The end is nigh (of 2012) so I thought I’d get in early with some pharmacy predictions for 2013, and given how much uncertainty the NHS will be in from April I’m expecting to be as good as the Mayans in getting this right.
Starting from April the biggest changes will obviously affect our colleagues currently in primary care: the lucky ones will end up being part of a Commissioning Support Unit (CSU), the really lucky ones will be in a Clinical Commissioning Group (CCG). Many won’t be lucky and there’s a real risk that some great talent that may be lost from pharmacy altogether: at a certain level in PCT-land you’re not clinical enough to keep your banding in a hospital, and you’re earning too much to go straight into retail. Pharma is one option, but they’re not a safe bet if your mortgage depends on it.
For the lucky ones their work will be dependent on how focussed and forward thinking their CCGs are: there are some real opportunities to make a difference to patients and their medicines, but I fear that most of their work in 2013 will be nickel & diming.
Sticking with the NHS, let’s consider our hospital colleagues. Again money dominates: acute trust funding, FT or not, is going to get a kicking especially when CCGs try to squeeze tariffs or pull activity via referral reduction or re-commissioning work into the community. In this instance, retention will be about specialisation – focus on a speciality disease area, be super clinical on it and prove you make a difference; my money’ll be on cardiovascular and endocrine. Other opportunities will exist though for those in trusts who hold vertically integrated community services….
Community services pharmacy is, I think, where the exciting stuff will start to happen: whether CFT, FT or independently based these services are being seen as the answer (wrongly) to the NHS’s ‘troubles’ and will need to really innovate to deliver outcomes on restricted budgets. Where better to show the value of pharmacists? If Medicines Optimisation has a natural home then this will be it. Hand in hand with this are our colleagues in mental health services: the new Health Secretary’s focus on dementia will play well here as funding will follow – again another good place for medicines optimisation to thrive.
Retail pharmacy: my roots and love in all of pharmacy. I think 2013 will be a holding year for retail with little changing, but I suspect that it’ll be the calm before the storm of self-selection and remote supervision in 2014. The difficulty will come from a lack of proven outcomes for what is done already, a squeezed budget from central NHS coffers and a lack of a cohesive plan for more commissioned clinical services. An influx of pharmacists from PCT-land may also add pressure to the workforce, and staff may find (as locums are now) that remuneration and T&Cs are adversely affected. And if that’s not bad enough you’ll all still be selling homeopathy.
Academia: I have no idea! You’ll have to speak to Messer’s Bush and Cox (no seriously, they’re called that, and they aren’t a late-night Channel 5 comedy duo: go follow @josephbush and @drarcox to find out)
Industry – err. Dunno?!
There will be opportunities to do some innovative things in 2012 but it’ll be small-scale, patchy and uncoordinated; if experienced pharmacists have the balls then they’ll start up their own provider company (no CQC registration needed remember) and approach CCGs with ideas on what they can do to makes medicines count for patients.
In retail, the opportunities will be outside the NHS and with Local Authorities, using their key geographical positions, extended opening hours and enviable reach and footfall to place themselves at the forefront of what’s left of public health. But if anything, pharmacists are the most business-minded of healthcare professionals and in this current climate that is a huge strength.
But then again the best laid plans of mice and men and all that…
Roll on the New Year…