The Community Pharmacy Contractual Framework (CPCF) in England is ‘not fit for purpose’ and has contributed to the financial pressures that pharmacies are facing, a parliamentary committee has found.

Following an inquiry into the sector, the Health and Social Care Committee (HSCC) published a report today which recommended that the CPCF be ‘completely overhauled’, with ‘urgent’ reform of the way pharmacies are funded.

‘There is clearly something wrong if the funding that pharmacies receive from the NHS does not cover medicine costs, given their core function of dispensing medicines,’ the committee, chaired by former pharmacy minister Steve Brine, stated.

They added that any new contractual framework must:

  • ‘Close the gap in funding that community pharmacy has experienced over the course of the current CPCF’;
  • ‘Focus on reducing complexity’, as the current model is ‘overly complex’, and ‘ensure pharmacy owners can clearly understand and predict their cash flow, including de-risking the purchasing price of medicines’;
  • Avoid the current situation in which funding for clinical services subsidises dispensing, ‘to the detriment of both’, and instead ‘ensure funding is explicitly available for both dispensing services and clinical services’;
  • And ‘include the capacity for flexibility in the event of increased demand, greater activity or inflationary pressures, for example through indexation’.

Expanding Pharmacy First, vaccinations and PrEP

The report also called for the government and NHS England to ‘match the sector’s own ambition’ and publish a long-term vision for the further development of community pharmacy clinical services.

And the government should ‘commit to the ongoing promotion of Pharmacy First beyond what has already been announced’, the HSCC report added.

NHSE should also commission community pharmacies to deliver all routine and seasonal immunisations for adults and children, as well as supply the HIV prevention drug PrEP, the committee said.

Establishment payment for consultation rooms

It also recommended that a new ‘establishment payment’ be introduced to support the development of consultation spaces for patients, as suggested by Community Pharmacy England during the inquiry.

‘This funding should be targeted at pharmacies that are the most reliant on NHS work as their main source of income and could be linked to a commitment to provide an agreed level of NHS service,’ the report said.

'Essential reading' for next government

Paul Rees, chief executive of the National Pharmacy Association (NPA), said the report was 'essential reading' for the next government and should be 'first on the desk for any incoming health secretary', who should 'adopt the MPs’ recommendations without delay.'

And he highlighted that 'an independent cross-party committee of MPs has validated what we have been saying for years – that pharmacies have enormous potential to support their communities, and other parts of the NHS, if they are not hamstrung by the financial crisis which is leaving them on the brink of closure'.

Meanwhile, Neeraj Shah, head of public affairs at the Company Chemists' Association (CCA), welcomed the report.

'Choosing not to properly fund the community pharmacy network to dispense the NHS medicines that patients need is a false economy,' he said.

'Community pharmacy has proven time and time again how it can deliver when it is supported with investment. The opportunities set out in the report such as the provision of all routine and seasonal immunisations for adults and children, and the expansion of Pharmacy First point to an exciting future for the sector.

'We hope that the next government will provide the investment the sector needs to realise this and to protect patients’ access to medicines.'

Janet Morrison, chief executive of Community Pharmacy England (CPE) said that the negotiator agreed with the select committee's funding recommendations as well as its calls to continue to promote and expand Pharmacy First.

'Ahead of the general election we are urging all political parties to commit to supporting community pharmacies and their patients by introducing a long-term sustainable funding model, reviewing the medicines supply chain and investing in the clinical future of community pharmacies including through workforce planning and support.

The new government must take note of these important recommendations from the Select Committee. We will be raising this directly with them and with NHS England and we want to work constructively with them to deliver solutions for pharmacy, for patients and for primary care, at pace,' Ms Morrison said.

Meanwhile, Dr Leyla Hannbeck, chief executive of the Independent Pharmacies Association (IPA) said the association was 'overjoyed to finally hear some clear thinking from an independent review body', adding: 'we have been shouting loud and clear for years now that the community pharmacy contract is broken, and that our medicines supply system needs urgent review.'

'It is good to see that the committee report understands [the pressures on community pharmacy] and agrees with us. For many pharmacies it is too late but many can be saved if our broken contract and funding is addressed immediately. We have always maintained our dedication to patient care and we demonstrated that during the pandemic when we kept our doors open. If invested in and supported the pharmacy network can be a huge asset to our NHS and help lift the pressures elsewhere in our healthcare system,' she added.

And Tase Oputu, England board chair of the Royal Pharmaceutical Society (RPS), commented: 'Whoever wins the general election, this report sets out clear priorities for pharmacy and there’s no doubt the next government must act on today’s recommendations and put improving patient care at the heart of its agenda.'

Responding to the report, a Conservative Party spokesperson told The Pharmacist that it recognised 'the important role that pharmacies have in helping patients receive care more quickly in their local community'.

'That is why we launched our Pharmacy First approach earlier this year, backed by £645 million, to help community pharmacies. 98% of pharmacies have signed up. This is in addition to the £2.6 billion provided to the sector every year.'

The spokesperson added: 'Rishi Sunak and the Conservatives are delivering on a clear plan to boost the role and support for pharmacies, as we take the bold action needed to help people live healthier and happier lives.'