The subject of top-level talks, and their inclusion (or otherwise) of all those affected, is obviously a topical subject. In healthcare, we used to say ‘no decision about me without me’ and I always thought that was rather a sound principle.
Community pharmacists up down the land could be forgiven for thinking that is the opposite of what’s happening when it comes to the talks between CPE and DH, which could literally decide whether they have a business going forward.
Of course no-one is suggesting design by committee - there has to be a negotiator and a client and Janet Morrison is right to say she can’t provide a ‘running commentary’ - but pharmacists being so unsighted is far from ideal.
The excellent Nick Kaye at the NPA spoke for many when he called out the secrecy around NHSE’s economic review into community pharmacy funding.
This piece of work, commissioned in 2022 with next to nothing of its’ detail shared with the then chair of the Health Select Committee (yours truly), is still not forthcoming and Nick is right to say the public needs to understand the fragile nature of the pharmacy network before any new deal can be agreed.
Read more: NHSE economic review chance to ‘prove’ unsustainability of pharmacies
‘All parties to the consultation have access to the details of the work to date’, DH told C+D this month which suggests it still (somehow) isn’t finished and that begs the question how either side can negotiate a new deal without the full picture on funding.
Thrash it out
Turning to what’s goes in inside the room at this time, I do have some insights to share.
First and foremost to bear in mind, and I personally think this is regrettable, Ministers are unlikely to be present.
CPE, DH and NHSE will thrash it out based on an offer agreed by the Secretary of State - agreed by Downing Street.
And that worries me.
Don’t get me wrong, I am not saying it could wait any longer given the current contract expired last year and these negotiations should have been concluded a year ago, but to do this before the Ten Year Plan (and more importantly, the Spending Review) is agreed presents a risk.
There’s no question pharmacy is important to Ministers, given moving the focus of care from hospitals into the community is one of the three core shifts Wes Streeting wants to oversee.
But standing this process aside from the Spring (when we expect both the plan and the CSR to show themselves) doesn’t suggest the sort of step-change the sector has said is needed to stem the closures let alone herald a new era for pharmacy as a true equal in primary care.
Truth is, Government will come to the room with their offer based on what Rachel Reeves has signed off.
They will listen intently to CPE, who will no doubt return again and again to the substance of their Ten Year Plan submission and hopefully (if they’re smart given what stands behind them if not met) touch on the NPA’s contract demands.
Read more: NPA sets out five contract demands - or collective action
They will want to remind officials of Labour’s manifesto commitments around a Community Pharmacist Prescribing Service and subsequent statements on an expanded Pharmacy First offer.
I am quite sure they’ll return to the need to halt closures but given a reticence to even acknowledge such on the part of Government (see my earlier point about the economic analysis!) that is going to be hard.
And lifting their gaze to the years ahead, I’d expect a focus from CPE on the full implementation of the shared plan for implementing all aspects of the ‘Vision for Community Pharmacy’, all the while reminding Government of the undoubted potential for pharmacy to improve access to health care, including immunisations, and reduce the pressure on general practice.
Read more: Is it just me or is this new vision document slightly blurry?
Discussions will have been lively, and polite, and I’d bet CPE do more talking than NHSE / DH.
But at the end of the day, the offer is the offer and no-one round that table has the authority to go further.
When the talking is done, it goes back to Downing Street to agree - what they already agreed. And then it’s time to sell the deal, something I know from experience both sides have every interest in doing as enthusiastically as possible, whatever they feel might have been.
