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 National Pharmacy Association (NPA) has called on the NHS England to uplift funding for pharmacy contractors to enable them to cover higher staffing costs
along with a range of other cost-inflating factors.
This follows latest data released by the recruitment platform Locate a Locum, which showed a huge increase in locum rates for pharmacists in 2021 and predicted the
trend to continue.
The report noted a 71 per cent surge in the cost of employing locum pharmacists in England, from the 2020 average to the second half of 2021.
NPA chief executive Mark Lyonette said: "There is a heavy reliance on locums in community pharmacy to maintain continuity of services with the average pharmacy
operating 50 hours per week. Consequently, increases in locum rates have a big effect on the cost base.
"Pharmacies face a range of general cost pressures beyond locum rates, including much higher energy costs. We hear a lot about the cost of living crisis; our
members are facing a cost of doing business crisis and it's every bit as real.
"The underlying underfunding, significant general inflationary pressures and specific cost increases relating to the locum workforce together make a powerful and
urgent case for new funding."
Community pharmacies will be able to deliver approximately 15 million blood pressure screenings by 2026, revealed the Company Chemists' Association (CCA)'s new
research.
This will also prevent 15,000 people from suffering heart attacks or strokes. CCA has called the Government to take up their offer and commission pharmacies as the
first port of call for cardiovascular care.
"Thousands of lives can be saved with ambitious commissioning and the investment to match," said CCA.
There is an opportunity to use the expertise of community pharmacy to go further and provide the care these newly identified patients' need. To do this the sector
needs funding and workforce.
The association said: "Community pharmacy is under great financial pressure, suffering a real term funding cut of over 30% over 8 years. With funding, the sector can
transform to deliver this critical need for patients.
Whilst there are plans to train Independent Prescribers (IPs), there are no clear roles for them to use these skills. There is a need to accelerate training plans to
allow pharmacists to deliver the service described here and play their part in CVD management."
Community Pharmacy England (CPE), the Company Chemists' Association (CCA), the Royal Pharmaceutical Society (RPS) and the National Pharmacy Association
(NPA) on Tuesday (5 March) released a joint manifesto for community pharmacy in anticipation of the upcoming general election expected later this year.
The manifesto has been designed for widespread use within the community pharmacy sector to facilitate engagement with political parties and parliamentary candidates.
In their #VotePharmacy manifesto, the pharmacy bodies have highlighted a robust six-point plan to unleash the potential of pharmacy.
Election candidates are urged to express their support in six key areas, which include:
Filling the funding gap and committing to long-term sustainable funding to empower pharmacies to deliver more NHS care.
Enhancing the community pharmacy workforce to ensure they can meet the evolving needs of patients.
The Royal Pharmaceutical Society (RPS) has published its general election manifesto highlighting some of the key challenges the next Government will face to
support patients and the NHS.
The manifesto calls on general election candidates to show their support to securing patient access to medicines, a better-connected NHS, enhancing accessible
prescribing in local communities, and maximising health improvement through locally accessible pharmacy teams.
Candidates are urged to called on the next Government, if elected, to support the pharmacy workforce to deliver patient care, unlock the potential of new advances
in medicines, and continue to support funding for the UK science and research community.
The manifesto highlights the need for investment in IT infrastructure to support a better-connected NHS to enable all health professionals to access and update a
patient's record.
The Health Select Committee Expert Panel has concluded in its report published on Tuesday (25 July) that the funding aspect in the community pharmacy sector
'requires improvement' based on the evidence received.
The Expert Panel reviewed nine Government commitments, seven of which were from the Community Pharmacy Contractual Framework.
It was found that available funding was not sufficient to keep pharmacies open, struggling financially with increased demand for dispensing, workforce pressures
and rising costs due to inflation. One of the other commitments requiring improvement covered a scheme intended to protect access to local physical NHS pharmaceutical
services in areas where there were fewer pharmacies.
Professor Dame Jane Dacre, Chair of the Expert Panel, said: "Pharmacy plays a key role in the delivery of care so it's disappointing that progress overall to
deliver on the Government's commitments was rated as 'requires improvement'.
The government has earmarked £200 million to enhance NHS resilience and expedite patient care during the upcoming winter season. This extra amount will
bolster the health service during its busiest period, while protecting elective care so we can keep cutting waiting lists, Prime Minister Rishi Sunak has said.
On August 13, the Prime Minister and Health and Social Care Secretary met with clinical leaders and NHS Chiefs to strategise and refine planning for urgent and
emergency care, while prioritising the preservation of waiting list targets for the upcoming winter season.
"Patients can be reassured that I will always back the NHS, so that those who most need help and support will get the care they need," Sunak said. "Winter is
the most challenging time for the health service, which is why we've been planning for it all year - with huge government investment to fund new ambulances, beds
and virtual wards."
"This £200 million investment, assured by the Department of Health and Social Care as new and additional funding, should aid NHS leaders in their preparations and
mitigation for what will be a seriously difficult winter period," said Matthew Taylor, Chief Executive of NHS Confederation. "The priority now is swift allocation
of funding to local systems for optimal utilisation."
