Community Pharmacies must start to think in a co-operative way. This is the way to encourage change. Change that delivers better outcomes for the local communities.
Primary care is mainly built with independent contractors. In fact four groups of independent contractors operate within this arena. You could mix in here a community services provider, a mental health provider and a social care provider. And add a little police and ambulance and fire services, some housing and education with a whole host more. Well that is what makes up community based public services. The contracts are all set up individually which creates isolation, competitive behaviour and gaps between services for people to fall between.
It has to stop! We have to start to think in a more joined up manner which starts with the community at the heart and builds the services around in a joined up manner.
I am seeing GP practices forming co-operatives. One in Brent provides services for approximately 80,000 people. The co-operative are able to provide a greater range of services, sharing both management and clinical skills and experience across the group. The sharing is important for them to all improve to a level and move forward consistently providing a quality service to their community.
As a guess there would be 10 community pharmacies that are within the boundaries of the co-operative. A further guess would say 5 independent or small chains and 5 from the multiples. I could add 6 dentists and a further 6 optometrists, but that would add a further layer of complication for today.
Would the 10 community pharmacies form a parallel co-operative and create a memorandum of understanding? Would they get around the table as a ‘team’? And would they discuss the needs of the local community with the local community to work out how they could better work together as a group and as an important part of a larger initiative? And would companies change their ways of working to support this?
I was going to focus on the multiples, but I suspect that the independents won’t find this easy either. It requires some fundamental changes in the way that Pharmacies are run.
- Co-operatives must form a general working structure that allows them to meet with and work with other local service providers
- Pharmacists, usually managers rather than owners, must be empowered and supported to negotiate local working arrangements and service development.
- Pharmacists must be supported to develop local services within the joint co-operatives either in tandem with or instead of national company driven services
- Companies must find ways of supporting and incentivising stability within a single location
Members of that community will begin to see that they have not 10 access points for healthcare, but 20 and services that might be offered by a few can now be offered by all. With co-ordination and information sharing it might just look seamless. MURs and common complaint services can link across practices and pharmacists can join in late night and out of hours provision. A wider range of public health services would be more efficient if fully linked up with GP practices.
This might seem a big hurdle, but to get 10 GP practices and 10 community pharmacies working closely together in a single community will be a great start and an example to encourage other providers to join together.