Monthly Archives: March 2020

When The NHS Needed £20billion In Productivity Savings

Back in the day, October 2016, a question was being asked “How much can CCGs save by ending pharmacy repeat dispensing?”

We read that “Pharmacy minister David Mowat is a man with a lot on his plate. Signing off on a reconsidered pharmacy budget for England will be number one on his priority list, so one might assume medicines wastage is further down his to-do tray.

“But on one of the few occasions when he did speak to community pharmacists, at a Pharmaceutical Services Negotiating Committee (PSNC) event last month organised to persuade him of the sector’s value, he stated that pharmacy will not “get away” from the £20 billion the NHS needs to make in productivity savings”.

A week later, NHS England chief executive Simon Stevens went a step further by highlighting “legitimate considerations” about how much community pharmacy is spending to dole out “£8 billion-worth of medicines”. If the last few years had seen pharmacy’s service provision dominate debates, it’s clear the focus is back on dispensing.

Clamping down on medicines waste is nothing new, an influential study published in 2010 conservatively estimated that unnecessary primary care and community prescriptions cost £300 million in England every year.

But what has changed is that this research, conducted by academics at the University of London and the University of York, is now routinely cited by GP-led clinical commissioning groups (CCGs) who are cracking down on medicine waste as the latest cost-cutting efficiency drive. And as Mr Mowat’s warning implied, community pharmacy has found itself very much in the cross hairs.

It was reported that Southport and Formby, as well as South Sefton, CCGs are piloting a system they claim will prevent “wasted medicines” and “improve the safety of repeat prescriptions”. The latest such repeat ordering initiative is in West Lancashire, a CCG which this month launched a new campaign to tackle medicines waste, snappily titled: “Being a hoarder is out of order!” (Pictured below).

They said “Help us minimise medicines waste. Medicines are expensive, so try not to order more than you actually need. £600,000 a year is spent in West Lancashire on wasted medicines. If this money was not wasted in this way, it could instead be spent on, for example: 50 hip replacements, 50 cataract operations, 40 heart by-pass operations, 10 knee replacements and five full-time nurses”.

So we had reached the stage of the CCG deciding, reasonably enough, that hoarding was to blame for there not being enough money for other NHS purposes. Moving on to how we received our medicines, they could be collected and or delivered, at no cost to the patient. Then, there was suddenly a charge to the patient for delivery, and finally there was no delivery because patients being unable or unwilling to pay and the chemists were unwilling to lose money.

And so we are where we are today. It all started with medicine waste, and ended with such zeal to save money that the only losers were, and are, home bound patients.

Peter Gregory, a GP and clinical lead at West Lancashire CCG, said at the time “With this campaign, we want to give [patients] the confidence to take control of how they take and order their medicines, and to only order what they need. Ultimately, it is about everyone in West Lancashire working together, residents, GPs and pharmacists, so that collectively we can help to tackle this issue of medicines waste”.

And on being warned of the “unintended consequences” that these schemes could have on patients who are “vulnerable, time poor and/or require assistance”, Pharmacy Voice has advised that schemes seeking to “unpick” the support services pharmacies offer patients to help them with their medications should be “considered and consulted on with local pharmacies, general practice and patients so that people are not adversely impacted”.

And now we have the coronavirus, about which the West Lancashire CCG stated “There are no prescription medicine shortages as a result of Coronavirus, but the difficulties facing isolated elderly, disabled, and at risk patients trying to obtain their prescriptions from their chosen chemists, hopefully by free delivery, have still not been resolved”.

Followed by, 19th March from CCG, “We are currently dealing with an exceptionally high level of demand for prescriptions and need to prioritise issuing of prescriptions to those that need them most”.

We wrote “Patients receive medication prescriptions because they need them, so to now be told the POD has a need to prioritise issuing of prescriptions to those that need them most indicates a judgement will be made that some of us need them less”.

And then we were told, 24th March “A national community pharmacy medicines delivery service for England is due to start “in the next few days”, the Pharmaceutical Services Negotiating Committee (PSNC) has said. As part of the new service commissioned by NHS England & NHS Improvement, community pharmacies will deliver medicines to self-isolating patients during the COVID-19 outbreak.

Up to 1.5 million people in the UK have been told to stay at home for 12 weeks – a process known as shielding – as they are at the “highest risk of being hospitalised by the virus”, housing secretary Robert Jenrick said at a daily press briefing from 10 Downing Street on March 22.

