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Pharmacy contract: the sector reacts

By Isabel Shaw

25 Feb 2020

Changes to the pharmacy contract, announced this week, will see new clinical services, alterations to some funding streams and changes to terms of service.

One major change will include a new essential service that will involve pharmacists supporting patients with the new NHS discharge medicines service (DMS) from hospital, as well as a hepatitis C testing service.

The updates to the community pharmacy contractual framework (CPCF) were announced on Sunday (23 February), in a joint letter by the Pharmaceutical Services Negotiating Committee (PSNC), the Department of Health and Social Care (DHSC), and NHS England and NHS Improvement (NHSE&I).

Pharmacy leaders have their say on the changes:

NPA: ‘A well-developed and properly integrated role in clinical services is a more secure basis’

The National Pharmacy Association (NPA) welcomed the updated community pharmacy contractual framework because it implies the ‘further integration’ of community pharmacy services within NHS pathways.’ However, noted that funding is still lacking.

The NPA’s acting chair Andrew Lane said: ‘The announcement implies further integration of community pharmacy clinical services within NHS pathways, which we welcome. A well-developed and properly integrated role in clinical services is a more secure basis for our future than is dispensing alone.

‘The current core funding for England’s pharmacies isn’t enough to achieve the transformational improvements the secretary of state says he wants over the coming years. This is a fact that NHS chief Simon Stevens really must respond to, to meet policy objectives like improved access to primary care.

‘The outcome of the first annual review of funding under the contractual arrangements will affect the extent to which pharmacies can successfully take the path that’s being laid. That is why, to inform the review, the NPA has commissioned an expert economic analysis of the sector’s capacity to deliver new services and sustain improvements over the five years of the contract and beyond.’

RPS: ‘The wellbeing of the workforce needs to be a priority to ensure they can deliver on this deal.’

Claire Anderson, Chair of the English Pharmacy Board, welcomed the new ‘recognition of community pharmacy’ through the DMS, however, expressed the need for the wellbeing of the workforce to be a ‘priority’.

She said: ‘The five-year framework announced last year offered some certainty for pharmacists, planning ahead it is important that this settlement is being expanded. The Community Pharmacist Consultation Service shows great promise for referral services that will be rolled out and we need to build on this platform to show what a key role pharmacy plays in providing urgent patient care.

‘It is great to see a proper way of utilising the pharmacy integration money to support the transformation of community pharmacy and the acknowledgement of the hub and spoke challenge for independents. We also welcome the recognition of the role that pharmacy plays in supporting the safer use of medicines through the new Discharge Medicines Service.

‘Nonetheless, it is frustrating that money remains at the same rate for new services and the limited details on some of the updates in the deal, particularly regarding the review of the Pharmacy Quality Scheme.

‘Pharmacists and community pharmacy teams work incredibly hard every single day but they are already extremely stretched financially in terms of resources and capacity. The wellbeing of the workforce needs to be a priority to ensure they can deliver on this deal. We would like to see this integrated into future agreements between PSNC, NHSE&I and DHSC.

Numark: ‘It will improve the relationship between primary and secondary care’

A Numark spokesperson said they welcomed the DMS and also highlighted suggestions on how to ensure the service lasts.

‘We welcome the news of a service aimed at improving patient compliance and safe use of their medication. It will also improve the relationship between primary and secondary care and support the transition of patients across the sectors.

‘To ensure the longevity of the service and to enable our members to allocate appropriate resources for delivering this service Numark urges the PSNC in ensuring a fair remuneration is negotiated.’

PDA: ‘We remain deeply concerned about the apparent lack of additional resource to facilitate this’

The Pharmaceutical Defence Association (PDA) raised concerns over the feasibility of the contract due to the lack of funding and staffing reductions in the sector. 

Alima Batchelor, head of policy at the PDA said: ‘Whilst the PDA is pleased to see the proposed expansion of clinical services offered via community pharmacies, we remain deeply concerned about the apparent lack of additional resource to facilitate this. There is no real assurance that reductions in MURs and dispensing volume due to Hub & Spoke will release the staff time required to provide new clinical services.

‘Other NHS E&I initiatives such as the increase in pharmacists moving to work in general practice will only increase the pressure on those pharmacists who remain in community pharmacy. Couple this with ongoing support staff reductions in the large chain multiples and the feedback about unsustainable and distressing working conditions, which the PDA routinely receives from its members, is entirely predictable.

‘Community pharmacy providing a range of clinical support services as an integrated part of primary care must be the way forward for managing the increasing demand of an ageing population, but this promise can only be fulfilled if staffing levels pay and working conditions make community pharmacy a truly attractive and rewarding career.’

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