The current funding model for community pharmacy does not contain ‘the right incentives’ to deliver clinical services to patients, a new report outlining a long-term vision for the sector has suggested.

A clinical future for the sector, helping to relieve the burden on general practice and other overstretched parts of the health system, formed a key part of the government’s recent delivery plan for recovering access to primary care.

While that came with an additional injection of funding for the delivery of new services, a new report by The King’s Fund and the Nuffield Trust has suggested that a complete overhaul of the way the sector is funded is required to enable the profession to deliver more clinical services to patients.

It recommended that ‘consideration should be given to applying the same model for NHS funding of GP premises to community pharmacies, for the space required to deliver clinical services’.

Those interviewed for the think tanks’ report consistently said that ‘the current community pharmacy contractual framework does not contain the right incentives to drive progress towards the future vision for community pharmacy’, the authors said.

‘There were, however, divergent views on what funding approach should be adopted in the contract,’ they added.

One idea advocated by some interviewees was ‘at least a partial use of patient registration that would then allow for some capitated funding to be given to community pharmacy, allowing a move away from a fee-for-service model’.

However, ‘others suggested that the strength of the community pharmacy sector was its accessibility, with patients and the public able to attend any pharmacy, and so did not think that registration and capitation would be appropriate’.

Payments linked to quality measures were also debated by those involved in the blueprint, although there was ‘a clear acknowledgement that the extent to which any measures overlap with Quality and Outcomes Framework (QOF) incentives for GP practices would be problematic’ and would create ‘unhelpful competition for the resource between the two sectors’.

‘Primary care in England is experiencing a deep access crisis and for the foreseeable future, there is more than enough patient demand to keep both general practice and community pharmacy busy (indeed, too busy),’ the report, commissioned by Community Pharmacy England (CPE), added.

Speaking to press about the report this week, CPE chief executive Janet Morrison said that the negotiator was currently looking into ‘the economic and social value of community pharmacy’, as well as ‘reinvestigating alternative funding models and systems’.

‘We will be taking those forward with our committee to weigh up and think about more and we'll do some more research and evaluation on all of the different ways in which we could be funded,’ she added.

CPE was ‘starting to work on evaluating the different models and formats for funding’ alongside current negotiations for the recent £645m injection of funding for community pharmacy and the next one-year contractual agreement, noted Ms Morrison.

However, she added that ‘some breathing space’ was needed ‘to talk more frankly’ with DHSC and NHSE ‘about the way that we go forwards’.

She said that in addition to discussing the role of community pharmacy in delivering the government’s primary care strategy, the negotiator needed to have ‘open discussions’ about ‘what works or doesn't work in the contract now’.

‘They may be thinking that the contract doesn't work too well now either,’ Ms Morrison added.

A DHSC spokesperson commented that ‘community pharmacies play a vital role in the NHS and already provide healthcare advice and support and we provide £2.6 billion every year to the sector.’

They added that the government was ‘taking a long-term view on how we can improve the health service’ and said that its ‘Major Conditions Strategy will look at the prevention and management of conditions – including dementia, cancer and diabetes – that are responsible for the highest proportion of ill health in England’.

And they emphasised that the government had this year announced a Pharmacy First service in England would ‘enable community pharmacies to supply prescription-only medicines for seven common conditions without patients needing to see a GP and to support more blood pressure checks – which can pick up hypertension – and oral contraception consultations’.

And they confirmed that discussions were continuing between the department, sector and stakeholders around how the £645m additional investment into pharmacy services, including Pharmacy First, would be spent.