Shielded patients will be asked to have their medicines collected and delivered to them by “friends, family or a volunteer” before being directed to the pharmacy provided delivery service if this is not possible, the PSNC explained in a statement on Sunday. “We anticipate the service will commence in the next few days,” it added.

Well, it hasn’t started here in West Lancashire, and there is queuing at pharmacies such as Rowlands in Aughton , as these pictures kindly provided by Roger Blaxall of QLocal prove. 22 in a queue last Friday, 12+ today, Will it ever start here? Don’t put money on it!


Rosie On Skelmersdale Railway

West Lancashire MP Rosie Cooper has received further assurances from the Department for Transport over the commitment to delivering Skelmersdale Railway.

Following the General Election, during which the Prime Minister promised the funding, MP Rosie wrote directly to Boris Johnson asking for further detail on his announcement and how the Skelmersdale project can access the money it needs to come to fruition.    

The Transport Minister Chris Heaton-Harris MP replied on behalf of the Government to confirm that £500m has been pledged to start reopening lines closed following the Beeching report, reconnecting smaller towns, regenerating local economies and improving access to jobs, homes and education.  

However, many residents expressed their lack of trust and confidence in the Prime Minister to actually deliver the project. Rosie, who has long campaigned for Skelmersdale Railway, understood the concerns of her constituents and made these clear to the Prime Minister and Department for Transport.

In response, Rosie has received the reassurances and continues to campaign to ensure that Skelmersdale Railway is delivered, she said “I can understand the distrust of residents of Skelmersdale who feel they have been let down and I made their feelings known to the Prime Minister and the Transport Secretary and that my constituents will not accept broken promises.

“The Transport Minister responded to reassure me, and residents, that they were keen to work with Lancashire County Council to discuss the case for bringing a rail link to Skelmersdale and seeking Government funding.

“He stated that the initial £500m funding could be used to accelerate the development of schemes that are already being considered for restoration – something we are well on with here having already progressed the case for Skelmersdale Railway through the initial GRIP (Governance for Railway Investment Projects) stages. I am clear that I will hold the Prime Minister to his promise.    A railway station in the heart of Skelmersdale will open up a world of economic and social opportunities for the town and its residents”.    

That’s not strictly true, is it? It won’t open up a world of social opportunities for the elderly and disabled residents of Skelmersdale any more than it does all those others in West Lancashire who have been denied by WLBC and LCC the free off peak rail travel enjoyed by the City Regions that enjoy huge capital grants from central government. 

If Shapps is really talking to LCC and working with them, surely now is the time for us no longer after about ten years campaigning, to be the “left behind” in off peak rail travel equality?



They All Deserve A Medal

Letter to Qlocal “I recently wrote to the Prime Minister to ask if a medal could be struck and awarded to those fighting (and dying) on our behalf. A copy of the hand-written letter is below. I hope you will see the merit of this request and put the weight of your readership behind me.

“I am over 70 and therefore in self isolation and wish I was younger and fitter and could more.I hope this small gesture is my small contribution to the real crisis facing us.

“I had sent a copy of this letter to most of the major press papers and if you watched the daily press conference, you will have seen the Mirror reporter has taken my suggestion on board and put the question to Mr Dominic Raab”.

Dear Prime Minister,

You recently described the battle against CoVid-19 as a ‘war’, therefore it follows that those on the front line are the foot soldiers against this deadly unseen enemy.

Following this argument, the hundreds of thousands of volunteers you called upon to join the battle could be seen as the latter day equivalent of a ‘dad’s army’. At some point in the foreseeable future we will as a nation beat this invisible enemy.

May I humbly request that you consider striking and awarding this army with a medal of honour for bravery above and beyond the call of duty? There is a precedent for this. I believe that an award called the “Silver Medal” was awarded in 1916 to around 1.5 million citizens.

To close, I wish you a speedy recovery so that you can lead us to a total victory. Your country needs you.

Yours sincerely,
Derek Andrews,
Ormskirk, Lancs. L39 4YH

Well done Derek Andrews, who could disagree with the emotion of “Dad’s Army” being replicated now?

Angry About, Or Ignorant Of, Selfish Aughton Over 70s?

How sad it is to read, over at QLocal, that somebody, very thoughtlessly, wrote ‘Stop being selfish!’ Aughton pensioners told”.

I’m a community support worker in Aughton/Ormskirk. I live in Aughton and my local shop (Dave’s Aughton Food Stores) is the best! A time like this they have stepped up and Dave and family and staff are deserving keyworkers – so much appreciated…Would like to add as a concerned carer too many over 70’s are out.

