying to their local politician that they can’t get a pharmacist for the next two weeks, however, so officialdom appears happy to embrace the status quo for community pharmacy.
On hold
Our six-year-old, who was ready for a break I’m sure, fractured her wrist a couple of days back. We didn’t even consider contacting our GP, although when one has one’s GP’s personal mobile, the level of service we could get in a situation like this is thankfully reassuring and much appreciated. Going through another ‘new’ receptionist, as the gatekeeper, would likely have much less favourable results. It is not only patients who get the brick wall either, with one receptionist roaring down the phone at one of my colleagues last week, before hanging up. A requested call back by her to one of the GP practice partners never materialised. If the message for a personal call back ever made it to them in the first place, of course.
So, we headed for the Laya SwiftCare clinic in Galway with our lady, where we could walk in, wait a short time, see a GP, have an X-ray, a cast, and with a return visit to a consultant in a fortnight. How is it so easy for this to happen in the private sector? With health insurer involvement in community pharmacy imminent, we will have to stay on our toes, as whatever happens, more of the same is unlikely to prove to be a recipe for long-term success. Pharmacies offering adjacent online GP services to patients is becoming increasingly popular as an example, and is it any wonder, given in-person accessibility in many cases.
Keeping it all in balance, given our perpetual motion, and an unnerving tendency towards chaos, has me again reflecting this month. I guess the experience of having children join us in recent years has educated me around the demands, responsibility, and upheaval that our present family situation often brings.
Our workforce needs collegial support and flexibility also in order to thrive, and this can be tricky,
given the in-person demands of retail community pharmacy, in tandem with the ongoing shortage
of skilled staff and community pharmacists
It takes a village … as our American neighbours remind us when it comes to our kids. Our workforce needs collegial support and flexibility also in order to thrive, and this can be tricky, given the in-person demands of retail community pharmacy, in tandem with the ongoing shortage of skilled staff and community pharmacists. More pharmacy courses at third level are in the pipeline, which hopefully will prove to be a positive for all involved – patients, pharmacists, and employers.
Sun, sea, sand, and stress
We had a situation where it was next to impossible to book holidays a couple of years back without paying mercenary rates for sometimes very average locum cover in terms of accuracy, work ethic, engagement, and productivity. Thankfully, there are some great locum pharmacists, and we try and keep our relationships warm with the best of them, and make the whole experience of returning to work with us a pleasant and mutually beneficial one.
Hourly rates are dropping significantly, which may precipitate a move towards a steady income, working as pharmacy employees, and showing a commitment to the relationships in the pharmacy team and with the patients. The inability to find a competent and committed supervising pharmacist was the primary reason which led us to selling one of our pharmacies in the not-too-distant past. When we did get somebody for a period, when locum work dried up, they returned to locuming when the market changed again. While it is helpful to understand if you’re employing a missionary, or a mercenary, one can only speculate in some cases at the outset. That’s just the way it is. Focus on what is in one’s control, and suck it up, I guess!
I did hear a story of a WhatsApp group of city locums colluding to cancel locums at the last minute to drive up rates for cover for one another. Who would do such a thing to somebody who was looking forward to a few days off, perhaps with flights and accommodation booked. Perhaps with family and young children? Surely not somebody in a caring, professional, and patient-centred profession. I just don’t believe it. You’d want to be a real piece of work to dick somebody around like that. I suspect karma will have a role to play in due course. Anyway, so we’ve had a reprieve from what has seemed like six months of rain, in the last week. My dad was a devil for going on about the weather, and often had his mood attached to the weather on any particular day. Here I am going on about it. In any case, everything feels lighter and brighter with the longer days upon us, and some much needed sunshine. I think that I get a bad dose of seasonal affective disorder, but lake swims, rest, and the gym continue to help me keep the black dog away. There’s a bit of work in it though, and not every day is a great day, but there we go. Roll on a great summer, whatever it looks like. Hope yours is a good one!
Ultan Molloy is a business and professional performance coach, pharmacist, facilitator, and development specialist. He works with other pharmacists, business owners, and third parties to develop business strategies. Ultan can be contacted on 086 169 3343.
