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The final quarter of 1995 was largely uneventful for pharmacy in the great scheme of things, but with some hint of events that would define the years to come. 

In October, the UniChem Convention visited Marrakech. The week-long event will be remembered more for the spectacular number of delegates who succumbed to food poisoning rather than the quality of the conference sessions. 

Wholesaler conventions were big things back then, with multimillion-pound budgets, 400-plus delegates and a generous dollop of industry sponsorship. Those days have long gone, perhaps for the better in these difficult times.

Back in 1995, the Royal Pharmaceutical Society of Great Britain had belatedly woken up to the fact that it had a professional leadership role alongside its statutory one – it was responsible for both back then – and launched Pharmacy in a New Age, a process intended to provide pharmacy with a blueprint for its future development. 

PIANA, as it was known, was a surprisingly successful exercise and set a direction of travel for pharmacy that is still being followed today.

Asda boss Archie Norman was rattling his sabre over Resale Price Maintenance, cutting prices on vitamin supplements covered by the scheme. Medicines were at the time one of only two categories of goods (the other being books) exempted from the Resale Prices Act, which meant the same price was charged in all pharmacies. Independents viewed RPM as a vital in protecting their OTC business from the price cutting tactics of supermarkets and the larger multiples. 

After years of acrimony, peace was starting to break out between pharmacists and dispensing doctors, due in no small part to indications from Government that it had seen enough. The DHSS in Northern Ireland laid down a marker by issuing new guidance on rural dispensing, which extended to 5km the distance patients had to live from a pharmacy before their GP could dispense for them. 

The Institute of Pharmacy Management International published the results of a survey among independent pharmacies on the NHS contract. Over half of contractors rated the national negotiator PSNC as ineffectual, a whopping 93 per cent said remuneration was unsatisfactory and 85 per cent were dissatisfied with their terms of service. 

Sounds familiar? The smouldering discontent would lead to the introduction of a ‘new contract’, complete with the radical idea of medicine use reviews, a decade later. We’ll return to that.

Meanwhile, mandatory training for pharmacy medicines counter staff was being rolled out. The RPSGB had decreed that new counter staff must take an accredited course by July 1996. ‘Experienced assistants’ could opt to sit a 30-minute MCQ paper with 55 questions to gain exemption from undertaking a course. 

March of the multiples

The march of the multiples was well underway. End-of-year figures showed Moss, Tesco and Boots were pipped in the pharmacy acquisition table by upstart Superdrug, making good on its promise to be operating 40 pharmacies by the end of the year. 

The year 1996 started with something of a bang. In January, the Consumers’ Association magazine Which? published a damning report suggesting that incorrect medicines or advice were given in nearly half the pharmacies visited by its covert shoppers. It was a topic that Which? revisited several times in the following years, much to the sector’s dismay.

Meanwhile, UniChem offered £547 million for Lloyds Chemists, a figure topped by Gehe a month later with a bid of £584m. The whole affair was referred to the Monopolies and Mergers Commission, where it spent months under scrutiny before Gehe came out as the winner of the prize in 1997.

Other notable events in 1996 included the NPA’s 75th anniversary and later in the year the unexpected death of its larger-than-life director Tim Astill, who was succeeded by John D’Arcy, who later put that experience to good use in overhauling Numark. 

In a story that would run and run, the Office of Fair Trading decided to refer RPM to the courts, and the Department of Health announced plans to pilot instalment prescriptions and repeat dispensing.

Fast forward to January 2000…

…and everyone was breathing a sigh of relief that the millennium bug had not destroyed their pharmacy’s PMR computer software. 

In a pilot scheme, 16 pharmacies in Manchester, Salford and Trafford Health Action Zone started providing emergency contraception under a ‘group protocol’ and Boots the Chemists announced it was piloting an online shopping service on its website. Although the RPSGB had just issued Standard 19, its first guideline for the online supply of medicines, Boots played it safe and stuck to baby and beauty lines. 

LloydsPharmacy went one step further, with parent company Gehe ruling out a move into online pharmacy services. Chief executive Michael Ward opined: “The pharmacy process should be a face-to-face consultation with customers that adds value.” 

Allcures, which started trading the following month, had no such scruples, claiming to be the UK’s first full-service online pharmacy, with Pharmacy2U following closely behind.

Back in 1999, inspired no doubt by the white heat of the IT revolution, the Government had decided that scripts should be transferred electronically from GP surgery to community pharmacy by 2002. With hindsight this timeframe was touching in its naivety. 

PSNC chairman Wally Dove proposed that pharmacists could offer flu vaccinations after a mini flu epidemic stretched GP resources. He also had a go at the Department of Health over its “frustrating intransigence” on the switching of prescriptions to the paid bundle if no exemption was completed. Pharmacy contractors were losing £9 million to £10 million a year, he said. Fifteen years later they were still losing £899 per pharmacy a year, according to the negotiator.

In January 2000, Dr Harold Shipman was found guilty at Preston Crown Court of the murder of 15 patients under his care. His total number of victims was later estimated at around 250 and he is believed to be the most prolific serial killer in modern history. His modus operandi involved administering lethal doses of diamorphine and subsequent public inquiries led to a raft of regulatory changes that impacted on pharmacy.

In March, closer to home, the infamous peppermint water case came to court. An infant had died after being prescribed Alderhey Peppermint Water Mixture. Concentrated chloroform water had been used in the dispensing instead of chloroform water double strength. This tragedy effectively saw the end of extemporaneous dispensing in community pharmacy – secundem artem consigned to the history books.