“Please stay in! I feel sad that most of them have attitude “my numbers up” as I was quoted by one elderly man. Well I have a young family and the majority in Aughton who are key workers do also. Stay safe, stay home, elderly STOP being selfish!”

Read that again…most of them have attitude “my numbers up” as I was quoted by one elderly man. Yes, one, not the many, into thousands, of Aughton’s over 70s! I’m peed off by what this lady claimed.

Just how many of the “Over 70s” did she speak to so as to quote her “most of them have attitude” accurately? Just one! I’m 80, and for the duration I don’t go out other than for short exercise, and I know that my elderly neighbours are being helped, as we are, by other good neighbours bringing our essentials. I didn’t make it today to collect my essential prescription from Rowlands, someone did it for me!

This lady claims to speak about many hundreds, perhaps thousands, of law abiding elderly and disabled Aughtonians, yet she quotes just one! I can’t imagine how and why she makes this attack on us, but as usual there are two sides to every story.

In the whole of West Lancashire there are 1,029 out of the total population aged 65 and over living in a care home with or without nursing, the 2014 figure was 851. As would be expected, the number of people in care homes increases with age. And so, incidentally, does the number NOT living in care homes but in their own homes. What do they do, hide away or else become selfish?

Also in 2014, there were 8,200 65 to 74, 5,400 75 to 84, and 1,700 85+, all in their own homes. The health of old people in West Lancashire varies, particularly between the most and least deprived areas. As people age they are more susceptible to strokes, coronary heart disease, osteoarthritis and dementia. Evidence suggests that people will live longer, but will spend longer in ill-health. [Source for all figures the WLBC Report “An Ageing Population In West Lancashire”]

Is it any wonder that when a coronavirus comes along some, or perhaps just one who happened to meet Sarah M, of these people might say “my number’s up” because ANY infection might be enough for a “number to be up”? And just for the record, Public Health England estimates “that on average 17,000 people have died from the flu in England annually between 2014/15 and 2018/19”. Public Health England, warned “Whilst the flu is common, it can be deadly for older adults, very young children and people with underlying health conditions”.

Rosie Cooper Praises Rail Safety Father And Son

Track-engineering father and son keep railway running safely.

Railway upgrades by a father-and-son duo are today helping keep critical supplies and key workers moving across Britain. Over the past three weekends, Howerd Kernahan, 50, a senior programme manager for Network Rail, and his track worker son Rafael, 18, have been part of an engineering team improving the Wigan-Kirkby line.

Taking extra safety precautions to halt the spread of coronavirus, the team laid 1km of new track through the 172-year-old Upholland tunnel, in West Lancashire, to make it more reliable for passenger and freight trains moving between Merseyside and Greater Manchester. The job, which finished at the weekend, involved laying 3,000 sleepers and 3,000 tonnes of ballast (railway foundation stone), and improving trackside drainage.

Howerd, a former British Army captain from Southport, Merseyside, said “I strongly believe it is important I’m out there on track leading my team at this difficult time. I feel honoured that my son and I can be part of the wider railway family doing our bit to keep critical supplies and key workers moving in Britain’s hour of need”.

He added “Throughout this job we have all worn protective equipment, including masks, and wherever possible have kept two metres between us in line with government social-distancing guidance”.

Network Rail is working collaboratively with trade union colleagues to help keep track-working staff safe, in line with government health guidelines designed to halt the spread of coronavirus.

West Lancashire MP Rosie Cooper said

“Superb! What a magnificent effort from everyone involved. It just shows that in these difficult times we can still do essential work safely. This will help the railway stay open for key worker journeys as well as for freight traffic, moving essential fuel, food and medical supplies around the country. This magnificent effort helps all our communities. I want to thank everyone involved”.

Upholland tunnel was built in 1848 and takes in 887 metres of the Kirkby branch line underneath the village of Upholland. The track renewal was carried out overnight over three consecutive Saturdays – 14, 21 and 28 March – by the Central Rail Systems Alliance, made up of staff from Network Rail, Balfour Beatty and Atkins.

Fears Grow For The Corona Virus?

Fears grow for the Corona virus as it’s suspected it may have been infected with a dose of Dominic Cummings!

Cummins was recently seen running away from Downing Street.

His manner suggested he was leaving the scene of the crime, as the Prime Minister became infected. Not one to shirk a fight with anyone, Cummins probably thought he was most likely to terrify the virus into submission!