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The tripartite negotiations to set the arrangements for the Community Pharmacy Contractual Framework (CPCF) in 2022/23 - Year 4 of the five-year CPCF deal - have now begun, the Pharmaceutical Services Negotiating Committee (PSNC) said. The discussions, beginning ahead of the start of the financial year, are taking place between the PSNC and the Department of Health and Social Care (DHSC) and the NHS England and NHS Improvement (NHSE&I). It will cover issues related to service, funding and other arrangements for pharmacies in 2022/23, in line with the five-year CPCF deal. The three entities will also discuss the progress made to date, which has been partly impacted by the Covid-19 pandemic, and the recent joint Annual Review process, where PSNC raised serious concerns around the available capacity within community pharmacy.

The Pharmaceutical Services Negotiating Committee (PSNC) has developed a webtool to help community pharmacy contractors estimate the impact on their payments under the new discount deduction system. The calculator aims to illustrate the changes to discount deduction that a pharmacy could experience during the transition to the new arrangements from October 2022 to January 2024, when the new system will be fully in place. PSNC's calculator requires contractors to input information about their individual pharmacy dispensing mix (i.e. split of reimbursement by appliances, brands and generics) to provide an estimate for the level of impact the new discount deduction system will have. "The impact on individual pharmacies cannot be estimated without using dispensing mix data, meaning that any estimates which do not take this into account will not be reliable," said PSNC. For years many contractors have been frustrated by how discount is applied to their accounts and have often raised concerns about the blanket nature of its application to PSNC.

The Pharmaceutical Services Negotiating Committee (PSNC) has urged the pharmacy contractors to follow appropriate procedures for unplanned temporary closures due to current workforce pressure, to avoid a breach of terms of service. "If the temporary closure is not for reasons beyond the contractor's control, this may be a breach of the terms of service," said PSNC. The committee also informed that in some areas, NHS England regional teams may ask contractors to complete a new notification form for any temporary closures that request more information than the standard form, for example, on the mitigating actions taken by the contractor. It added: "Completion of these forms is voluntary but may help to show NHS England that the closure was for reasons beyond the contractor's control, or that the overall circumstances of the closure, including time closed and steps taken to ensure patient and public needs are met, indicate that there is no public interest in taking any regulatory/performance action (such as a breach notice) against the contractor."

The Pharmaceutical Services Negotiating Committee (PSNC) has called the 'new general practice contract' which was imposed by NHS England on Monday (6 March) as 'simply unreasonable'. The imposition of new contract followed a failed talk of British Medical Association (BMA)'s with the negotiator. The association's main issue with the contract is the lack of further funding beyond that agreed in 2019 as part of the five-year deal. PSNC Chief Executive Janet Morrison said: "The breakdown in GP contract negotiations for the second year running is another blow for primary care. The verdict of the GP negotiators is that the demands being made of doctors by Government and the NHS are simply unreasonable." "Community pharmacy is being treated with the same disregard: too much is being asked of us, with far too little funding available." The committee has been raising the issue and challenges faced by the community pharmacists with the government. The government is asking pharmacies to do more by taking giving additional services but the committee is of view with no extra funding the community pharmacies will collapse.

The Pharmaceutical Services Negotiating Committee (PSNC) has notified that it is now mandatory to attend face-to-face training for both injection technique and basic life support training periodically for pharmacists and other vaccinators providing the annual flu vaccination service. "Community pharmacy contractors are required to demonstrate that all vaccinators, including pharmacists, providing the flu vaccination service in their pharmacy have the skills needed to do so," said PSNC. Prior to this change, pharmacists and other vaccinators needed to undertake a refresher face-to-face training for both injection technique and basic life support, including administration of adrenaline, every three years. Vaccinator needs to evidence competence PSNC said: "Contractors and vaccinators will now need to consider when it would be appropriate to attend refresher training or if ongoing competence of an individual vaccinator can be evidenced, without the need for face-to-face training. "An individual's continued competence may be influenced by their prior experience vaccinating patients, including the overall number of vaccines administered and the regularity with which they administer vaccines."

