St Mawes Memorial Hall was packed to capacity – and beyond – on the evening of 5th February for the meeting to discuss what pharmacy services are needed in the area. With 120 information sheets issued, and most people sharing copies, it was clear this is something about which the community feels very strongly.

Keith Warren, Chairman of St Just in Roseland Parish Council, introduced representatives from NHS England (Devon, Cornwall and Isles of Scilly) – Janet Newport, Contracts Manager; Julia Cory, Head of Primary Care and Sally Dutton, Primary Care Support. Unfortunately Sarah Newton MP was unable to attend as she was participating in a key Parliamentary debate on GPs, but she has been fully involved and wrote offering her support to keep open what she called “this vital service”.

If the spontaneous applause which greeted the arrival of Faisel Baig, our pharmacist, and Linda Bunn, the Medical Counter Assistant, set the scene, it was the number of people who turned up to show their support, and the quantity and quality of points raised by pharmacy users, local residents and visitors which later carried the day.

After admitting she was amazed by the turnout, Janet Newport explained the background to funding for small local pharmacies such as this one, including the imminent ending of the National Small Pharmacy Scheme. She noted the close working relationship between the pharmacy and the surgery and acknowledged Faisel’s important role in a community which is, in many ways, unique because of its location and significant peaks and troughs in population.

Julia Cory explained that part of their remit was to engage with communities and she was impressed to see so many people wanting to put forward views, vital in providing information about local requirements and which would aid decision making and influence future funding.

Praising the “fantastic GP service”, Faisel set out the main services he currently offers:

• prescription ordering and dispensing;
• over the counter (OTC) medications and pharmacist present medicines;
• health advice without appointment , health awareness and good health promotion including blood pressure testing;
• extended services including emergency contraception and treatment for minor ailments; and
• support with ongoing or new medication and use with OTC medicines.

In response, many people said how much they valued the range and availability of services, given the reduced surgery hours in St Mawes (currently one full day and three half days per week), the distance from other facilities and limited public transport.

On the issue of alternatives, Faisel said that although it was possible to obtain small packs of painkillers elsewhere, the range was limited, and for medication like Feminax, Calpol, Night Nurse, and Canesten etc it was necessary to visit a pharmacy. He said that one of the biggest advantages was access to someone fully trained to advise on and sell the right thing – in other words to “sell safely”. He and his staff were trained to note if someone frequently purchased similar medication and might suggest an alternative or a visit to their GP.

Brian Chenoweth, Vice Chair of St Just in Roseland Parish Council, set the tone by referring to the recent meeting at which all councillors expressed grave concern about the loss of funding to the pharmacy and their support for the GP service, but not at the expense of the pharmacy, which was not just about dispensing. He reminded people that, without funding, the pharmacy would no longer be viable and the nearest alternative for residents of the Roseland was at least 18 miles away.

For reasons of space it’s impossible to list all the heartfelt views expressed at the meeting, many along the lines of “if it’s not broke, don’t fix it” and “it’s more than a pharmacy, it’s an amazing resource”. This is a cross section:

• praise for the home delivery service and access for the less able eg through the provision of advice over the phone;

• it’s part of an integrated NHS taking pressure off GPs and other front line services;
• for people without a car, getting to Portscatho relies on the expensive and erratic bus service, and a wait of over two hours to make the return journey. For people living in St Mawes it’s vital to be able to access a full range of medication there;
• lack of alternatives in the area and concern that if residents of St Mawes and the surrounding villages have to travel to Truro or St Austell they would do all their shopping there, to the detriment of village shops;

• during the peak visitor season there is a need to provide treatments for sunburn, seasickness, sprains etc. the result of the beach, water based activities, including the ferry, and the coastal path.

• the pharmacist can identify and deal with conditions like anaphylactic shock or hypoglycaemic coma which require immediate action from someone with relevant knowledge, when even waiting for the air ambulance might mean help is too late;

Representing the local surgery, Dr Black called Faisel “a breath of fresh air” who offered a number of services to the community. However, the practice could not afford to lose dispensing income, because their funding had been reduced by around £7000 a year over the next seven years, part of an overall reduction in NHS funding. He said that, although it would be possible for the practice to extend their dispensing service to cover a wider area, the surgery supported a continuation of funding to the pharmacy, the funding for the pharmacy and the surgery coming from different, separate NHS pots.

