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Do I qualify for funding through the Pharmacy Access Scheme?


31 Mar 2017

Gordon Hockey, from the Pharmaceutical Services Negotiating Committee, answers your questions about the scheme

The Government’s cuts to community pharmacy funding have understandably sparked despondency from the profession, as well as fears that many pharmacies will be forced to close. But in an effort to save pharmacies deemed essential for patient access, the Department of Health (DH) also threw a lifeline in the form of the Pharmacy Access Scheme (PhAS). This seeks to soften the full effects of the cuts for some pharmacies, offering an average £2,900 per month for 2016/17.

Read on for a comprehensive guide to the scheme by Gordon Hockey of the Pharmaceutical Services Negotiating Committee (PSNC), including whether your pharmacy qualifies, how the funding is calculated and how much funding it could receive.

What is the PhAS?

The PhAS is a national scheme that aims to provide a baseline level of patient access to NHS community pharmacy services in England. Eligible pharmacies receive an additional payment, meaning they will be protected from the full effects of the reduction in funding that was imposed on 20 October 2016 and came into effect on 1 December.

The DH model has changed since the scheme was first proposed to the PSNC, and selection for the scheme is now based on a simple pharmacy-to-pharmacy distance (one mile), with a last-minute amendment for ‘near-miss’ pharmacies (those that just miss out on the scheme) in deprived areas as a result of concerns about the scheme.

Where is the funding coming from, and will it continue after the stop date of 31 March 2018?

PhAS been introduced alongside the imposed funding package as a 16-month scheme that started on 1 December 2016.

For the most part, the funding for PhAS comes from other pharmacy contractors because it’s taken from the community pharmacy contractual framework. It will cost approximately £15m in 2016/17 and £24m in 2017/18. Eligible pharmacies can be any that dispense fewer than 109,012 items a year and, therefore, some smaller pharmacies not receiving PhAS payments will support some larger pharmacies that do.

The DH decided that the additional ‘near-miss’ review category will be paid for separately, not out of the community pharmacy contractual framework, because it was a last-minute change and not subject to consultation. The DH has given no indication about whether the scheme will continue beyond the scheduled stopping date of 21 March 2018.

How do I find out if my pharmacy is on the ‘eligible’ list and how is eligibility decided?

A pharmacy must meet all of the following criteria to be considered:

•Was on the pharmaceutical list on 1 September 2016.

•Is not in the top 25% of the largest pharmacies by dispensing volume (dispensing 109,012 items per year or more).

•Is more than one mile away from its next nearest pharmacy (by road).

The pharmacies that the DH has already calculated to be eligible for PhAS payments are listed on the Government’s website, which can be accessed from psnc.org.uk/PhAS. The pharmacies on the list will receive PhAS payments automatically.

Contractors should note that the first list, published on 20 October, included inaccuracies and was replaced. Contractors should check the current list.

If your pharmacy is not on the current list and you think it ought to be, you need to apply for a review (see below). However, applying for a review doesn’t mean the DH will necessarily accept you onto the scheme.

How is the payment calculated and will the Quality Payment affect it?

The PhAS payment for 2016/17 is calculated as follows:

1 The pharmacy’s actual remuneration for 2015/16 is identified (excluding locally commissioned services) and reduced by an efficiency saving of 1%.

2 The estimated remuneration for 2016/17 (based on the funding cuts) is calculated by subtracting the figure in 2 (above) from the figure in 1.

For 2017/18, the same approach is used for estimated remuneration, except that the efficiency saving is 3% and it assumes the pharmacy qualifies for 100% of the quality payment. Any PhAS pharmacy not meeting the quality payment criteria is still eligible for its PhAS payment, but the payments will not make up any shortfall in the quality payment scheme.

The DH states that the average PhAS top-up will be £2,900 per month in 2016/17 and about £1,500 per month in 2017/18. The first payment for PHAS pharmacies will appear on their FP34 Schedule of Payments relating to prescriptions dispensed in December 2016, which will be paid by March 2017. For pharmacies that opened during 2015/16, or between 1 April and 1 September 2016, the DH has indicated that an estimate of the PhAS payment will be calculated using prescription volume data and will be adjusted later when further data is available.

How does pharmacy consolidation (mergers) work?

The amendments to the 2013 Pharmacy Regulations prevent a new pharmacy from applying to ‘step in’ straight away if two pharmacy businesses merge and one closes. This aims to protect two or more pharmacies that consolidate onto a single existing site.

How do I apply for a review?

The review process is for those who think their pharmacy should be on the DH’s eligible list but are not. There are three review categories:

1 Inaccuracies – covering scenarios such as incorrect pharmacy postcode

When applying:

•Highlight the inaccuracy, specifying what it is and explaining why you think it means the pharmacy should be eligible for the PhAS payment.

•If the inaccuracy relates to an incorrect pharmacy postcode, the Ordnance Survey’s Open Road Network will be used to calculate distances.

•There is no need to demonstrate your pharmacy is critical for access.

2 ‘Near-miss’ pharmacies in areas of high deprivation – covering pharmacies located in the top 20% most deprived areas and 0.8–1.0 miles from the nearest pharmacy.

When applying:

•Use the online Index of Multiple Deprivation (IMD) to check that your pharmacy is in the top 20% – you would be eligible if the data shows an IMDdecile of 1 or 2.

•Confirm the pharmacy’s postcode so that the DH can verify from its own data that the pharmacy falls within the appropriate distance from its nearest pharmacy.

•Demonstrate that your pharmacy is critical for access.

•Your pharmacy cannot be in the top 25% of pharmacies by prescription volume.

A specific application form has been made available and further information on the review process is available on the Pricing Authority’s website. All links are available on psnc.org.uk/PhAS. Contractors had until the end of February to apply. The one exception to this deadline is the physical feature anomaly review. Applications may be made at a later date, but must be made
within three months of the emergence of the physical feature anomaly.

NHS England strongly encourages applicants to provide all relevant information with their application and will only request further information where this is needed.

3 Physical feature anomalies – covering scenarios such as semi-permanent roadblocks

When applying:

•Provide evidence demonstrating the physical feature makes the nearest pharmacy more than a mile away or prevents patients using that route.

•Demonstrate your pharmacy is critical for access.

•Your pharmacy cannot be in the top 25% of pharmacies by prescription volume.


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