In his own words, within just days of taking up office as the Pharmaceutical Contractors' Committee chief executive, Gerard Greene has hit the ground running.

 The immensely challenging role has been one which the former Northern Pharmacies Ltd superintendent and PCC chair has already taken on with zeal and enthusiasm, but is acutely aware of the obstacles in the way of contract negotiations and the difficulties which pharmacy contractors are currently experiencing. Gerard tells Laure James about what it is like to be representing one of the most highly regarded and cost effective healthcare professions in Northern Ireland, while in one of the most demanding positions in pharmacy.

'My involvement with PCC goes back almost a decade to 2001 when I became a board member for the Southern Area,' Gerard remembers. 'During that time I have witnessed the diverse and immense challenges that have faced PCC and have consequently impacted on the profession. These have included discussions and negotiations around dispensing services, new contract discussions, Category M, various legislative changes that impact on community pharmacy, EPES, the introduction of new community pharmacy services, changes to wholesaler arrangements and Direct to Pharmacy schemes to name but a few.'

Each of these issues has presented and continues to present different challenges to both PCC and the profession. PCC, as the representative body for contractor pharmacists has had to approach and deal with these issues quite often in different ways. 'This has needed to have been done in order to progress what are often complex issues in a satisfactory manner on behalf of contractor pharmacists,' Gerard continued. 'As well as dealing with issues as they arise PCC also has a duty to look to the future ' to develop a strategy for community pharmacy services and to be a formative influence in the design, development and implementation of new services and contractual arrangements in the future.'
PCC's responsibility extends not only to the contractors which it represents but also to the wider community pharmacy network and to the public that use community pharmacy service day-in, day-out. 'Within PCC, in terms of the Committee members and the office staff, there is a determination to continue to drive community pharmacy forward so that it plays a more integral role within the primary healthcare team,' he continued. 'PCC has undertaken a modernisation program over the last few years to ensure it is well placed to meet the challenges that lie ahead.

'The new offices at 5 Annadale Avenue in Belfast are the first part in that modernisation process ' the PCC strategy and business plans will be reviewed and personnel within the office, both from a professional and administrative point of view will be enhanced to meet the needs going forward. Expertise has, and will continue to be brought in to deal with specific issues as and when they arise ' currently PCC is working with a range of consultants on a number of work streams, from e.g. evaluating current service provision right through to new contract planning, to ensure that PCC gets the best possible advice and can influence matters in a significant and authoritative manner.'
With the ever increasing workload and demands on the community pharmacy team it is easy to overlook the tremendous contribution made by the profession to the health and well-being of the Northern Ireland population. Among the qualities and achievements identified by Gerard include:

'    A profession that is used by over 123,000 people every day across the network of 525 community pharmacies in Northern Ireland.
'    A profession that is underpinned by a network of highly trained and skilled pharmacists who are experts in medicines and how medicines are used to manage disease.
'    A profession that dispenses over 32 million prescription items, valued at almost '400 million per annum within a highly regulated environment and to the highest standards in relation to patient safety.
'    A profession that has consistently achieved the highest levels of patient satisfaction of all primary healthcare providers.
'    A profession that embraces and seeks to offer new community pharmacy services such as Minor Ailments, Repeat Dispensing, medicines reviews, addiction services, smoking cessation etc.
'It is clear that community pharmacy offers a tremendous platform on which to build and modernise the service that is provided to the public,' Gerard added. 'However this cannot happen unless there is significant investment in the community pharmacy sector going forward by DHSSPS both in terms of financial support and resources. But before we look too far to the future there is a need to resolve some major issues that are impacting on current service provision.

'Unfortunately contractor pharmacists have had to endure and cope with the unlawful application of Category M in Northern Ireland since 2006. This has had, and continues to have an intolerable impact on our sector ' pharmacy contractors have been financially disadvantaged by the application of Category M in Northern Ireland and are suffering financial hardship as a result.

'The High Court ruled in January of this year that the application of Category M reimbursement prices was unlawful, that community pharmacy contractors are entitled to fair and reasonable remuneration and that this should be paid in a timely fashion. As a consequence community pharmacy contractors are now entitled to seek compensation from DHSSPS.'

Since the ruling the PCC has been engaged in a wide range of actions designed to bring about recovery of Category M monies unlawfully withheld from contractors by DHSSPS. 'During April, PCC held two information evenings, in Belfast and Cookstown, to update contractors on the Category M situation and other current issues,' Gerard said. 'The turnout at those meetings was extremely high and that alone gives an indication of the importance that contractors attach to getting a satisfactory settlement for Category M. At those information evenings PCC and its legal advisors outlined that, in the event of current negotiations with DHSSPS not being satisfactorily concluded, further legal action would inevitably have to be pursued in order to seek the compensation due.

'At the meetings and in phone calls to the PCC offices in the short time that I have been in post Contractors have  spoken of the financial hardship that they are experiencing & how it is impacting on the operation of their pharmacies ' they are having to re-finance their pharmacy businesses, they are having difficulties meeting bank and wholesaler obligations and they are struggling to invest in the additional staff and resources needed to cope with the increasing workload being experienced currently. This is unprecedented in the history of community pharmacy and requires urgent remedial action by DHSSPS. Such is the depth of feeling at this stage that the vast majority of contractors in Northern Ireland have agreed, that if a negotiated settlement cannot be reached for Category M, to commit to further legal action.'

While it is both disappointing and frustrating that the profession has had to endure such difficult times there is this one final opportunity for DHSSPS to make a positive statement to community pharmacy during the discussions and negotiations currently taking place.

'There is no doubt that a lot hinges on the next move by DHSSPS. In the event that the Category M issue can be satisfactorily resolved through the current discussions and negotiations, PCC is committed to moving forward into a new era of innovative pharmacy services to complement the current services provided. The new era of an innovative community pharmacy service can only be achieved if there is significant investment in the community pharmacy sector. Fair and equitable funding is required to ensure a sustainable service can be provided ' resources, both in terms of staff and information technology, are absolute pre-requisites.

'We look to the strides made within the hospital pharmacy sector where significant resources and funding have been committed to the sector in recent years ' a modern infrastructure involving IT and robotics supports  the many new hospital pharmacists now working directly on the wards and who play an integral role within the hospital healthcare team ' if the same level of commitment can be shown to the community pharmacy sector then our profession will make even greater strides in delivering healthcare to the Northern Ireland population.
'I have no doubt that if the current hurdles are cleared and DHSSPS commits to funding an innovative and sustainable service going forward, the profession will not be found wanting ' the ball is in the Departments court.'