In March 2000, exactly two years after Dr June Crown’s Review on the Prescribing, Supply and Administration of Medicines was published – a mere twinkling of the bureaucratic eye – the Department of Health announced legislation was on the way to allow pharmacists to prescribe. 

Around 20 years later and the NHS Pharmacy First Plus service in Scotland and Pharmacy Independent Prescribing Service in Wales showed how an IP qualification could be used to deliver NHS services in a community pharmacy setting.

In April, every contractor in England got a letter from pharmacy minister Lord Hunt. As someone in the press commented: “When everyone gets a letter from the health minister, you can bet there will be bad news behind the sugared words.” 

Pharmacies were about to be sandbagged as a consequence of a dust-up between the Government and the generics industry over drug prices. Exit Category D from the Drug Tariff and – eventually – enter Category M and NCSO endorsements.

Elsewhere, a pharmacist called Sandra Gidley announced she was standing as the Lib Dem candidate in the Romsey by-election. Sandra started a trend; the profession today has a couple of pharmacist MPs sitting at Westminster.

Farewell Anne

On a more sombre note, obituary notices appeared in the pharmacy press for Anne Anstice, the editorial director at CIG, who had launched Pharmacy Magazine five years earlier. She died prematurely, having been diagnosed with cancer six months previously. 

A promising young pharmacist called Richard Thomas, fresh from helming The Independent Community Pharmacist for five years, replaced her as Editor. He’s still there.

After five years the OFT’s referral of RPM to the Restrictive Practices Court had still not been heard. The changing retail landscape and the Community Pharmacy Action Group’s delaying tactics meant the case, scheduled to go to court in April,     was further delayed. It would not be heard until 2001– an odyssey indeed – but the outcome would eventually be the demise of RPM. Some maintain that the impact of that decision on pharmacy is still being felt to this day.

In September Lord Hunt was making headlines again at the British Pharmaceutical Conference. Hold the front page: the Department of Health actually had a plan for community pharmacy! Pharmacy in the Future was billed as the most radical overhaul of pharmacy services since the control of entry regulations were introduced in 1987.

For the first time local pharmacy services free from the “restrictions of the rigid national remuneration system” were on the agenda. Individual named pharmacists may hold contracts alongside pharmacy owners, said the Minister. So, what happened to that one?

Tucked away in the small print was a ministerial “expectation” that the RPSGB would “link continuing registration with demonstrated professional development”. More ominously for the Society, he also advised that within the year the Government would be consulting on legislation to modernise the Society’s disciplinary procedures. From such insignificant beginnings, a new independent regulator, the General Pharmaceutical Council, would emerge some 10 years later. 

As an aside, and for proper historians only: 100 years earlier, in September 1900, a new fluid beef product called Oxo was launched into chemists only at a bargain price of 10d for a 2oz bottle. Like much else, now only found in supermarkets… 

Skip to 2005…

“It is satisfying to reflect on how far the profession has developed in the past 12 months,” raved the editorial in one pharmacy title in a December 2005 issue (not PM, surely?). PSNC, the perennial target of blame when things aren’t going well, topped a poll of ‘organisations that had done the most for pharmacy in 2005’! Was this the year pharmacists thought their glass might be half full?

The Big Event of 2005 was the introduction of new contractual frameworks across the home nations on April 1. The details had been hammered out and voted on in 2004, with over 90 per cent of contractors in England and Wales coming out in favour. The Scots not only voted in support of their new contract but agreed a novel two-year funding deal into the bargain. 

The agreements were widely hailed as the start of shift in the dial towards a more clinical role for community pharmacists and introduced a new service – medicine use reviews. Whatever happened them?

In other news… Remember Distalgesic (co-proxamol)? After being handed out like Smarties for years it was deemed too toxic for Jo Public and withdrawn from dispensary shelves in February. 

Department of Health statistics showed that multiples (companies with more than five branches) represented over half of all pharmacies, compared to third a decade earlier. In a move that was to sour its relationship with the sector for years, GSK introduced a new discount structure for products that faced competition from generics and parallel imports. 

Ghislaine Brant, the pharmacist who had the misfortune to supply mass murderer Dr Harold Shipman with his CDs, appeared before the Statutory Committee facing seven charges of misconduct. The chairman called a halt to the case after a month, saying there was no case to answer.

The RPSGB, having got itself tied up in knots over a new Charter in 2004, faced further uncertainty as the Foster Review widened the Government’s investigation into the role and function of a number of professional regulators. 

In May, the second ETP implementation site in England went live in Croydon. NHS Connecting for Health faced a mounting tide of criticism for its lacklustre implementation programme as the year unfolded. 

Also in May, Phoenix emerged as the buyer of Numark, but the bigger business news story came in October when Alliance UniChem and Boots announced plans for a £7 billion merger. The deal was sweetened for Boots shareholders with a £1.7bn distribution from the sale of its manufacturing operation. 

In December Keith Ridge [pictured] was appointed chief pharmacist at the DH following the retirement of Jim Smith. He was charged with raising the profession’s profile. In another inspired appointment, model Jerry Hall was unveiled as Bayer’s global ambassador for erectile dysfunction, charged with raising… yes, well let’s move on…

• Next time: We look back at events in pharmacy between 2005-2015