Independent financial review of community pharmacy to focus on clinical services

The independent financial review promised in the Community Pharmacy Contractual Framework (CPCF) will be an analysis of the commercial case for clinical services, rather than ‘a financial review of the viability of community pharmacy per se’, the deputy chief pharmaceutical officer for England said last week at an event.

Speaking at an event for members of the Association of Independent Multiple Pharmacies (AIMp) in Birmingham on 29 September, Dr Bruce Warner said the economic review would seek to build a business case for the provision of clinical services within a community pharmacy setting.

He added that the review will look into which clinical services were working well, which could be scaled up and potential new opportunities.

He claimed that this could then be presented to the Treasury in time for the next CPCF to be agreed.

Dr Warner told delegates: ‘It’s not about a financial review, in terms of the viability of community pharmacy, per se. It is very much a review into the financial and commercial aspects of developing clinical services – and what's really required.

‘It's genuinely to give us the best possible chance of building a business case that we can go to the Treasury, to say we work with the sector, and this is what we need to really develop those clinical services. And that business case has got to be as robust as it possibly can be.’

Dr Warner said that increase in independent prescribing, with all new pharmacy graduates qualifying as independent prescribers by 2026, could open new doors to the types of services that pharmacists could provide, such as managing long term conditions.

However, he said that it was ‘almost inconceivable’ that the current funding model was ‘fit for purpose’ to allow community pharmacists to manage long term health conditions, saying that new funding models may need to be explored.

He said: ‘We have to ask ourselves, is the funding mechanism we've got fit for purpose in terms of using independent prescribing to manage long term conditions? It's almost inconceivable that it is to be honest. So, what changes need to be made? How do we develop a funding model that actually makes this work in terms of independent prescribing, and looking after the patient?'

Dr Warner’s comments come after a new Pharmacy Contraception Service was introduced in the most recent Community Pharmacy Contractual Framework (CPCF), which will allow community pharmacies to manage repeat prescriptions of oral contraception from January 2023, and initiate oral contraception from October 2023.

However, PSNC said that pharmacies were struggling to deliver their current services, and that there was a ‘real question mark’ over whether community pharmacies would have the capacity to deliver more clinical services without further funding.

In a press briefing, PSNC chief executive Janet Morrison described the CPCF funding arrangement as ‘not sufficient’ and said that PSNC would continue to explore additional funding routes, including short term solutions such as business relief and energy tariffs.

She also said that PSNC would ‘continue the conversation’ around establishing a Pharmacy First scheme in England.

She said that conversations would explore ‘the need to establish a properly funded and properly organised service with additional funds that can recognise the growing demand, but also put it on a firmer footing, providing greater access to primary care and helping to address public health and health inequalities’

Amid rising dispensing costs, PSNC and the Department of Health have begun conversations about reforming the price concession system.

For many community pharmacies, day-to-day operational costs are also a pressing concern. The AIMp has recently joined retail and hospitality leaders to call for a reduction in business rates and VAT on energy bills, which chief executive Dr Leyla Hannbeck said ‘would make a significant difference’ for pharmacy.