The owner of a local holiday company said that “St Mawes is the tourist flagship of the Roseland and, with efforts to make Cornwall a 52 week a year holiday destination, it’s essential to cater for older visitors as well as young families, all of whom are significant users of pharmacy services for sunburn, minor infections etc. They don’t want to spend their holidays seeking out medical help at a surgery or A&E. In fact many visitors check access to local medical services before making a booking.”

A local care worker said she looked to the pharmacist and his trained staff for support, particularly when the surgery is closed, and for incontinence supplies for the elderly, food supplements for recovering patients and advice for new mothers.

Jane Curtis, of St Mawes Bakery, spoke of the problems of small businesses; if an accident occurs on the premises, and the designated first aider is unavailable, they rely on the pharmacy, which is also in great demand by passengers arriving by ferry. She praised the help provided during a recent health issue at the school which was dealt with effectively by the pharmacy who advised on dealing with cross infection and helped increase awareness.

Stressing the importance of a continued pharmacy service, St Mawes resident, Marrilyn Morris, quoted some valuable statistics: “over a 12 month period, there is a footfall of some 360,000 visitors, excluding those who arrive by car to accommodation with parking or by bus from nearby campsites or further afield, pleasure boats or their own boats. Those numbers significantly increase during periods such as Falmouth Week, Tall Ships and other national events”.

Messages were received from many who could not attend. Builders working in the village, not all local, sent messages to say they were 100{c8c3b3d140ed11cb7662417ff7b2dc686ffa9c2daf0848ac14f76e68f36d0c20} behind the campaign as they relied on the pharmacy for first aid. There were also messages from holidaymakers saying how much they valued access to immediate advice and medication.

There was a very limited response to the Chairman’s request for ideas for additional services, which was judged to be an indication of the high level of satisfaction with what is currently provided. In response to a request for extended opening hours, many people thought that his customers already expected so much from Faisel he might be driven away if too many or unreasonable demands were made!

Other proposals were unfortunately limited in their application, since they are governed by NHS rules. However people were encouraged use the Suggestion Box in the pharmacy and there is the possibility of extending the minor ailments service and the setting up of further group services.

In response to a question from Cornwall Councillor, Julian German, about the next stage, Janet said they would look at Faisel’s proposals, together with comments made at the meeting and in writing. Then they will calculate, as far as possible, the cost of providing that service. The current arrangement ends on 31 March so an interim scheme will be put in place, before a 12 month reviewable contract is agreed. Although it was felt by many that something more long term was appropriate, Janet explained that the review would concentrate only on ensuring the service continued to meet local needs.

The final contribution was from Adam Purser, who summed up the overwhelming feeling of those who attended by saying “the case is proved”.

The Chairman closed the meeting by asking for a show of hands on the proposal that funding should continue. The outcome was no surprise and, although no confirmation was given, the NHS representatives gave a clear indication they consider the cause a just and worthy one, deserving of future funding.

As local resident, Yvonne Fuller said afterwards “although the final decision will not be known for several weeks, we were left in little doubt that the NHS representatives were entirely in support of the pharmacy and would do their best to secure adequate funding.  They all said they had never before experienced such a wholeheartedly enthusiastic meeting or met such a marvellous village community”.

So, to sum up: The hall was fit to bursting, with people later reporting they couldn’t get in; that, together with the plaudits for the vital service Faisel provides must surely have persuaded the NHS representatives of the importance attached to the pharmacy, and the need for continued funding. If it didn’t, then the drive down here certainly helped them understand our relative isolation.

Over the coming weeks I hope to report on the latest [good] news. Meanwhile, Faisel reminds us all that his role is helping us take care of our health and he invites us to call in at the pharmacy and help ourselves to a chocolate (while stocks last) – a little thank you for everyone’s support and friendship.

Sallie Eden

The NHS would also love to hear from those who couldn’t attend. Please take a moment to have your views heard on their survey. The survey is available at: https://www.engage.england.nhs.uk/consultation/pharmacy-services-survey-st-mawes The closing date for responses is: 28 February 2015