New and expanded services, including the contraception service and the Pharmacy Quality Scheme, cannot go ahead without additional funding, namely a fully funded Pharmacy First scheme, the Pharmaceutical Services Negotiating Committee (PSNC) told the Department of Health and Social Care (DHSC) and NHS England (NHSE) yesterday.

They also said that NHSE must stop directing more patients to pharmacies via communications campaigns, and that DHSC should consider putting caps on existing Advanced Services to protect core dispensing funding.

PSNC chief executive Janet Morrison said that with pharmacy businesses ‘on the brink of collapse’ it ‘makes no sense whatsoever’ to add additional services without additional funding.

‘The Government simply has not put enough money into the contract and there isn’t the capacity within the sector to deliver them,’ she said.

She added that additional funding should start with a fully funded Pharmacy First service.

‘The question Ministers now face about the investment needed to deliver Pharmacy First is not whether they can afford it, but whether they can afford not to do it,’ Ms Morrison added.

Yesterday, PSNC told DHSC and NHSC that they should pause the rollout of new services such as the contraception service and the 2023/24 Pharmacy Quality Scheme (PQS).

‘This isn’t because we don’t want these services – community pharmacies are incredibly ambitious about the services they could provide to their communities – but because we don’t believe pharmacy owners have the capacity under current conditions to properly undertake this work,’ said Ms Morrison.

In its latest financial analysis, PSNC said that it anticipates that by 2024/25 overall service demand will be approaching 300% of the level it was in 2015/16, amid rising costs on wages, energy and loan repayments.

PSNC also said that it would resist any further moves to reduce fees or payments ‘as this will cause dispensing to collapse and ultimately undermine the safety of medicines supply’.

She added: ‘Government and the NHS have all the evidence they need to show them that without urgent action they – and the public – will lose significant parts of the community pharmacy sector, and soon. This would be catastrophic for pharmacy, patients and for primary care and we are doing everything within our power to prevent it from happening.’

In addition to Pharmacy First funding, PSNC has asked for:

  • All pharmacies to be allowed to reduce their core opening hours by 30% on a permanent basis and temporarily reduce core opening hours by as much as one day each week;
  • All pharmacies to be able to implement unlimited closed door working so long as it is notified to the NHS after the event;
  • All pharmacies to be allowed to refuse to dispense prescriptions if dispensing under pressures could mean that professional standards that are below those generally accepted;
  • All pharmacies to be allowed to refuse to dispense prescriptions where there is no reimbursement for the individual contractor.
  • A moratorium on new Distance Selling Pharmacy applications for two years;
  • Hub and spoke dispensing to be limited to supply only from NHS contract spokes;
  • Pharmacists to be allowed to make formulation changes at their own professional discretion, rather than through an SSP;
  • Major supply chain/Drug Tariff reform;
  • The removal of dispensing requirements such as needing to ask for patient exemption evidence and patient signatures for paid for prescriptions;
  • The removal of other requirements including taking part in health campaigns, producing a practice leaflet and undertaking clinical audits.

NHSE and DHSC have been approached for comment.