There is a time to be realistic and put away those rose coloured glasses. The Public Accounts Committee is probably a good place to start.
So they don’t believe that there is a clear and transparent transformation plan because everyone thinks that the STPs are just a mechanism for cutting costs. It is interesting to see that some STPs are already in ‘severe financial difficulty’ and are being asked for a recovery plan even before they start.
At last someone has realised that the local authorities have been cut to the bone and urgent action is needed to stop it all falling down and creating back pressure in the NHS.
And at last someone is asking about the consequences of the funding cuts and if the whole pack of cared will come tumbling down. Of course they realise that constant plundering of the NHS, for example removing the national insurance rebates, creates an unsustainable service.
The £1.8b bail out of hospital trusts has helped some, but it has not cleared the debt as intended – there may be £1.2b left to find. CCGs have been asked to create a 1% surplus to help this. And we know that many trusts out there are struggling to even identify enough possible cuts to balance their books – nothing is safe. And another £1b is being transferred from capital to revenue – so don’t expect any new buildings or maintenance or new technologies to be implemented soon.
One might suggest that it has become a world where we partner successful organisations with failing ones to cover debts and fines become one way of recouping money at the expense of other areas of the NHS. However, I am not one that suggests that this is a route to privatisation – there is just not enough money to tempt sensible companies to enter the fray.
Please don’t think that integration of health and social care is the best way forward – the National Audit Office could not find any compelling evidence that it worked. It is the stuff of leaders who have lost their way and need to find a horse to ride.
But things for the Pharmacy Profession is not all bleak. We have pharmacists in large numbers taking up roles within General Practice. We see some results from the PIED project putting Pharmacists in Emergency Departments – well done Mr Terry and co.
However, we must think a little about community pharmacy as it becomes clear that the current NHS contract will need cross-subsidising by private and retail services. It will introduce a bright new world where community pharmacists (who have always been clinical) take on even more exciting roles in the diagnosis and treatment of a wider variety of conditions. There are huge opportunities to drive better outcomes for patients through enhanced self-care and offering direct care.
So welcome to the bright new world where pharmacists are becoming ever more valuable healthcare professionals and community pharmacy can develop in leaps and bounds