An organisation representing pharmacists says Scottish ministers should broaden who they talk to as they seek a new contract for community pharmacy.

Late last month, the pharmacy owners’ body, Community Pharmacy Scotland (CPS) reported that talks with the Scottish government on the contract had broken down. Maurice Hickey, Head of Policy for the Pharmacists’ Defence Association (PDA) in Scotland, says inviting frontline employed and locum pharmacists, who deliver the contract, to the negotiating table could pave the way to a better deal that benefits patients, taxpayers, and community pharmacy teams.

There is a need for discussion and decision-making that listens to and balances the rights and responsibilities of both employers and workers, to generate benefits for individuals, organisations, and society.

Even though Scotland provides the most generous community pharmacy settlement in the UK, recent reports suggest it is not enough for pharmacy owners with CPS’s rejection of the latest funding proposal in May.

Though the Scottish government found an extra £20m to ease pressures related to medicines price increases, an overall agreement has still not been reached.

The UK-wide chains may be doing less well in the parts of their networks covered by the Westminster government’s contract, but the taxpayers and government of Scotland need to be given reassurance that they are in no way subsidising funding shortfalls in England’s pharmacy contract.

Owners of pharmacy contracts in Scotland have been paid on terms agreed with CPS for many years, for drugs dispensed and pharmaceutical services supplied. The attractiveness of owning a community pharmacy in Scotland is reflected in the apparent buoyancy of the market and the prices businesses are willing to pay to own more of them.

When Lloyds Pharmacy’s Scotland branches recently came on the market, they appear to have been sold exclusively to existing contractors, including the UK-wide multiple, Rowlands Pharmacy, who have acquired 30 of them. Other small and medium-sized Scottish pharmacy chains have apparently been able to double in size overnight by acquiring branches.

Despite pharmacy owners seemingly being able to invest and grow their businesses, the scale of extra government funding provided to the pharmacy owners has not trickled down to their employee pharmacists or other staff, whose wages have stagnated for the last 15 years. In many cases neither has it been reflected in investment in staffing levels, premises, or training. The General Pharmaceutical Council (GPhC) which regulates Scotland’s pharmacies continues to report unsuitable and sub-standard premises, and pharmacists are often told to undertake training unpaid, during non-working hours.

Pharmacies closing their doors for all, or part of a day has also been an issue in Scotland over the last few years.

The PDA has sought to highlight this problem as it is a matter of public interest and patient safety. Often excused by claims of a lack of locums or shortages of pharmacists, this ignores the increase in the number of GPhC registered pharmacists from 41,000 to over 60,000 in the decade to 2021. Pharmacists are, however, deterred from working in pharmacies that are understaffed and offer poor working conditions.

Business owners are paid regardless of occasions when they choose to keep their pharmacies closed – even if locum pharmacists were available to work in that location at the time. By keeping their pharmacies closed they may have been denying patients, their carers and the local community, access to a pharmacy. This poses a potential risk to the health of patients.

All of this contributes to the increasing low morale and intolerably high rates of poor health and burnout among pharmacists as recorded by the PDA’s Safer Pharmacies Survey and other sector research. The PDA has raised all these concerns and more with ministers and civil servants, yet the government has fixed dialogue exclusively with the pharmacy owners via their representatives at CPS, excluding the representatives of individual pharmacists. The PDA believes that this runs contrary to the Scottish government’s commitments enshrined in the Fair Work Convention.

Community pharmacists deliver NHS Scotland pharmaceutical services to patients and the PDA says that they do this well under the most difficult and trying conditions, often sacrificing their own wellbeing to provide safe patient care. However, they could do so much more and better if the government would include their representatives in tripartite discussions to help shape the conditions in which they practise.

In this spirit the PDA calls on Michael Matheson, Scotland’s new Cabinet Secretary for Health and Social Care, to agree that within the spirit of the Fair Work Convention, there should be tripartite discussions around all aspects of community pharmacy provision. Discussions must involve the government on behalf of NHS Scotland, CPS on behalf of the owners, and the PDA as the pharmacists’ representative.

Read more about pharmacy in Scotland: £20m pharmacy cash injection small amid rising costs; Community Pharmacy rejects funding deal;  A pharmacist on the frontline; Study shows value of pharmacy in care homes

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