Community pharmacy teams are urged to share their views relating to the new NHS Booking and Referral Standard (BaRS). "This will ensure that the tool supports the needs of pharmacy team members and their patients," said the Pharmaceutical Services Negotiating Committee (PSNC). BaRS is an interoperability standard for healthcare IT systems which should enable booking and referral information to be sent to or from care providers, such as community pharmacies, quickly, safely and in a format useful to clinicians. "The intentions are that the BaRS IT standard will eventually be available in all care settings. The way the standard could be used in pharmacies is currently being considered, including the potential for use for referrals from NHS 111 to community pharmacy." The BaRS team are conducting interviews (usually lasting 30-45 minutes) to hear more the current experiences and the future preferences regarding sending and receiving referral messages.

The Pharmaceutical Services Negotiating Committee (PSNC) has rejected Department of Health and Social Care (DHSC) and NHS England's proposal on price concessions reform and relief measures to ease pressure on pharmacies. The Committee called the proposal 'insufficient' to meet the sector's needs considering the impact of the current crisis, reflecting on the economic pressures that accelerated through the autumn and winter. The Ministers and other decision-makers have shown their interest in the potential role of community pharmacy, particularly in using a Pharmacy First approach and making use of PGDs and the skills of independent prescribers. But the Committee had made clear to them that without new money this is all a pipedream. "We need an urgent injection of funds into the sector, otherwise we will continue to see a degradation of services and eventual collapse of the network. The Committee is clear that there is no further place for warm words while pharmacy collapses," said PSNC. The Committee reflected that the 5-year CPCF agreement had been based on working together to create the capacity and context necessary to deliver the shift towards greater service delivery. Not only has that capacity-release not happened due to slow progress by Government, but pharmacies have also been burdened with these additional, and insurmountable, challenges.

National pharmacy bodies have expressed their disappointment on the launch date for Tier 1 of the Pharmacy Contraception Service which has been announced by NHS England (NHSE) as '24th April 2023′. Pharmaceutical Services Negotiating Committee (PSNC) said that this start date for the service has not been agreed with PSNC and is in direct contradiction of our warning to Ministers that no new or expanded services can be rolled out in 2023/24 unless extra funding is put into community pharmacies. Responding to this announcement, PSNC Chief Executive Janet Morrison said: "This is despite our warning last month that without additional funding, the roll-out of Year 5 additional services and the Pharmacy Quality Scheme is neither feasible nor affordable. Community pharmacies are having to work harder and harder for less money and many are at breaking point. And just this week the results of our 2023 Pharmacy Pressures Survey have confirmed the worsening situation. Clearly our view is not because contractors don't see the benefit of the service. This is a much-anticipated service that could deliver real benefits to patients and community pharmacies are always eager to support public health initiatives. But capacity in the sector is now so stretched that more money is needed to safely resource additional work. We have repeated our concerns to the Department in recent days and reminded them of the potential for a properly funded community pharmacy sector to play a greater role in providing clinical solutions and relieving pressures elsewhere in primary care."

The Pharmaceutical Services Negotiating Committee announced last week that it is in discussions with the Department of Health and Social Care (DHSC) and NHS England about relieving capacity pressures, such as a relaxation of pharmacy opening hours requirements. PSNC is also scheduling webinars to talk with contactors about the steps they might be willing to take in future, to cut costs, should emergency financial relief fail to materialise. The pharmacy regulator reported that many of its members felt that it was no longer tenable for pharmacies to keep offering all of the free and non-core services to patients that they would like to, and that all contractors should consider what steps they could take to try to safeguard their businesses and their core services for patients. PSNC is also keen to talk to contractors about their current situation and the steps they might be willing to take in future, should emergency relief not be forthcoming.

The Pharmaceutical Services Negotiating Committee (PSNC) has shared materials to help community pharmacy in communicating relevant advice to people during this heatwave. The UK Health Security Agency (UKHSA) has issued a heat-health alert for the next few days. It has also published a beat the heat poster, along with its heatwave guidance, which could be used in pharmacies to raise awareness. "During this heatwave, the public may turn to community pharmacy teams for advice about staying well during the hot weather or to seek assistance when feeling unwell because of the heat," PSNC said. It has previously developed materials that may be used by community pharmacy teams to communicate relevant messages contained in the Heatwave Plan for England and the NHS website guidance on how to cope in hot weather.