In an oral parliamentary debate on community pharmacy held on Monday (20 March), the government was asked for an indication of 'how much it would cost to
make the best use of community pharmacies'.
A number of Peers at the House of Lords spoke out in support of pharmacies, while others asked when would the government address the current crisis in the sector.
Kicking off the session, Baroness Hodgson asked the responding minister, Lord Evans, about recent pharmacy closures as well as underfunding. She asked whether the
government would 'enter into discussions with PSNC to look at introducing a fairly funded pharmacy first service as soon as possible which will help relieve the
work load on GPs'.
The minister responded: "We have already introduced and funded a range of service in community pharmacy that make use of the clinical skills of pharmacy teams… we
continue to discuss with PSNC how the government can best support the sector to provide support to patients."
The House of Lords oral questions session was opened by Baroness Hodgson on behalf of Baroness Cumberlege as follows: "To ask His Majesty's Government what plans
they have for making the best use of community pharmacies".
The NHS England has introduced a training programme for 1000 staff to broaden their community pharmacy roles, thereby improving patient access to services.
Among them, 500 pharmacy staff will be trained to supervise pharmacists during prescription training, while the remaining 500 will provide support for various
training, including pre and post-registration programmes for pharmacists and pharmacy technicians.
According to the NHSE, pharmacist and pharmacy technician roles are rapidly evolving due to healthcare changes and increased demand for clinical services in
community pharmacy. "There are 3,000 independent prescribing training spots available for 2023/24. Educational supervision is a crucial part of this to enable the
ongoing transformation and skills development of the growing pharmacy workforce."
The NHSE-funded training, scheduled to begin next month, will ensure that those involved in educational supervision, including Designated Supervisors (DSs),
Pre-registration Trainee Pharmacy Technician education supervisors and Designated Prescribing Practitioners (DPPs), can effectively support learners.
Community Pharmacy England has submitted a full and detailed written response to the Health and Social Care Select Committee's pharmacy inquiry.
The Committee is expected to hold oral evidence sessions when Parliament returns in the Autumn. The commencement of this inquiry follows on from those held on
other primary care sectors, including Dentistry and General Practice.
According to the Committee website this inquiry 'will explore issues impacting different types of pharmacy, with a particular focus on community, primary care and
hospital pharmacy services'.
Key themes of CPE's submission include- Suggestions on future service provision; Challenges with the pharmacy workforce; Longstanding underfunding of the sector;
and Current pressures.
Janet Morrison OBE, Chief Executive of Community Pharmacy England, said: "This is an extremely important opportunity for all who work with and in the Pharmacy
sector, to highlight not only the extreme challenges we face, but also ideas and suggestions for what more we can do to help patients and the public in the future.
Pharmacists globally are broadening their roles to support self-care, aiming to enhance patient health outcomes through increased contributions and proactive
behaviours, according to a new report.
However, significant barriers, including inadequate funding and limited access to patient records, impede the optimisation of self-care activities and outcomes
improvement in this area, the International Pharmaceutical Federation (FIP) said in its report.
The FIP report, titled 'Community Pharmacy Insights: Supporting the Need for Self-Care,' gathers insights from 238 respondents across 55 countries with the aim
of providing evidence-based policy support for workforce development.
Nearly all respondents (93.2 per cent) indicated that pharmacists should actively engage in providing self-care support, FIP said. Furthermore, 48.9 per cent
supported the involvement of pharmacy technicians, while 39.2 per cent endorsed the participation of pharmacy assistants and other team members in offering
self-care support.
In a significant move to address health disparities and enhance clinical research, community pharmacies across several regions are set to become central
players in the Genes and Health study.
Led by Queen Mary University of London and funded by the Wellcome Trust, this national initiative aims to improve health outcomes within British-Bangladeshi
and British-Pakistani communities.
Professor Mahendra Patel, Director of the Centre for Research Equity at the University of Oxford, highlighted the importance of this approach.
"By engaging the broader pharmacy workforce, including technicians, we aim to establish a research-ready infrastructure within community pharmacies," Patel
told Pharmacy Business.
He shared that the initiative marks a transformative step in integrating pharmacies into the clinical research landscape.
The Thames Valley and South Midlands Clinical Research Network (CRN) is managing a pioneering pilot program for this study, which will initially focus on
pharmacies in Banbury, Oxford City, Reading, Slough, High Wycombe, and Aylesbury.
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.
Pharmacy bodies are "bitterly disappointed" that the latest deal on the national contract makes no commitment to "fresh funding", with one organisation calling
it "the biggest dis-service ever done" to community pharmacy.
The only commitment made in monetary terms was one in which NHS England agreed to write off a sum of £100m in excess margin earned by contractors in previous years.
This allowance, which can't be seen as new cash injection, was said to have been made in recognition of the pressures facing the sector.
The figure - reached after what the the Pharmaceutical Services Negotiating Committee called "a tense period of negotiations" with the Department of Health and Social
Care and NHS England - will cover the final two years of the current five-year Community Pharmacy Contractual Framework.
The deal was announced by PSNC chief executive Janet Morrison at an annual LPC Conference in Manchester on Thursday (22 September). Welcoming the attendees, she
assured everyone that the committee was well aware of the pressures the sector was facing.
