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Mixed reaction to English community pharmacy contract


By Costanza Pearce
Reporter

23 Jul 2019

Pharmacy organisations have expressed mixed feelings towards the announcement of the new English community pharmacy funding deal.

The ‘landmark’ £13bn five-year funding settlement, which will award English community pharmacies £2.592bn per year until 2023/24, was announced by the Pharmaceutical Services Negotiating Committee (PSNC) yesterday afternoon (22 July).

While year-on-year funding levels remain unchanged, the new contract will spend the funds on different areas, such as increased delivery of clinical services.

 

RPS: ‘absolutely the right direction’

The Royal Pharmaceutical Society (RPS) said there was ‘much to welcome’ in the contract, including transitional payments to meet costs such as integration into primary care networks (PCNs) and the introduction of new services that will ‘showcase’ the potential of community pharmacy.

RPS chair Claire Anderson said: ‘A shift to a major clinical future is encouraging and is absolutely the right direction for community pharmacy. We have long called for pharmacists in the community to play an expanded clinical role and there is much to welcome in the new contract with focus areas on urgent care, prevention, medicines optimisation and safety.’

She added that the new community pharmacy consultation service, which will refer patients with minor ailments to community pharmacists rather than GPs, will be ‘game-changing for our primary care systems’.

‘It will also have a positive impact on relationships within the multidisciplinary primary care team and in educating patients about the types of support and expertise that pharmacists provide’, Ms Anderson said.

However, she called for continued focus on medicines optimisation despite the phasing out of medicines use reviews (MURs) and expressed concerns that the contract will not go far enough to ease the financial pressure on the sector.

She said: ‘A five-year settlement will offer some certainty for contractors who want to plan for the future, although with funding remaining flat and contractors potentially facing rising costs, the sector will no doubt be keenly watching how further details on services and payments are negotiated each year.’

 

NPA: ‘the £2.59bn needs to be a floor not a ceiling’

The National Pharmacy Association (NPA) said it ‘strongly supports’ the new contract’s clinical focus and its recognition of the greater role that community pharmacy can play in urgent care and public health.

However, NPA chief Mark Lyonette said: ‘The five-year term of this settlement gives us the long view we asked for, but static funding year on year means it will be very difficult to deliver the transformational improvements we all want to see. The Government must be prepared to direct more money into community pharmacy, if it becomes clear that funding is insufficient to maintain current core services and invest in positive new developments like the community pharmacist consultation service.

‘We note the proposed annual review each October. To ensure the service levels required for patients, we suspect the £2.59bn needs to be a floor not a ceiling.’

 

CCA: ‘community pharmacies must embrace the new services and engage with PCNs’

The Company Chemists’ Association (CCA) said that although the unchanged funding levels for the next five years will present ‘significant challenges’ to the financially strained sector, it is ‘encouraged by the direction of travel’.

CCA chief Malcolm Harrison added: ‘The CCA and its members have been calling for a more clinically focused contract framework in recent years. We hope that the community pharmacist consultation service will allow community pharmacists and their teams to continue to refocus the sector on the delivery of care.

‘We believe it is now critical that all community pharmacies embrace the new urgent care services and engage with PCNs so that the sector is more integrated within the NHS. We are also pleased to see the use of the Pharmacy Quality Scheme to support the sector-wide agenda for patient safety improvement.’

 

Phoenix UK: ‘a funding cut in real terms’

PHOENIX UK group managing director Steve Anderson welcomed the contract’s focus on the clinical role that community pharmacy ‘can and should play’ and said it would ‘fundamentally reshape’ the sector.

He called on contractors to ‘embrace [the contract] and make it work in our best interests’, but joined with the rest of the sector in voicing concerns about the funding levels awarded.

Mr Anderson said: ‘While PHOENIX UK welcomes a five-year funding arrangement in principle – as that provides a degree of certainty which has previously been lacking – the framework raises more questions than it answers. It is disappointing that the Government has recognised the ongoing importance of community pharmacy in delivering improved healthcare outcomes but has decided not to invest [more] in it.’

He added that it is unclear how the £200m in funding streams that are set to end over the next 24 months will be redistributed and that the new contract brings ‘little if any relief’ to financial pressures.

He said: ‘The funding arrangement is in practice a funding cut in real terms: as a result of inflation, wage increases, business rates, locum rates etc the sector’s cost base is rising and yet funding will remain flat over the five-year period.’


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