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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 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 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.

The specification for the Pharmacy Contraceptive Service has been launched for pharmacy contractors to download from the NHSBSA website. However, the service will not start on 11th January 2023, as originally planned, but it is expected to commence in early 2023, revealed the Pharmaceutical Services Negotiating Committee (PSNC). It added: "The exact start date is yet to be agreed, as now the service specification has been published, community pharmacy IT system suppliers need time to develop support for the service, so this is available to contractors from the service commencement date." Commenting on the publication of the service specification, Alastair Buxton, Director of NHS Services, at PSNC said: "When time in their busy professional lives allows, the publication of the service specification ahead of the start of the new service provides contractors and their teams with an opportunity to learn more about it and to consider whether it is something they will have the capacity to provide in due course.

Pharmaceutical Services Negotiating Committee (PSNC) has launched two surveys to gather data on the pressures that people working in community pharmacies are facing. Pharmacy teams have informed the negotiator about the ongoing financial and operational pressures and expressed concerns that these pressures could impact patients' care. The surveys would give a snapshot of the problems faced by pharmacies and the results will be used in ongoing discussions with NHS England & NHS Improvement and the Department of Health and Social Care. The results will also help PSNC to make pharmacy's case in conversations with the MPs, ministers and the national media. The two separate surveys are for: Pharmacy business owners/head office representatives - This survey covers the pressures faced by businesses, including financial and staffing pressures. Pharmacy teams - It covers the day-to-day pressures experienced by pharmacy teams including supply chain issues, patient interactions/experience and staff morale.

As 19th September has been declared a bank holiday for Her Majesty Queen Elizabeth II's state funeral, the Pharmaceutical Services Negotiating Committee (PSNC) has advised that there is a need for some pharmacies to remain open for public interest. NHS England has discussed with PSNC how this will impact community pharmacy and is in the process of sending a letter to all contractors, setting out the above and requesting that they work with their local NHS England team to help plan arrangements for pharmaceutical provision in the area on the 19th of September. In considering arrangements for the 19th, contractors are encouraged to: Consider the needs of their patients, including any specific clinical needs, since patients have little time to prepare. In particular, patients who collect controlled drugs in instalments should be considered, noting the use of approved Home Office wording on prescriptions (see further information on our Controlled Drug prescription forms webpage). Consider staff availability. It is likely that many schools and childcare settings will close, affecting childcare arrangements.

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 new Flat Fee payment to roll out in April 2023 to all pharmacy contractors who dispense at least 101 items a month, up to a national total of £70m on an annual basis. "The value of the Flat Fee payment has now been determined at £533 per month and will be introduced in the April 2023 Drug Tariff," said the Pharmaceutical Services Negotiating Committee (PSNC). "As with all payments, the Flat Fee payments are subject to change throughout the year depending on the overall level of funding delivery to Community Pharmacies. This will be carefully monitored by PSNC and DHSC, and any funding changes will be communicated to pharmacy contractors as soon as they are known," said PSNC.

The Pharmaceutical Services Negotiating Committee (PSNC) has raised concerns over the impact that high medicine price rises are having on contractor. Recently, the Department of Health and Social Care (DHSC) has granted the final list of price concessions for December 2022. The latest additions bring the total number of concessionary prices granted for the month of December to 198, surpassing the previous record of 159 granted in September 2022. PSNC has heard from hundreds of community pharmacy contractors who are paying inflated prices for antibiotics used for the treatment of Strep A and who have rightly been concerned about the lack of certainty around the final reimbursement prices for these medicines. It added: "We welcomed the involvement of the Competition and Markets Authority (CMA) to look into the pricing of antibiotics. But the number of reports we are getting from contractors about medicines price rises are just not acceptable and this goes far beyond the antibiotic crisis."

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)'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).

The Pharmaceutical Services Negotiating Committee (PSNC) has announced the margin delivery rates will increase from October as the agreed £100m write off is implemented. "The baseline margin allowance will remain £800m per year in 2022/23 and 2023/24," said PSNC. "Margin levels in the last two full years (2020/21 and 2021/22), as measured by the Margin Survey of independent pharmacies, were in excess of the baseline allowance, meaning that an excess was accrued." As new services have been introduced and take up of these has accelerated, the amount of unallocated funding left in the CPCF is now less than it previously was. As such, the value of the Transitional Payments will decrease from its current level. Some of the unallocated funding remaining in 2023/24 will be repurposed into a Flat Payment for all contractors (see details below). Over the course of the second half of 2022/23, the value of the Transitional Payments will be phased down. This will start in October 2022 with a reduction in payment levels to approximately 85% of the current level, as shown in the following table:

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.