"I heard how contractors are feeling and their frustrations over growing pressure and lack of financial support from the government. They confirmed that many now
are unable to deliver the full range of services, and others are struggling to maintain core levels of services. And the ongoing impact of capacity and workforce
crisis is critical, leading to temporary closures.
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 Royal Pharmaceutical Society (RPS) Scotland the BMA's Scottish GP Committee has called for improvements to the pharmacotherapy service.
The joint statement released by the organisations on Friday (13 January), has recognised that much progress has been made but states that further improvements are
needed to fully maximise the benefits of the service.
It highlighted the need for better use of skill mix, including more clearly defining roles and responsibilities; improved IT enablers to reduce administrative burden;
and further developing a tandem model of working comprising hubs with in-practice activity
The two organisations state that inadequate funding and workforce shortages are a real threat to the pharmacotherapy service.
They have urge Scottish Government to reconsider its recent decision to reduce funding for training pharmacy technicians.
Clare Morrison, RPS Director for Scotland, said: "In the statement, we stress that the use of pharmacists' clinical skills must be maximised.
The Company Chemist Association (CCA) highlighted its concerns around the recruitment of pharmacists into Primary Care Networks as well as the need for
additional investment.
Commenting on the Ipsos survey findings, the Malcolm Harrison, the Chief executive of the CCA said: "We welcome the findings of the Ipsos survey, confirming that
patients value the quality of service and advice community pharmacies routinely provide.
"We are very concerned however that this cancer detection pilot, and all other pharmacy services, are at risk if the NHS is not prepared to inject urgently needed
funding into the sector."
He stated that without substantial investment, "we will see the continued erosion of the service pharmacies can provide."
In addition to the need for critical additional funding the association is also calling on the NHS to pause the recruitment of pharmacists into GP surgeries.
He said: "Patients are suffering because the demand for pharmacists in England is now significantly greater than that which the existing workforce can deliver."
Recently, the English Health Secretary has talked about introducing a 'Pharmacy First' model similar to that which exists in Scotland. This would be a win-win
outcome providing people with better access to essential healthcare support, advice and treatment whilst relieving strain on other parts of the NHS, not least GPs
and A&E.
It is a no-brainer and yet despite a few media headlines there are still no firm proposals on the table to make this a reality. It surely cannot be right that you
can receive a broad range of patient care services in Scotland which are not available in England. It works well in Scotland, Wales is keen to develop more
pharmacy-based services and Northern Ireland, leaving aside the current funding dispute, has had a minor ailments service for many years.
If the English Health Secretary is sincere in his interest in adopting an English version of the Scottish model, then there are critical aspects he needs to
consider.
Firstly, start with the patient journey through the healthcare ecosystem from illness prevention through to long-term condition management. What is the role of
community pharmacy and how do we guide people to seek support from the most appropriate healthcare professional?
What is the vision for community pharmacy delivering patient care in the next decade?
The lesson from Scotland is that the government needs to sit down with the sector and map that out together. There are no quick fix overnight solutions. This needs
to be a long-term commitment backed by adequate funding. Supervision regulations need to change and there needs to be a thought through workforce strategy which
avoids community pharmacy shortages as that does nothing to deliver improved patient outcomes.
The NHS plans to train hundreds of pharmacy staff, expanding their ability to provide advanced clinical services and assume wider roles in dispensing medicines.
With a targeted launch in September, up to 840 pharmacy technicians can join in the training programme. The online modules will cover consultation skills,
therapeutics, clinical decision-making, assessment skills, and service improvement.
"Community pharmacies are pivotal in local communities, and this novel training scheme empowers them to extend their service offerings to a wider patient base,"
said Health Minister Neil O'Brien. "Through our investment in the workforce, we're bolstering the implementation of the Pharmacy First initiative with £645 million,
ensuring patients have access to expert assistance for various common ailments, including urinary tract infections and earaches."
NHS said the training will offer flexibility to align with the working schedules and prior experience of community pharmacy technicians. It will combine independent
online e-course study, educational supervision, and clinical skills training. Facilitated workshops will concentrate on enhancing clinical assessment skills and
applying knowledge and skills through case studies, practice activities, and group discussions.
The English health secretary has fumbled the opportunity to prevent a crisis in the NHS this winter. She either does not understand or value the role of
community pharmacy as the third pillar of patient access to essential healthcare.
Her announcement that she wants community pharmacy to provide more services to take the strain off A&E departments and GP surgeries comes on the same day DHSC
announces no new long-term investment to sustain the sector.
Does she not understand that as a result of years of government underinvestment in England the network is in decline with random closures across the country? Too
many pharmacies are temporarily closed every day due to workforce shortages beyond the control of pharmacy owners.
Adding a new service here and there, even with some additional funding, does not address the longer term viability of the network which needs to know which patient
services it will be expected to provide over the next 10 years - not just the next few months - and how those will be adequately remunerated.
Asking more from our sector with no new investment is a strategy which is bound to fail. The pharmacy contract remains economically illiterate. The sector's finances
need open heart surgery not a couple of paracetamol tablets.