Most of the LPC executive team attended a very useful workshop recently in Leeds, led by Steve Lutener from the PSNC, on the recent changes that have been made to the legislation, and guidance, under which market entry and exit can occur.
 
Thinking about market entry, we were told all about the new market entry regulations based on the pharmaceutical needs assessment (PNA), for both routine applications and Excepted applications (change of ownership, minor relocation, or distant selling), and the associated guidance issued by the DOH to help implement the regulations.
 
We considered, and discussed, examples to ensure that we will be better prepared for contract applications made under the new regulations - given that the LPC is recognised as the official body representing contractors in the PCT area.
 
On receiving an application, the PCT must determine whether granting it would meet a current need for pharmaceutical services and must consider whether to invite other applications. If it does this, the PCT can defer the application and consider all of them together. The PCT can refuse the application for a variety of reasons including "if it considers that to grant the application would lead to an undesirable increase in the availability of essential services."
 
The regulations place a number of obligations on applicants and the PCTs - and hopefully will make market entry a more sensible process and so it's all change with applications - the necessary/desirability clauses have gone.
 
Thinking about market exit, we also considered the sanctions that  PCTs (or successor) bodies can make on existing contractors...
 
Regulation 69 states that, if there is a dispute, there is a requirement to attempt local resolution first - unless the PCT is satisfied that it is appropriate to move further at once due to the severity of the dispute (perhaps the pharmacy premises have not been open during core hours, or to protect the safety of the public or to protect revenue of the PCT etc.).
 
If this is not achieved then regulation 70 allows for a remedial notice to be issued by the PCT and regulation 71 provides for abreach notice to be issued. If the dispute relates to a failure to provide, or failure to provide at a reasonable standard, a service that the contractor is required to provide, then the PCT can withhold part, or all, of the remuneration due to the contractor (according to guidelines).
 
In essence, then, these are financial penalties (fines?) which will be applied to contractors in certain instances for failure to carry out obligations under the contractual framework, such as audits, patient questionnaires etc. or perhaps failure to provide an enhanced service to a reasonable standard!
 
Failure to improve or carry out remedial action may, as an ultimate sanction, lead to removal of the contractor from the PCT pharmaceutical list...
 

Once again things are going to get difficult for contractors...

 I've just been reading the news from the PSNC about the interim funding arrangements.  
 It seems that "this year" it has not been possible to complete the difficult negotiations regarding the funding arrangements - and so an interim settlement has been agreed, which will be delivered by implementing adjustments to the Drug Tariff from October.


 The changes will bring funding levels in line with an interim total funding figure for 2012/13 which is based on that agreed for the last financial year (£2,486m).

 The changes also take into account the results of the 2011/12 margins survey, which shows that pharmacies’ retained purchase margin exceeded the sum allowed by £235 million in the last financial year.
 In essence, the changes being introduced will reduce practice payments by 15p per item (to 58.2p per item) and generic medicine reimbursement prices (Category M) by £72.5 million per quarter, resulting in an overall reduction in average item value (AIV) of 45p per item.


 Remember that the result of this interim settlement will be felt most severely at New Year when final payments will be received for prescriptions dispensed in October...as these payments will reflect the lower fees.

Click Here to read the full information from the PSNC

I read a really interesting editorial, and article, in the C&D recently about pharmacists, and pharmacies, being subjected to crime...The bottom line is that the number of crimes committed in UK pharmacies in 2011 exceeded the number of pharmacies - and the chance of experiencing burglary, robbery or assault is almost 17%...worse still, over the past year pharmacists have been threatened with needles, screwdrivers and guns!
 
In our pharmacy, we've been subjected to swearing, yelling and had a box of combs thrown at a pharmacist over the past year. I know of other pharmacies, locally, that have suffered a lot worse...
 
In light of these disturbing figures, it's probably worth all pharmacies revisiting procedures to ensure that they are prepared - so that all pharmacy staff can react quickly and appropriately to threatening, or criminal, activity - to stay safe and hopefully defuse the situation so it doesn't escalate out of control!