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No future for community pharmacy

From Mr A. Jolley, MRPharmS


In response to the invitation in the PJ 23/30 March 2013 issue to “let us know what annoys you” let me offer my submission regarding the changes to the new medicine service payment structure applied in May 2012. This made graded payments for NMS depending on the ability of a pharmacy to meet the target number of interventions provided (the payments being, namely, £20, £25 or £28, with the offer of a loyalty bonus).

My first reaction to this is why is one patient’s NMS intervention below the target figure considered less valuable than the same intervention provided to a patient above the target figure? This suggests the value to patients is of less interest to NHS Employers and the Pharmaceutical Services Negotiating Committee than the importance of trying to justify the spending of NHS money on anything but the core service of dispensing.

It is well reported that certain multiples have, in the past, offered inducements to customers to take up both medicines use reviews and the NMS by offering discounts on pharmacy purchases but, since May 2012, the PSNC and NHS Employers have offered “graded inducements” to contractors to increase the uptake of these interventions while the overall income from core dispensing decreases.

My second reaction is that the graded payments system exposes the sheer desperation of NHS Employers and the PSNC to justify the invention of MURs and the NMS, which are now often offered to patients who are identified by patient medication record computer-generated flash messages, with the same intensity as “cold calling” telephone payment protection insurance sales. In my view the PSNC is negotiating community pharmacy into oblivion as a profession due to its acceptance of the supermarket mentality of NHS Employers, as illustrated by these graded payments, which, within a few years, will disappear or the targets will be set higher and higher and then the payments will decrease as they have with prescription items.

I believe that present fees for the NMS and MURs are today’s “loss leaders” from the PSNC and NHS Employers, with the special offer of 40 per cent extra if pharmacists meet their target. I?also believe that soon community pharmacy will be left dispensing prescriptions for next to nothing, thus leaving the way open for only the large multiples to be in a position to offer the service, which in turn could lead to dispensing services being franchised.

How do I justify this idea? Well look what happened to the domiciliary oxygen service. If an old pharmacist can work this out, do you think that the Department of Health has not already done so? So I challenge the PSNC to prove me wrong and for once in my life I hope it can, for I see no future for community pharmacy.


Arthur Jolley

Warrington


ALASTAIR BUXTON, head of NHS services, PSNC, responds: Recognising the positive patient benefits which can result from the NMS, the revised payment structure was designed to encourage pharmacy contractors to build the service into their business processes. The structure provides reward for each NMS intevention provided while also encouraging the provision of the service to the greatest number of patients.

Citation: The Pharmaceutical Journal DOI: 10.1211/PJ.2013.11119503

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