The Pharmaceutical Services Negotiating Committee (PSNC)'s members are seeking immediate rescue packages for the sector to help with energy bills and to ease
capacity constraints.
In a meeting held on 14th and 15th September, the committee members expressed their anger and frustration on the reluctance of NHS England and government to fund
pharmacy sustainably.
The meeting was held to consider practical steps to ease the pressures on the community pharmacy sector, and to oversee the progress of negotiations on the Community
Pharmacy Contractual Framework (CPCF) and other work.
Committee members, as pharmacy contractors, shared their experiences of the current pressures on all contractors, including the inability to deliver some services
and to maintain core service levels; the capacity and workforce crises facing the sector; the critical need for funding support this winter; and the urgent need for
Government to adapt the Price Concessions system to meet the needs of contractors.
"The Price Concessions system is no longer working for contractors in the current volatile medicine supply environment and PSNC is clear this is not acceptable,"
said the committee.
The Pharmaceutical Services Negotiating Committee (PSNC) has published an update on the work it is doing as part of the Transforming Pharmacy Representation
(TAPR) Programme to take forward the mandate from contractors to deliver the Review Steering Group (RSG) recommendations.
The update is primarily aimed at LPCs - with whom PSNC has been working closely on some of the TAPR work over the summer.
The TAPR Programme is being undertaken in support of PSNC's work to address the severe challenges facing the community pharmacy sector at present.
Alongside ongoing negotiations with Government and the NHS, two of the TAPR workstreams - focusing on Vision and Strategy, and on Influencing and Negotiation - are
essential to supporting CPCF negotiations.
"The workstreams are looking at the future of community pharmacy and how best to persuade policymakers to implement a shared vision, with their objective being to put
the sector in a stronger position going into future CPCF negotiations," said PSNC.
The Pharmaceutical Services Negotiating Committee (PSNC) has appointed Sunil Kumar, an independent contractor from Darlington, as the Regional Representative
for the North East and Cumbria region.
"Kumar will represent all independent contractors in the region at the PSNC Committee until 31st March 2023, which is the end of the current term for all Regional
Representatives," said PSNC.
PSNC's North East and Cumbria region covers the areas of Community Pharmacy County Durham; Community Pharmacy Cumbria; Gateshead & South Tyneside LPC; North of Tyne
LPC; Sunderland LPC and Tees LPC.
The Pharmaceutical Services Negotiating Committee (PSNC) has raised concerns over the NHS ad campaign highlighting how community pharmacies can support patients
with non-health advice amidst the growing pressure on pharmacies.
It believes the campaign will only 'worsen' the pressure on pharmacies.
"It is always deeply concerning to see campaigns directing people to pharmacies without any regard for the pressures they are under: it is irresponsible and extremely
unhelpful," said PSNC Chief Executive Janet Morrison.
She called the campaign 'particularly irritating' just weeks after the committee rejected a series of proposals from NHS England and DHSC on relief measures to ease
pressure on pharmacies as being totally inadequate.
"NHS England Board Members have noted the pressure on pharmacies - so why are their teams so often acting to make these pressures worse? We need to see a radical
change in how NHS England treats pharmacies and we're continuing to press for that via our influencing and campaigning work," she added.
The NHS launched the new campaign on Monday (27 February) to highlight how high-street pharmacies can support patients with non-urgent health advice for minor
conditions including coughs, aches and colds.
The Pharmaceutical Services Negotiating Committee (PSNC) has reminded community pharmacies (its members) to update their NHS Profile Manager information.
Ahead of the NHS contract quarter deadline- 30th June 2023, the committee has urged its members to ensure that their pharmacy's NHS website and Directory of
Services (DoS) profile information is kept up-to-date.
The Pharmacy Terms of Service requires pharmacy owners to verify profile information at least once per quarter, however the new NHS Profile Manager has been
introduced to make the process as quick as possible and it can be done on either a smartphone or computer.
PSNC said: "We continue to work with NHS England and the NHS Profile Manager team to make the process as easy as possible and to improve the management tool. Our
feedback has led NHS England to automatically set pharmacy opening hours to 'closed' for many bank holidays (however these can be reset to 'open' if required)."
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."
The Pharmaceutical Services Negotiating Committee (PSNC) has called for improved workforce planning to be undertaken by the government and NHS.
However, for this to happen, it added, "high quality workforce data for community pharmacy needs to be available."
For this reason, the Department of Health and Social Care (DHSC), NHS England and PSNC have agreed that it will be a Terms of Service requirement for contractors
to complete the annual Health Education England (HEE) community pharmacy workforce survey, which will then provide a full picture of the community pharmacy workforce,
including identifying the number of vacancies and regions where these are particularly hard to fill.
PSNC said: "It is acutely aware of the challenges that contractors and their teams are currently facing, so in recognition of the workload associated with completing
the annual workforce survey, we have negotiated with DHSC and NHS England that the requirement to undertake an annual patient satisfaction survey will be removed from
the Terms of Service from 1st October 2022."
This means that contractual requirement will no longer apply to contractors in 2022/23 and going forward.
The Pharmaceutical Services Negotiating Committee (PSNC) has invited pharmacy contractors, LPCs and others in the sector to share their views on an open
consultation on the "future of community pharmacy".
"The consultation - which takes the form of an online survey - is the first opportunity within PSNC's vision project for individuals and organisations to share
their thoughts with Nuffield Trust and The King's Fund," said PSNC.
The survey is happening in addition to an extensive programme of research, interviews and initial meetings of the vision Steering Group, Advisory Panel, and Working
Groups, all of which have contractors, LPCs and other representatives of the sector at their heart.
The online survey, asks five questions on topics such as Future policy goals; Why previous reviews and policies may not have fully achieved their objectives; Design
principles that should underpin the service offer made by community pharmacy; and Blocks and enablers for change.
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 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.
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.
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 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.
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."
In its response to NHS England's consultation on 'the future of vaccination services', the Pharmaceutical Services Negotiating Committee (PSNC) has suggested
that a wider range of NHS vaccinations being available from community pharmacies could support the achievement of increased vaccination levels.
PSNC said: "Any additional services that contractors could provide can only be considered with additional remuneration above the current global sum in the community
pharmacy contractual framework to ensure that the services are adequately resourced."
Alastair Buxton, director of NHS Services at PSNC, said: "We've always known, and the evidence supports this, that community pharmacies are one of the most popular
and accessible places for people to receive a range of vaccinations.
"The NHS was slow to take advantage of this at the start of the Covid-19 pandemic, so we welcome this consultation from them to bring together a wide range of views
on the topic.
"In the longer-term, if the right funding and support is in place, many pharmacies could help deliver a much wider range of NHS vaccination programmes - giving the
public the convenience and service that they want, and taking pressure off our general practice colleagues. It makes perfect sense, and we look forward to the NHS
response to this consultation."
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 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 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.
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."