On Monday (22 July), the Government announced a five-year funding deal for English community pharmacists.
English community pharmacies will receive one £2.592bn funding package per year until the end of 2023/24, according to an agreement between the Pharmaceutical Services Negotiating Committee (PSNC), the Department of Health and Social Care (DHSC) and NHS England and Improvement (NHSE&I).
This means that current year-on-year funding levels remain unchanged since last year, although the new contract will spend the money on different priorities. More details of the contract will come out over the next few months, and PSNC will negotiate new services and payments each October.
MUR and establishment payments will be phased out
Medicines use review (MUR) payments and the establishment payment will be phased out from October 2019, although the funding for both is being reinvested back into the sector.
According to PSNC, MUR and establishment payments will be gradually phased out over the next 18 months. Contractors will be paid for a total of 250 MURs per year until the end of 2019/20, falling to 100 in 2020/21, with the service being decommissioned at the end of that year.
‘All contractors can provide 250 MURs in total throughout 2019/20, but no more than 200 in the first half of the year,’ PSNC clarified.
Baseline funding worth £164m was set aside for the establishment payment up until the end of 2018/19, with that sum dropping to £123m in 2019/20. No, or lower, establishment payments are expected to be made from April 2020, PSNC said.
Transitional payments will be made to help cover some costs
Contractors will receive monthly transitional payments from October 2019 until March 2021. These will be linked to dispensing volume and will also recognise:
- Preparing for more services, including the need to introduce new staff
- Engaging with PCNs
- Every pharmacy achieving at least healthy living pharmacy level one status.
- Preparing for Serious Shortage Protocols
- Introducing the Falsified Medicines Directive.
A new national consultation service
A new national service, the community pharmacist consultation service (CPCS), will be commissioned from the autumn, bringing together the NHS urgent supply advanced service (NUMSAS) and the digital minor ailments referral service (DMIRS) into one service.
The CPCS is designed to help the sector move towards preventing ill-health, provide urgent care services, support patients who have recently left hospital and help patients avoid visiting their GP or A&E.
The service incorporates two existing pilot services – the national urgent medicine supply advanced service (NUMSAS) and the digital minor ailments referral service (DMIRS).
In 2019/20, the CPCS will take referrals from NHS 111, but is expected to include referrals from GP practices, NHS 111 online, urgent treatment centres and possibly A&E over the remaining four years covered by the contract.
PSNC clarified: ‘Each phase will be piloted first using funding from the Pharmacy Integration Fund (PhIF), with roll out subject to successful evaluation and value for money.’
Contractors who are ready to provide the CPCS from 1 December 2019 will receive an initial transitional payment of £900, while those who are ready by 15 January 2020 will be able to claim £600. Each CPCS consultation will be remunerated with a £14 fee.
This payment model will be reviewed from 2021/22 onwards.
An updated quality payments scheme
The quality payments scheme has been renamed the pharmacy quality scheme (PQS). As with the quality payments scheme, the new scheme will allow contractors to claim back money for meeting certain quality targets.
According to the contract, the PQS will run for the next five years, with £75m to support it.
The current gateway criteria to qualify for the quality payments system, including setting up an NHSmail account and a NHS.UK pharmacy profile, are set to become mandatory under terms of service requirements.
Meanwhile, gateway criteria for the new PQS include offering the flu vaccination and/or new medicine service and ensuring that 80% of staff have achieved level 2 safeguarding status for children and young people over the last two years.
The PQS’s quality criteria – which contractors can achieve in exchange for extra funding – are split into ‘bundles’ covering management and safety and prevention.
One quality criterion involves demonstrating that local pharmacies have ‘agreed a collaborative approach’ with their PCN, including electing a lead pharmacy representative to communicate with the network on behalf of all the PCN’s contractors.
Plans for how to spend the pharmacy integration fund
The pharmacy integration fund will finance service pilots (see below) that could be commissioned nationally if they are successful.
A continuation of the pharmacy access scheme
The pharmacy access scheme will continue with the current criteria and £24m per year in funding until April 2020. At this point, an updated version of the scheme will be introduced – contractors can expect details of this in October 2019.
More new services
As well as the CPCS, the new contract covers plans to introduce a new Hepatitis C testing service for patients who use needle and syringe programmes.
It also reveals that several new services – including one to find undiagnosed cases of cardiovascular diseases, a smoking cessation service targeting referrals from secondary care and point of care testing to tackle antimicrobial resistance – are due to be piloted in pharmacies.
If the pilots show that these services demonstrate value for money, they will be commissioned nationally.