The Pharmaceutical Services Negotiating Committee (PSNC) has urged pharmacy contractors to use Manage Your Service (MYS) portal only for all monthly FP34C submissions. To secure access to earlier advance payments on 11 April 2022, the committee has advised pharmacy contractors to submit their claims for NHS pharmaceutical services delivered in March 2022 no later than 5 April 2022. PSNC said: "The Manage Your Service (MYS) portal is now the ONLY route available to contractors for all monthly FP34C submissions. From March 2022, contractors will no longer receive the paper FP34C submission document through the post. However, the NHSBSA will continue to post out red separators for contractors to submit relevant forms each month.

The Pharmaceutical Services Negotiating Committee (PSNC) has confirmed that the community pharmacy contractors are 'not required' to undertake a contractor-chosen or an NHS England determined clinical audit in 2023/24. "A clinical audit on anticoagulants is included in the Pharmacy Quality Scheme (PQS) 2023/24. If contractors choose to not participate in PQS, and therefore do not complete the anticoagulant clinical audit, there is still no requirement to complete two clinical audits in 2023/24," said PSNC. "The Department of Health and Social Care and NHS England have also committed to consider, during 2023/24, the removal of the requirement for a contractor-chosen clinical audit permanently."

The Pharmaceutical Services Negotiating Committee (PSNC)'s 2022 Pharmacy Advice Audit revealed that more than 1.2 million consultations a week - or 65 million a year - are now being carried out by community pharmacy teams in England. This is an increase from 2021, when the audit results suggested that in total pharmacies were providing 58 million consultations per year. PSNC has published the findings of the audit of over 4,000 community pharmacies carried out earlier this year. During the audit, 82,872 informal patient consultations were recorded, with the average pharmacy completing 19 consultations per day. This suggests that more than 1.2 million informal consultations are taking place in community pharmacies in England every week. The audit helped to quantify the number of informal referrals being made to pharmacies by GPs and NHS 111, with 7,774 informal patient referrals into pharmacy coming from these routes; grossed up to a national level that means 117,000 cases per week. These are all referrals that could and should have been made by the NHS Community Pharmacist Consultation Service (CPCS).

Along with pharmacists, pharmacy technicians in England are now able to perform blood pressure checks as part of the Hypertension Case-Finding Service and deliver the Smoking Cessation Service (SCS). The government has amended Drug Tariff and includes the amendments to The Pharmaceutical Services (Advanced and Enhanced Services) (Amendment) (England) Directions 2023. Pharmaceutical Services Negotiating Committee (PSNC) said: "The service specifications for both services are currently going through NHS England's publication process; when these are published PSNC will alert contractors through their normal communication channels. PSNC resources for both of these services are also currently being updated."

Community pharmacy contractors will start receiving materials for the winter vaccines campaign via Royal Mail from today (November 8). It is the second mandated health campaign for 2021/22 in which contractors must participate as part of their NHS contractual requirements, after the NHS England and NHS Improvement and Pharmaceutical Services Negotiating Committee (PSNC) reached an agreement. The campaign pack, to be arrived in pharmacies, includes a briefing sheet; four A4 posters; one Q&A leaflet; and one A6 shelf wobbler along with social media and digital resources. PSNC has also reminded contractors to have "an action plan" promote Covid-19 vaccinations, particularly in Black, Asian and minority ethnic and low uptake communities.

The regulators have reduced the notice periods for change to supplementary opening hours for community pharmacy contractors from 1 October 2022. Following the Pharmaceutical Services Negotiating Committee (PSNC)'s discussions with the Department of Health and Social Care (DHSC) and NHS England as part of Year 4 negotiations, it has been agreed that the required notice periods for changes to supplementary opening hours will reduce to five weeks. Community pharmacy contractors who want to change their supplementary opening hours are required by their terms of service to notify NHS England. "If a contractor wants to increase supplementary opening hours at the pharmacy, this can be done with no notice - but notification of the change must still be given to NHS England," said PSNC. "To decrease supplementary opening hours at the pharmacy, at least five weeks' notice must be given to NHS England prior to implementing the change."

