A Christmas Tale part 2

Pharmacist Scrooge was again awakened from his bed. A Ghost introduced himself as Christmas present.

“How are you – are you enjoying Christmas?”
“Yes I will get a job soon – don’t you worry, everyone wants a medicines manager, we have been the only people in the NHS to have been successful.”
At that moment Scrooge was spirited away into a room deep in no 10.
“How do we get the economy going” said a worried Prime Minister, “the pharma companies say that they are making representatives redundant and not launching medicines in the UK” and “I have everyone saying that we are slow to take up new technologies even if they are recommended by NICE”

Pharmacist Scrooge’s face flushed with embarrassment. “They think it’s my fault!” “I was implementing evidence based cost effective medicines management and my budget fell every year”

In a moment he appeared in a community pharmacy and watched the discussion with an accountant. “I am afraid that things look a little tough. Corporation tax, personal tax and now reduced income” “Could you find other income streams to help”.

“Hmm I should have changed a while ago, but it is difficult to pay salaries to those clinical specialists when you can’t guarantee the income” ” we just did not get the right help and direction”

Before Scrooge could say a thing he appeared in a nice little room. “I’m sorry Tim, but it’s not been easy, I only get £16.50 an hour for locus now and there is so much competition”.
“But Mum, you are so clever, those courses and your independent prescriber status and all your patients love you”.

“I know Tim, but the GPs don’t employ many pharmacists and the community pharmacists are not even delivering MURs and NMS services and locally enhanced services are harder to find”.
“But there are always the hospitals”
“Yes, I know you are right, but they found it difficult to change as well and money is tight everywhere”
“So why do I have to go to the hospital every time I want some new medicines? The consultant is very nice, but he only smiles and asks how I am”. “I am sure the administrator said “kerching” the last time”.
“It’s not my fault shouted Scrooge”, but he soon found himself in his old office. The room was bare and the wind blew through the broken window. In the corner sat his old team.
“I should have taken that job at the GP practice”
“Have any of you got your interview at the CCG”
“No, they only have 0.3 wte and that will be shared”
“Has anyone told Pharmacist Scrooge yet?
“Tell me what, shouted Scrooge, what!”, but before he could answer he was in a plush new office.
“What’s going on in the profession?” Asked a tall man in a suite.
“I don’t really know” “did you know that they haven’t appointed a pharmacist in the LAT yet.
“What none?”
“We’ll no – just the specialist commissioning pharmacist, but no medicines optimisation pharmacists, not a single one.”
“Medicines optimisation pharmacist – what is one of those – we need good old fashioned medicines managers – drive down costs and control that budget”
“But doesn’t always driving down costs drive down quality? Shouldn’t we be supporting pharmacists to drive up quality? After all if you look after quality the costs will contain themselves.”
“Poppycock! I will write a letter to the LATs – tell them how annoyed we are”

Before Pharmacist Scrooge could say anything, he was whisked again to a different office. A man was sitting there with his head in his hands. “What should I do”. He moaned.
“Lead – come out and lead” said Pharmacist Scrooge – we need to be lead to a better place” but he was just shouting in his sleep – a very disturbed sleep.


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