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Community pharmacy

Backlash over 6% cut to community pharmacy funding

Sector hits out at “destructive” and “questionable” government plans to reduce contractual funding by £170m in 2016.

The government faces a strong backlash from community pharmacy bodies over plans to cut the community pharmacy contractual framework in England by 6.1% next year. In the image, Pharmaceutical Services Negotiating Committee (PSNC) chief executive Sue Sharp

Source: PSNC

Sue Sharpe, chief executive of the Pharmaceutical Services Negotiating Committee, describes the government’s plans to cut community pharmacy contractual framework in England as a “profoundly damaging move”

The government faces a strong backlash from community pharmacy bodies over plans to cut the community pharmacy contractual framework in England by 6.1% next year.

The Department of Health (DH) is seeking to reduce funding to £2.63bn from October 2016, down from £2.8bn this financial year. It also wants to introduce a range of other efficiency measures, including significant changes to the dispensing model.

Initial details were revealed in a letter to Pharmaceutical Services Negotiating Committee (PSNC) chief executive Sue Sharpe on 17 December 2015. The letter insists pharmacy “has to play its part” in delivering savings required by the government’s spending review and the NHS Five Year Forward View.

Sharpe describes the plans as a “profoundly damaging move” at a time of rising demand on primary and urgent care. “It will deliver a destructive blow to the support community pharmacies can offer to patients and the public,” she says.

After years of absorbing efficiencies, pharmacy owners will be “incredulous” that the government states further savings can be made without compromising service quality or patient access, she adds.

The DH will consult on the plans with pharmacy and patient organisations until 24 March 2016. They include a range of measures to make efficiency savings while extending clinical roles for the profession.

The letter describes the “real potential” for greater use of community pharmacy and pharmacists in areas such as public health, self care for minor ailments, long-term conditions and medication reviews. “To this end we need a clinically focused community pharmacy service that is better integrated with primary care,” says the letter, which is signed by England’s chief pharmaceutical officer Keith Ridge and Will Cavendish, director general of innovation, growth and technology at the DH.

The DH plans a new Pharmacy Integration Fund to achieve this, though few details have been given.

“The letter speaks of the potential for far greater use of community pharmacy and pharmacists in prevention of ill health, support for healthy living and minor ailments,” says Sharpe, “but almost inevitably the impact of the cuts will force pharmacies to reduce staffing levels and direct more people to GP or urgent care.”

The letter says some parts of the country have “more pharmacies than are necessary to maintain good access”. Sharpe adds that the threat to the network is “clear” but the letter lacks detail on how the NHS would manage this clustering.

National Pharmacy Association (NPA) chair Ian Strachan, pictured, says the plans look like “an assault on the very part of the health system that holds the key to solving many of its problems”

Source: National Pharmacy Association

National Pharmacy Association chair Ian Strachan says the plans look like “an assault on the very part of the health system that holds the key to solving many of its problems”

National Pharmacy Association (NPA) chair Ian Strachan says the plans look like “an assault on the very part of the health system that holds the key to solving many of its problems”.

“It calls for community pharmacy to step forward to meet spiralling health challenges, whilst announcing cuts that will severely hamper our ability to deliver.” Strachan adds that the government and NHS England should expect a “very robust challenge to this misinformed set of proposals; they rest upon a questionable evidence base, unbalanced opinion, and ignore the truly transformational opportunities in community pharmacy”.

The letter says the government wants to drive new models of ordering prescriptions and collecting dispensed medicines, including online ordering and delivery to the patient’s home, as well as the “optimisation of prescription duration” to avoid medicines waste. This is in addition to plans for wider access to ‘hub-and-spoke’ dispensing announced in October.

The DH will also seek to introduce a Pharmacy Access Scheme to increase funding to some pharmacies in rural or deprived areas, compared to other pharmacies.

Sandra Gidley, chair of the Royal Pharmaceutical Society’s English Pharmacy Board, says: “This news will make community pharmacists feel completely undervalued at a time when we are all working incredibly hard.”

She welcomes the new access and integration funds but says any cut to community pharmacy is “short-sighted if the government is committed to its stated aim of investing in primary care and prevention of ill-health”. She also warned that plans for ‘hub-and-spoke’ dispensing must not be “devised in isolation but worked up coherently to ensure patient care and access to pharmacy advice is maintained”.

However, Gidley adds that the government “wants something different from the sector” and that pharmacy must seize the opportunity to shape its own future.

Rob Darracott, pictured, chief executive of Pharmacy Voice, says the funding cut was “certain to hurt the sector” and that many contractors would be “rightly anxious” about how it will affect their businesses, staff and patients, he says

Source: Pharmacy Voice

Rob Darracott, chief executive of Pharmacy Voice, thinks the cuts are “certain to hurt the sector”

Rob Darracott, chief executive of Pharmacy Voice, says the funding cut was “certain to hurt the sector” and that many contractors would be “rightly anxious” about how it will affect their businesses, staff and patients, he says.

Although the impact on businesses remains unclear, the sector has “the expertise and knowledge” to achieve change and had already delivered 4% savings to the NHS, he adds.

Graham Phillips, superintendent pharmacist of Manor Pharmacy Group in Hertfordshire, says the cuts are “a disaster” for community pharmacy and could harm pharmacy business’s profits, used among other things to develop staff. He predicts “massive consolidation” of the network, and that independent pharmacies will be hit harder than multiples, which can more easily absorb these costs.

