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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.

A full CPE Committee Meeting was organised in London on April 17 and 18, 2024, to discuss crucial sectoral issues. Key topics discussed during the two-day meeting included intolerable pressures on pharmacy owners, the ongoing Community Pharmacy Contractual Framework (CPCF) negotiations, implementation of the Pharmacy First service, and governance changes. Committee Members reviewed the progress of CPCF negotiations with the Department of Health and Social Care (DHSC) and NHS England. These critical negotiations are being led by the Negotiating Team (NT), which includes independent pharmacy owners and representatives of CCA and non-CCA multiples. The CPE has been advocating for an uplift to the core global sum, margin write-offs, an agreed mechanism for regular funding increases linked to activity and inflation, annual uplifts to service fees, more fundamental reform of the margin delivery framework and an economic review of the medicines supply chain. The Committee also discussed the results of the 2024 Pharmacy Pressures Survey, which was conducted during March and April.

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 refused to accept the Department of Health and Social Care (DHSC)'s decision to get rid of 'transitional payments' from February 2023. The pharmacy negotiator said that 'any reductions in payments at this point will be impossible for community pharmacy contractors to manage financially.' "We are also continuing to be clear with officials and ministers that CPCF funding needs an urgent uplift to help businesses to cope with soaring costs being driven by inflation and the workforce crisis. We put a comprehensive business case to the government for this uplift in the last CPCF negotiations." The latest 'transitional payments decision' by the Department follows the announcement last year that the value of the these payments would be phased down over the second half of 2022/23 and will be based on the latest monitoring and analysis of funding delivery. PSNC says it submitted a fully-costed bid for a 'Pharmacy First' service in its last round of negotiations alongside the case for an uplift to core CPCF funding. Both of these were refused.

The Community Pharmacist Consultation Service (CPCS) will be expanded to enable urgent and emergency care settings to refer patients to a community pharmacist for a consultation for minor illness or urgent medicine supply from Monday (15 May), the DHSC and NHSE said. The service builds on the progress made in GP referrals via the CPCS and hospital referrals under the Discharge Medicine Service. It was originally planned to launch in March, and fee for this service will be the existing CPCS fee of £14, as per the agreement for both year 4 and year 5 of the Community Pharmacy Contractual Framework (CPCF) 2019 to 2024 5-year deal. In an update on the CPCF, published today (12 May), the Department of Health and Social Care (DHSC) and NHS England (NHSE) has also committed to the 4 October 2023 launch date for the Tier 2 of the Pharmacy Contraception Service, subject to a positive evaluation of the pilot. The Tier 1 of the service was launched on 24 April, delayed by over three months. This new service enables community pharmacists to provide ongoing management, via a patient group direction (PGD), of routine oral contraception that was initiated in general practice or by a sexual health clinic. The fees for this service are as follows: a fee for each consultation of £18; and a set-up fee of £900, paid in instalments. The Tier 2 will "enable community pharmacists to also initiate oral contraception, via a PGD, and provide ongoing clinical checks and annual reviews," Alette Addison, deputy director for pharmacy, dental and optical at the DHSC and Ali Sparke, director for dentistry, community pharmacy and optometry at the NHSE, said in a letter.

The Pharmaceutical Services Negotiating Committee (PSNC) has expressed disappointment as the government continued to refuse to "a much-needed broader funding uplift" for the community pharmacies in England. This follows conclusion of the first Annual Review of the progress of the five-year Community Pharmacy Contractual Framework (CPCF) deal by PSNC, the Department of Health and Social Care (DHSC) and NHS England & NHS Improvement (NHSE&I). "We remain deeply frustrated by government's refusal to agree a much-needed broader funding uplift for the sector, but we are determined to continue to look for better ways forward for the sector throughout 2022 and beyond," said Bharat Patel, PSNC vice-chair, negotiating team member and an independent contractor. Patel noted that despite some important wins such as recognition of key challenges faced by pharmacies, the commitment to consider these as part of our Year 4 negotiations, and agreement to take forward work on service fee and other regulatory changes, the PSNC is disappointed that the review did not lead to "immediate and tangible outcomes and improvements for contractors." The negotiator had put forward data and analysis showing the capacity and cost constraints faced by pharmacies.

Nuffield Trust and The King's Fund are seeking feedback from community pharmacy on their proposals for the future of community pharmacy and they are seeking feedback from community pharmacy stakeholders. The online survey is the latest opportunity for pharmacy owners, LPCs and others in the sector to engage with the project to develop a Vision for Community Pharmacy. Nuffield Trust and The King's Fund want to hear their views on their proposals, ahead of the publication of the final report later this year. The vision is critically important, as it will be used to develop the future strategy for the sector and lay the groundwork for the next Community Pharmacy Contractual Framework (CPCF) negotiations. The survey is asking for thoughts on key aspects of the vision and its recommendations. The vision has been developed by Nuffield Trust and The King's Fund following an extensive programme of research, interviews and 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 vision project team are looking forward to hearing views from across the sector on their proposals and what will need to happen to make them a reality.