To help the pharmacists understand the Serious Shortage Protocols (SSPs) for three Hormone Replacement Therapy (HRT) products that was recently announced by the Department of Health and Social Care (DHSC)'s, the Pharmaceutical Services Negotiating Committee has shared top tips on the correct SSP endorsement and submission requirements. Top Tips by PSNC for pharmacists on HRT SSPs: Always double check that endorsements reflect the requirements outlined in the supporting guidance published for each SSP on the dedicated page of the NHSBSA's website. When endorsing using EPS, contractors are reminded to select the SSP endorsement and input the correct three-digit reference number leaving a space in between 'SSP' and the three-digit reference number for example, SSP 019. Remember to insert the leading zero in the three digit reference number. Each of the affected HRT medicines has its own SSP reference number. Check that the correct SSP number is endorsed for e.g. for Oestrogel® Pump-Pack 0.06% gel the SSP endorsement should be 'SSP 019'. Please note the 'NCSO' endorsement is no longer accepted for SSPs. Endorse the SSP product dispensed including the quantity. Ensure your endorsements are accurate and clear - NHSBSA processing staff must be able to determine what has been supplied. Contractors should note that SSP claims submitted using EPS tokens are no longer permitted.

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."

Any prescription for Promethazine hydrochloride 10mg tablets x 56 submitted for payment to the NHSBSA for July 2022 will be reimbursed at the new price of £17.77 not as per the price concession of £13.45 announced in the 4th concessions update published on 29 July 2022, said the Pharmaceutical Services Negotiating Committee (PSNC). In July 2022, PSNC received several reports from contractors unable to obtain Promethazine hydrochloride 10mg tablets (56) at the published Drug Tariff price of £4.24. Therefore, it submitted a request for a price concession, which was granted and subsequently published but this was later withdrawn after confirmation from the Department of Health and Social Care (DHSC) that due to the price change mechanism, the reimbursement price for Promethazine hydrochloride 10mg tablets has increased from £4.24 to £17.77 for July 2022. PSNC said, "Following the price change mechanism rules, for generic drugs (excluding drugs in Category M), a price change up to and including the 8th of the month takes effect for prescriptions dispensed in that same month. Any price change after the 8th takes place in the following month."

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."

The Pharmaceutical Services Negotiating Committee (PSNC) will be hosting a Parliamentary drop-in event for MPs on Monday (14 November). "The event will last for roughly two hours, during which MPs will have the opportunity to drop-in and have their blood pressure measured by a fully qualified pharmacist," said the committee. It added: "This event will be a great opportunity to talk to MPs from across the political spectrum about the incredible work pharmacies are doing up and down the country, to demonstrate the Hypertension Case-Finding Service and to discuss the frontline role pharmacists play in delivering vital services and free, expert advice." The other community pharmacy bodies, including the National Pharmacy Association (NPA), the Company Chemists' Association (CCA) and the Royal Pharmaceutical Society (RPS) will also be present on the day, providing the sector with a valuable chance to present a united front on the big issues facing contractors throughout the country.

From July 2022, Manage Your Services (MYS) portal will be the only route available for pharmacy contactors to submit all new prescription returns/referred back items and disallowed items, reminded the Pharmaceutical Services Negotiating Committee (PSNC). Contractors will be able to view and submit the required information for all these items only through the MYS portal. The NHS Business Services Authority (NHSBSA) will send out a notification email from July (for the dispensing month of June) to the pharmacy NHSmail account if any new referred back or disallowed items have been generated for the contractor to complete on their MYS account. "Contractors can view any referred back items for completion by checking the 'Unpaid items' tab on MYS landing page," PSNC. "It is important to note that prescription returns/referred back items via MYS are only held in the system for a period of 18 months from the date they are first sent to the pharmacy for action; if contractors have not completed and returned any outstanding referred backs before this deadline has passed, the referred back items will be deleted from system."