“It will cause 10 years of attrition and damage, [and] prevent any innovation or investment in the future because there’s no cash to do it with,” he adds.

The Five Year Forward View is clear that we need to move “away from illness towards wellness” by encouraging healthier lifestyle, diet and exercise, as long-term conditions are increasing NHS costs. Yet, he says, instead of investing in the pharmacy network, which can deliver public health and minor ailment services at a time when there is a shortage of GPs, the government is taking “an axe to a network that the public loves and understands and trusts. It’s an absolute disgrace”.

Sunil Kochhar, who owns a pharmacy in Gravesend, Kent, says the announcement is “shocking but not surprising”, and is “just going to make us struggle a bit more”.

“The ones that will suffer are the public and our staff, because then we’ll have to make cuts in staff to compensate and then the quality of the service that we’re doing reduces.” He adds this would make patients more likely to visit their local GP or A&E department. 

Citation: The Pharmaceutical Journal DOI: 10.1211/PJ.2015.20200335

Readers' comments (8)

  • Profession (Independent & Multiples) must join together as a Unity against this and call for National Strike; to prevent damage to the quality of service patients expect to receive.

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  • Contractors have their bodies. it's individual pharmacists that need a national body membership akin to the BMA to speak for its members to government and employers in every sector. To embrace and influence changes. Pharmacist are facing change like never before and individual pharmacist have little influence over it.

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  • All of you community Pharmacists please make an appointment and speak to your MP's. It can help. I have worked in the NHS both as a contractor and as a Pharmacy Champion. I have been lucky enough to feel I understand payments to Pharmacy contractors and the amazing savings that have been generated over the years by the community pharmacy system. We have some the cheapest good quality drugs in the world but this system is at breaking point. The answer cannot be to add another tier (hub and spoke) to the model. I am sure any economist would say that another tier will only add costs in the long term. Our local Pharmacies offer a fantastic service. We are adding the healthy living message. We are supporting those in the community with their dossette needs through the existing contract. We are supporting the vulnerable at risk patients, the elderly, the addicted and the disabled. We are supporting the downward costs to the flu service and expected enter into a competitive contracting arrangement in 1 year. We are supporting the healthy living message. My team are motivated but this is not a good message. Other sectors are increasing their costs and having to be funded - Please persuade the government not to attack such a good value for money sector. I believe those from the hospital sector do not understand the role we play in the community and I am disappointed to see Keith Ridge's signature on the bottom of the letter to us presumably supporting a reduction in remuneration.

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  • Graham Phillips

    In response to David Pattinson: individual pharmacists have a trades union (the PDA) as well as a professional body (the RPS) to represent them. But what you seem to have missed is that if pharmacies close (inevitably this will be preceded by years of attrition) it is bad news for patients, pharmacy contractors and individual pharmacists alike. We all need to stand together and fight this.
    Regards
    Graham

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  • Pharmacies will close, there are way too many in a great number of locations and this will be exacerbated further with more and more patients/customers looking to pharmacy services on line and to the door. I hope we can protect and maintain an adequate local network of pharmacies.

    As for the RPS a professional body yes but without teeth, I have been a member of the RPharmSGB for many a year, but for how much longer it is not meeting the needs of its membership, hence not all pharmacists now join and subscribe. and the PDA has/may become a more viable option for many. Leaving us with the GPhC (GMC) and the PDA (BMA). This is not the same as RPS/PDA. A fractionated mess. I fear the RPS days are numbered as a glorified expensive support function to those pharmacists that choose to but don't need to join. RPS is not their to represent me as an individual pharmacist, PDA is!

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  • If HMRC tackled Boots' tax avoidance instead (over the past 7 years, when the company HQ went offshore, they have avoided paying an estimated £1.1 Bn in UK taxes), DoH would have no need to be picking the pockets of everyone else in the profession in this way. I do not see this as due to any lack of political will, but as evidence of a political will to create a multi-corporate feudalist society. When you also take into consideration that George Osborne also wants the self-employed among us to complete quarterly, instead of annual, tax returns - it is plain to me that this is an ideologically-motivated assault on small businesses aimed at enriching the already over-rewarded, under-contributing multiples, and reducing the rest of us to economic serfdom.

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  • Why is support so poor for pharmacy in general? I guess I am young enough to switch professions but there is no will to empower the profession at all. This is very demoralising.

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  • This whole story is truly demoralising. I have been working with technicians who feel that their pay differential is going to be severely reduced this year. Technicians have to pay to be registered and find time for CPD and are finding that they are paid little more than counter staff.
    There is a limit to how much "more we can do for less" in pharmacy!

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Supplementary images

  • The government faces a strong backlash from community pharmacy bodies over plans to cut the community pharmacy contractual framework in England by 6.1% next year. In the image, Pharmaceutical Services Negotiating Committee (PSNC) chief executive Sue Sharp
  • National Pharmacy Association (NPA) chair Ian Strachan, pictured, says the plans look like “an assault on the very part of the health system that holds the key to solving many of its problems”
  • Rob Darracott, pictured, chief executive of Pharmacy Voice, says the funding cut was “certain to hurt the sector” and that many contractors would be “rightly anxious” about how it will affect their businesses, staff and patients, he says

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