Community pharmacy representatives and MPs from across all political parties discussed the impact of winter pressures on pharmacies in England during a parliamentary drop-in event held on Tuesday (5 December). As many as 34 MPs attended the event, including Bradford South MP Judith Cummins, who hosted the event. Members of the Community Pharmacy England (CPE) Policy Team and LPC leaders briefed the politicians about the current winter pressures that all NHS community pharmacies are grappling with, and asked them to help get more support. CPE Chief Executive Janet Morrison said: "Community pharmacies play an active role to support their patients throughout the winter period, but the sector needs fair and proper funding to enable its vital services to be delivered in the long term. This event came at a key moment for the sector as we work towards implementing the Pharmacy First service and negotiations begin for the 2024/25 Community Pharmacy Contractual Framework (CPCF).

Community Pharmacy England (CPE) CEO, Janet Morrison said that the negotiations for the £645 million investment pledged to community pharmacies in 2023-25 have concluded. The government's primary care recovery plan is to be announced in a "few weeks" and negotiations for the Community Pharmacy Contractual Framework (CPCF) from April 2024 will begin. She said: "We have finished the substantive discussions on the recovery plan but detailed discussions about implementation are ongoing and we are awaiting final clearance from the Government and the NHS. "We hope that we will be in a position to make an announcement in the next few weeks and that negotiations on the CPCF from April 2024 will commence soon after that." Morrison reminded attendees that the Primary Care Recovery Plan is "to improve access to primary care by investing £645 million over the remainder of the year".

The Pharmaceutical Services Negotiating Committee (PSNC) will launch a new influencing campaign to build wider political support for community pharmacies this week. The campaign aims to ensure that MPs and Peers across Parliament understand the risks to pharmacy services that the current pressures on the sector are causing. In a Parliamentary event held today (Tuesday 15 November) MPs and Peers heard from PSNC, LPC and other pharmacy bodies about the current situation. PSNC briefed them on the urgent need for action to address the pressures on the sector. The committee will be working with LPCs and contractors to organise a series of pharmacy visits for key Parliamentarians including Minsters, Committee and APPG Members. This is happening alongside work to develop a new vision and strategy for the community pharmacy sector, all of which is part of PSNC's strategy to lay the ground for future CPCF negotiations.

The Pharmaceutical Services Negotiating Committee (PSNC) has commissioned Nuffield Trust and The King's Fund to develop a new vision and strategic options for community pharmacy. The report is expected to be published in early summer next year, to underpin the future strategy for the sector. It will also support negotiations between PSNC and policymakers as the current five-year Community Pharmacy Contractual Framework (CPCF) comes to an end. Those negotiations will decide what happens after April 2024, and they will be critical to the future of the sector. The development of a compelling vision and an effective strategy for community pharmacy was a key recommendation from the Pharmacy Representation Review Steering Group (RSG). It forms one of the workstreams of the Transforming Pharmacy Representation Programme (TAPR) currently being undertaken by PSNC. But it is also a project that PSNC wants to undertake anyway to help lay the foundations for those crucial upcoming negotiations.

Community Pharmacy England (CPE) has asked community pharmacy owners to share their views on preparations for the new national Pharmacy First service, ahead of the next full Committee meeting at the end of January. The advanced service, which is set for launch from 31 January, will allow patients to seek advice and treatment for seven common conditions directly from their local pharmacy, without the need to contact their GP practice. It is expected to help NHS free up 10m GP appointments a year. However, CPE chief executive Janet Morrison has previously expressed that the Pharmacy First investment is not the panacea for pharmacy's funding woes. Pharmacy owners' feedback will be used in the Committee's campaigning and influencing work to press for an uplift to core funding, CPE said.

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 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 government has extended VAT exemption from Monday (1 May) on healthcare services carried out by pharmacy staff under the supervision of pharmacists. HM Revenue and Customs has issued a note detailing the change to the VAT treatment of medical services. The Government said this will bring the VAT treatment of pharmacists in line with other registered health professionals providing medical services to the public. The Pharmaceutical Services Negotiating Committee (PSNC) said: "This is something that PSNC has been seeking Government agreement on for a long time, including in recent CPCF negotiations." PSNC believes that the extension of this VAT exemption will help as community pharmacy businesses try to make better use of the skill mix in their teams both now and in the future. "Not only does it enable contractors to review the VAT status of any locally commissioned services currently provided by non-registered pharmacy staff but also, in time, it could be used to amend nationally commissioned services to allow support staff to provide certain parts. For example, following a recent amendment to the service Directions, pharmacy technicians are now able to perform blood pressure checks as part of the Hypertension Case-Finding Service and deliver the Smoking Cessation Service.

The new board of the National Pharmacy Association (NPA) has adopted 10 principles for transforming the contractual framework in England. The board met for the first time in April, believes that the current Community Pharmacy Contractual Framework is failing NPA members, the wider sector, the NHS, Government and patients. The association's new vice chair, Jay Badenhorst, said: "We can't wait until the current framework limps to its finish line in 2024 before giving serious thought to the new race we must all run in the future." "Before negotiations for a new contract begin in earnest, we want to make our position clear to all of those who will be involved in its development. Years more of the same would be totally unacceptable. Tinkering at the edges of the current arrangements as the basis for a new deal could not achieve the transformation that is needed." Former chair of the NPA, Andrew Lane, listed some of the principles in a speech to industry leaders in January, but this is the first time the approach has been agreed in its entirety, following months of testing with NPA members.

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: