There has been a new expression of interest in a Community Pharmacy in Balmullo.
Formal consideration of this will probably begin in the autumn.

Community Pharmacy
In Scotland, qualified pharmacists apply to join the so-called pharmaceutical list permitting them to exercise the profession commercially, under contract to the NHS.

At the last count there were 85 Community Pharmacies in Fife. By working for the NHS, pharmacists hold secure contracts which enable them to buy in quantities of medicines at subsidised prices. At the same time they are in commercial competition with each other. The NHS in its turn seeks to ensure sufficient provision, in each part of the country, to support GPs with the medicines they prescribe for their patients. Community Pharmacists nowadays do more than fulfil prescriptions. They diagnose and may treat minor ailments; they administer long-running repeat prescriptions, especially for people with chronic illnesses (thus relieving the doctors of the chore of continually re-prescribing); they help with prostheses. As soon as a qualified pharmacist ‘expresses an interest’ in setting up in a given locality, the health board sets in train the formal application process and oversees it from start to finish. In Scotland generally this has been going on continuously, despite
the pandemic. At the time of writing there are 14 new expressions of interest for Fife, and Balmullo is the sixth on the list, which means an application could be initiated in the coming months. You can read about the formalities here:
https://www.nhsfife.org/services/all-services/pharmacy/community-pharmacy/joining-the-pharmaceutical-list-application-process/

In 2014 the Scottish Pharmaceutical Regulations were reformed to enable a nominated Community Representative from the local Community Council to take part in the application process. This person is called upon to comment in writing to the health
board, giving a general account of the community’s views. To help us, the Community Council might invite the candidate-pharmacist to come and speak to one of our public meetings, put his/her case and answer any questions. He/she may be asked, for
example, about the services likely to be offered and hours of opening. We shall notify you of any such meeting and invite you to attend.

Pre-application stage
If all the formalities are approved, the next stage will be a local referendum, in which the residents of our village (and anyone in the vicinity likely to use a Balmullo Pharmacy, e.g. from Logie, Brackmont, Lucklaw Hill) are canvassed on their views. Residents will
be asked not only whether they would like to have a local Community Pharmacy, but why. For example, they may be disabled or otherwise find travelling for a prescription awkward. Other factors might be the high proportion of elderly residents and the
presence of the GP surgery directly serving the village. While this phase is going on, the health board will, among other things, have sought written representations about it from the Community Representative, and from
‘any person whose name is included in the pharmaceutical list or the provisional pharmaceutical list and whose interests may, in the opinion of the Board, be significantly affected if the application were granted.’ 1

That is to say, from any potential commercial competitor to the candidate-pharmacist. The board will also select the personnel for the hearing at which the final decision is made. This decision is in the hands of an appointed Pharmacy Practices Committee.

Application hearing
The purpose of this decisive event is to determine the ultimate fate of the application,which the board will grant

‘only if it is satisfied that the provision of pharmaceutical services at the premises named in the application is necessary or desirable in order to secure adequate provision of pharmaceutical services in the neighbourhood in which the premises are located by
persons whose names are included in the pharmaceutical list. 2

The word ‘only’ is important here. The application process is tightly controlled by the health board. The hearing itself is run by health-board officials and chaired by a non-Executive Director. An Area Practices Committee of non-exercising (non-commercial)
pharmacists gives advice, and an NHS legal adviser may be called upon. But the three usually non-executive members of the health board on the PPC make the final decision.
The hearing is adversarial. Pharmacists from other, rival businesses, in writing or in person, are likely to intervene to argue, for example, that the neighbourhood is already adequately covered by the service to it which they provide; or that the
candidate-pharmacist is not a fit person because he is not ‘local’, or properly-informed about the community he would serve, etc. This is a rather strange event because the antagonists often already know each other as professional colleagues and, even, friends.
At times, too, big firms like Boots or Lloyd’s Pharmacies will send a manager from England to attack the application.
Meanwhile the Community Representative him/herself will be called upon to speak about the case, and perhaps also consulted by other persons present. In the past,Community Representatives have spoken to strongly support the candidate-pharmacist
and/or to add neutral information of general use to those present. Such information may also of course serve to weaken the candidate’s case. It only needs to be truthful.
Regarding premises, the previous possibility of leasing part of the Pitcairn Practice premises for a Community Pharmacy in Balmullo is no longer available. Any pharmacist candidate for Balmullo will have to find – and convert – some building or buildings in the village, even if he/she successfully applies. It will therefore be some time before we see a new pharmacy in the village.
Please get back to me if you have any questions or suggestions.

Peter Lomas, Member, Balmullo Community Council, 15 June 2022
pil77@btinternet.com

1 National Health Service (Pharmaceutical Services) (Scotland) Regulations 2009, article 5 (10), Schedule 3, 1 (c).
2 Ibid., article 5 (10).