As he prepares to leave his role with the National Pharmacy Association (NPA) to take on leadership of the nursing regulator, Paul Rees reflects on his year in pharmacy and his hopes for a fair deal for the sector.

‘I’ve loved working with the NPA’, Paul Rees told The Pharmacist this morning as he prepared to wrap up his work before the Christmas break.

Having spent much of his 13 months as NPA chief executive visiting ‘about 200 pharmacies’, he reflects: ‘I've really enjoyed working with the sector. I've really enjoyed all my visits to community pharmacies, I've been bowled over by just how friendly and kind people are. I've been greeted by people really positively in England, in Wales, in Scotland, in Northern Ireland.

‘It's a great sector, and it deserves a fair deal.’

'Community pharmacy is not treated with respect'

Underfunding of the sector is a major theme Mr Rees said he has noted since joining the sector in November last year.

‘Community pharmacy has seen a 40% cut in real terms over the last 10 years, and it always feels unfortunately, community pharmacy is seen as being second class, third class… it’s always an afterthought.

‘And I think that Matt Hancock's statements at the Covid inquiry, where he said that NHS England would always be as tight as possible on community pharmacy and only give the money it felt it absolutely had to – I think that highlighted what we've all suspected, that community pharmacy is, unfortunately, not treated with respect that other clinical areas are,’ Mr Rees told The Pharmacist.

‘The government needs to work with community pharmacy, to help make sure that pharmacy never ends back in this current sorry place,’ he added.

Pharmacy needs to be ‘supported to be put at the heart of primary care, which obviously meets many of the government’s stated aims in terms of shifting care from secondary to community and away from cure to prevention,’ he said.

‘I am hopeful that in the new year, the government will put a fair deal on the table. The fair deal would have to be not just a fair sum for 24/25 and 25/26 – it needs to be a start of a recovery for community pharmacy,’ he said.

A year of campaigning for the NPA

Mr Rees’s tenure as chief executive of the NPA has been marked by a drive ‘to get the NPA to a much more campaigning place’.

He said the NPA board were ‘totally supportive’ of the changes he put in place – from creating a new communications and marketing department to following the template of the ‘Patients First’ general practice campaign that Mr Rees led at the Royal College of General Practitioners a decade ago, ‘that led to government giving general practice 2.4 billion pounds of additional investment’.

‘We used the model, if you like, of that campaign, which was, you know, posters, mission sheet, stickers, postcards, and we sent them out to all independent pharmacies before the first day of action, and asked people to take part.

‘Obviously when you hold the first ever day of action in a sector you don't know how it’s going to go. So we worked hard to get the message out to all contractors,’ he said.

The general election being called earlier than expected ‘caught everyone by surprise’, Mr Rees said.

‘We only had a very short time to turn around the 20th of June day of action, because we wanted there to be cut through during the election so that candidates and MPs would be talking about community pharmacy,’ he added.

‘We were overwhelmed with just how much people took part… What I was really bowled over by was when I was going around the country in the lead up the 20th of June, pretty much every independent pharmacy I went to had our poster in the window, or had petition sheets on the counter or stickers visible.’

For the NPA’s second ‘day of action’ in September, a cross-sector petition amassed 350,000 signatures by the time a cross-sector delegation presented it to Downing Street.

The target had been to reach 300,000 signatures – the same amount that a similar petition as part of the RCGP ‘Patients First’ campaign had garnered.

But the community pharmacy petition has now reached more than 400,000 signatures.

‘That shows people care about pharmacy at least as much as they do about general practice’, Mr Rees said.

‘Pretty important for politicians to know!’

Next, the NPA balloted its members in England, Wales and Northern Ireland on whether they would consider ‘working-to-rule’ if the sector’s funding was not fixed.

The 63.5% turnout was described by ballot administrator Civica as ‘one of the highest they've ever known for a trade association’.

‘That's one of the highest turnouts on record, which shows just how angry community pharmacy teams are,’ Mr Rees said, comparing it to an average of 7-15% for most trade association ballots.

NPA members in all three nations balloted voted overwhelmingly in favour of collective action from January.

The days of action and the NPA’s collective action ballot resulted in ‘blanket media coverage’ for the sector’s plight, Mr Rees said.

‘That's what we wanted to achieve. We wanted to get to a place where it was a big national news story that community pharmacy, is being starved of resource,' he added.

The NPA will continue to have a high campaigning profile

‘‘I'm really pleased to say that our board and our membership were thrilled by our new campaigning profile.

‘They want what's best for community pharmacy, and they know that you have to get the message across, for the politicians to be taking seriously you need the public to be talking about you,’ Mr Rees said.

‘Obviously, I'm leaving in a couple of weeks.

‘Our board are determined that we continue at the same level long after I've gone.

‘The board have taken it upon themselves to make sure that the NPA continues to have a high campaigning profile until there is a fair deal for  community pharmacy that prepares the damage done by the last few years, and puts pharmacy on a clear pathway to a brighter future.’

We just need to help pharamcy on the political agenda

Mr Rees added: ‘We absolutely want to work in partnership with the government.

‘We’ve seen the government produce a deal for GPs for 25/26, we’ve seen the government produce a deal for junior doctors, we’ve seen the government produce a deal for train drivers.

‘So we just need to help keep the issue on the political agenda, because in politics, there are so many different demands and topics that politicians have to deal with, you have to make sure you keep it at the top of the agenda,’ Mr Rees said.

And he added: ‘MPs tell us: “You're doing the right thing, keeping the issue on the agenda, you've got to keep on fighting until you get that new deal.”’

'Disappointed' that there's no deal yet for pharmacy

Mr Rees told The Pharmacist that he feels that the NPA’s campaigning action has been ‘effective’, but also feels disappointed that a deal for the sector has not yet been reached.

‘The action has been effective, because until we led on the Save our Pharmacies campaign, the public was unaware of the funding crisis in community pharmacy, and you can only expect to be taken seriously by politicians if it's what voters are talking about. And voters are talking about a crisis in community pharmacy.

‘At the same time, we’re also very disappointed that there hasn't been a deal yet forthcoming.

‘We do hope that the government will put something on the table in the new year.

‘We do believe the government are aware of all the challenges the government wants to do the right thing, we just need to see something in writing on the table before we can consider pulling back from advising members to take collective action at the moment.’

After Mr Rees leaves his role on 16 January, the NPA board will meet on 20 January and then decide whether to advise members to take industrial action.

But Mr Rees said he’ll continue ‘rooting for’ the sector ‘from the sidelines’.

‘When I move on to my new role, I won't stop thinking about community pharmacy. I'm hoping that justice will be done.’