The Pharmaceutical Services Negotiating Committee (PSNC) has been reminding contractors to complete the 2022/23 Community Pharmacy Assurance Framework (CPAF) screening questionnaire by midnight on Wednesday, 31 August 2022. As a result of NHS regulations introduced at the end of 2020, completion of CPAF is now a requirement of the Terms of Service. "Therefore, contractors must complete the screening questionnaire and, if required, the full CPAF questionnaire," said PSNC. It has also recommended that any contractor who has yet to do so takes immediate action. "It should only take approximately 10-20 minutes to complete." Information and instructions on how to complete the screening questionnaire has been shared either via an email from the NHS Business Services Authority (NHSBSA) or from their own Head Office. Contractors are advised to contact NHSBSA by emailing nhsbsa.cpaf@nhs.net if they have not received details of the questionnaire, or if they have any problems or queries completing the questionnaire.

The Pharmaceutical Services Negotiating Committee (PSNC) has launched a four point plan at its parliamentary drop-in event for MPs and peers hosted on Tuesday (15 November). The event lasted for two hours, during which MPs had the opportunity to drop-in and have their blood pressure measured by pharmacists with experience of working on the front-line and were briefed on the urgent need for action to address the pressures on the sector. Outline of the four-point plan: Resolve the funding squeeze: Community pharmacy needs an immediate funding uplift to prevent large-scale pharmacy closures, as well as emergency business relief to get through this winter. Tackle regulatory and other burdens: Pharmacies must be protected from medicines market shocks, supported to help them weather the workforce crisis, helped to free up capacity and freed from red tape that does not enhance patient care. Help pharmacies to expand their role in primary care: Pharmacies could do more to support the delivery of primary care for example through offering clinical services for long-term conditions - like hypertension, diabetes and respiratory disease, supporting people to adopt healthier lifestyles and prevent the development of long-term conditions, medicines optimisation, and a much wider variety of NHS vaccinations.

The Pharmaceutical Services Negotiating Committee (PSNC) is encouraging community pharmacy contractors and their teams to take part in the negotiator's latest Pharmacy Advice Audit. The audit has been extended but results must be submitted by 23.59 on Friday (March 11). Under the audit, pharmacy teams need to record information about the informal healthcare advice that they give in a single day, which would provide a critical check on how people continue to rely on community pharmacies. The results of the audit will provide key evidence for use in funding discussions with the government and the NHS. Last year's Advice Audit highlighted the scale of the informal consultations that took place in pharmacies during the pandemic, and helped the PSNC to persuade MPs to support the case for Covid-19 costs.

What will it take to get help from the government before an individual or sector breaks? Pharmacists raised questions after the Pharmaceutical Services Negotiating Committee (PSNC)'s 2023 Pharmacy Pressures Survey confirmed the ongoing pressures and health issues faced by the pharmacies. Pharmacists are not all shocked by the PSNC's survey report as they feel the same as what has been reported related to their businesses and health. They hope the government listens and work with them to find resolutions. "We are bullied into a corner," said Salim Jetha Chairman, Avicenna. "Unlike other industries, we can't increase our prices. Most of the daily calls I get from Independents is about financial health of their business and any cost cutting would be detrimental to patient care. Urgent holistic review is required." Bristol pharmacist Ade Williams said: "The report is a dire indictment, and I would also warn, likely an underestimate of the extent and detrimental impact of the ongoings pressures and squeeze on Community pharmacies." "If the closest interface of the NHS to communities and patients is so distressed, what does that mean for those that need and depend on us? We are notoriously very stoic, so this is a warning light, which, taken with workforce pressures, market-exit activity, and other reports raising concern about wellbeing and stress, must beg the question; what will it take to get help before the sector and individuals break?" he questioned. The survey results don't surprise Kent-based community pharmacist Amish Patel. He said, "I have been feeling exactly what has been reported for far too long. I'm burnt out and would say beginning to suffer with my own health because of it. Now it's for PSNC to talk to government, and government to listen and work with us to find resolutions."