Six in 10 independent pharmacy owners say that less than half of their Pharmacy First consultations pass the gateway point for a service payment, a survey has suggested.

A majority of respondents said they were spending an average of 20 minutes or more on each consultation, according to the survey of 266 independent pharmacy owners conducted by the Association of Independent Multiple Pharmacies (AIMp).

And some 60% said meeting the increased minimum threshold from May would be a ‘struggle’ and 19% said it would be ‘unachievable’.

Contractors ‘fully behind’ Pharmacy First

AIMp chief executive Dr Leyla Hannbeck said the results showed community pharmacy teams were ‘fully behind delivering the Pharmacy First Service’, with 100% of respondents delivering the service in all branches.

Respondents to the survey ranged from owners of single pharmacy branches to owners of over 100 branches, with approximately 2,000 branches represented between them.

Participants were recruited through two WhatsApp forums for contractors of various sized independents, and the survey ran for five days from Wednesday 17 April 2024.

Funding ‘does not fairly reflect work’

Bur Dr Hannbeck also raised concerns that the level of funding provided for the service ‘does not reflect fairly on the level of work pharmacy teams need to put in to deliver the service’.

Six in 10 (59.5%) respondents said that ‘less than 50%’ of initial Pharmacy First consultations passed the gateway point for a claimable Pharmacy First consultation.

And the remaining four in 10 said that ‘50% and more, but below 100%’ were eligible for payments.

The majority of respondents estimated it took them at least 20 minutes to do a consultation, with 40.5% saying it took 20 minutes, 26% saying it took around 20 minutes, and 12% saying it took 30 minutes or more.

The remaining 21% said it took 10 minutes to do a consultation.

When asked if they were satisfied with how the Pharmacy First service was going, 59.5% of respondents said: ‘No, it is time consuming and underpaid.’

One respondent commented: ‘We should be paid for our time irrespective of whether consult hits gateway. This is no way to treat clinicians.’

And another said that Pharmacy First consultations took ‘double the time’ of a blood pressure check for the same payment.

They also suggested that consultations that do not meet the payment threshold could take ‘at least half the amount of time’ and ‘often more time’ than those that do, given the need to advise patients on why they are not eligible.

Seven in 10 say Pharmacy First has reduced capacity for other services

Almost three quarters – 71% - of respondents said that Pharmacy First had reduced their capacity to deliver other pharmacy services and activity, while 7% said it had not and 21% did not know.

Respondents said dispensing had ‘slowed down’, with prescription checking becoming ‘backlogged’ and that the situation was ‘increasing the pressure levels within the pharmacy’.

Several respondents said that ‘day-to-day tasks’ and private services were suffering, while others commented that they were less able to provide the New Medicine Service (NMS) and that patients were having to wait longer to see a pharmacist for general advice.

Pharmacy First was also said to be impacting pharmacists’ ability to provide blood pressure checks, with one highlighting that the consultation room was now occupied for ‘longer periods’.

And one respondent said they had stopped providing a supervised methadone service.

‘Time consuming, takes the pharmacist away from core services, money is not enough to employ additional skilled staff to manage workload,’ was one contractor’s response to the survey.

Concerns about increased thresholds from May

Dr Hannbeck also highlighted contractors’ ‘concerns’ about the increase in minimum consultation numbers required from May, when each pharmacy will need to do 10 consultations to receive the monthly fixed payment of £1,000 for the service.

Some 38% of respondents said the threshold increase was a ‘worry’, while 19% said the increase from five to 10 consultations was ‘unachievable’.

A further 19% said delivering five more consultations per month would be ‘difficult, but achievable’, while 59.5% said they would ‘struggle to achieve it’. Just 2.5% said they felt ‘positive’ about the increase in minimum thresholds.

Some 14% of respondents were currently failing to achieve the current minimum of five consultations per month, the survey revealed.

A further 69% were achieving it, but ‘struggling’, while 17% of respondents said they were achieving the thresholds ‘comfortably’.

A major reason cited by respondents for low consultation numbers was inadequate referrals from GPs.

‘It seems also that we are beholden to receptionist staff referring patients to us through the proper channels in order to be paid correctly,’ one respondent commented.

Others said that patient walk-ins were low due to a ‘lack of understanding of the service’.

‘Naïve’ to ignore Pharmacy First ‘realities’

Dr Hannbeck commented: ‘We all want the Pharmacy First  Service to succeed and flourish. As a sector we have consistently highlighted that we are very keen to support the NHS, however it is very naïve to ignore the realities reported by contractors if we want to ensure that the service is not set up to fail.’

And she said that AIMp will be discussing the results of the survey with officials at NHS England and the Department of Health and Social Care (DHSC).