 The Judicial Review relating to the changes imposed on community pharmacy on October 20th 2016 were heard in the High Court on the Tuesday 21st March. The review brought by PSNC and the NPA were heard together over 3 days. Today it would seem that the judge has dismissed both cases.
The NPA have issued the following statement: ------- High Court Judge “regrets” funding cuts, in watershed moment for local pharmacies 18 May 2017A High Court judge has “with some regret” concluded that he cannot overturn the Government’s decision to impose massive cuts on pharmacy services in England.Mr Justice Collins predicted hardship in deprived areas as a result of the cuts and said that criticism of the Department of Health’s “less than satisfactory approach” is justified. He dismissed the Government’s argument that the legal obligation to tackle health inequalities is a lesser duty than the public sector equality duty, which deals with discrimination. The Judgement also makes it clear that the unprecedented level of cuts was dictated by the Treasury’s need to save money, not by healthcare considerations. It states that incorrect financial assumptions were included in a letter from the Chancellor of the Exchequer to the Prime Minister in August 2016 – correspondence which cleared the way for the cuts to be approved at the highest level. He also pointed to the “real risk” of putting more pressure on GPs because of cuts to pharmacy services. Ministers had earlier claimed that the cuts could be achieved without impacting patient care. Significantly, the judgment places on the legal record the importance of pharmacies’ role in primary care, beyond dispensing. Recent budget calculations by civil servants have overlooked these wider benefits, and this error must not be repeated. The National Pharmacy Association (NPA) described the verdict as a watershed moment that exposes the flaws in current policy and opens the way for talks about a radically different approach – which sees pharmacies as a solution to longstanding NHS pressures, in deprived neighbourhoods and elsewhere. Commenting on the verdict, NPA Chairman Ian Strachan said: “The Judge said the decision to make cuts was lawful, not that it was wise. On the contrary, he comprehensively debunked the risible idea that the cuts are for the good of patients. “Overall, this is a compelling judgement that recognises the important role of community pharmacy in primary care, which some Ministers and officials have sought to diminish. We have also established an important legal principle, namely that the Health Secretary must now have serious regard to the duty to reduce health inequalities when making decisions about the NHS. This judgement sets important standards in terms of our sector and far beyond.” “This is a watershed moment for pharmacy policy. The flaws in the current Treasury-led approach have been exposed. We can now focus on changing the direction of policy going forward, and put the matter of the current funding settlement in its proper context. The new Government returned after the general election should seize this opportunity to change course. “It is a shame that we had to go all the way to the high court to bring this matter to a head, considering the widespread public support for the front line services provided by local pharmacies. “What is important now is to enter into constructive discussions about a positive way forward for the sector, patients, and the NHS. We want to engage with officials on implementation of a programme for change and improvement which builds on the strengths of our sector rather than seeks to dismantle it. By working together, we can make the pharmacy sector and the health system overall more efficient, whilst ensuring that no patient is left behind. “The community pharmacy network is a part of the health service that can truly be said to serve all communities, including the most vulnerable neighbourhoods. In mounting this legal challenge, we have seen it as our public duty to try to preserve access to healthcare for those in most need.” “The Court proceedings exposed a disturbing lack of understanding at the very heart of government about the role which community pharmacy plays in the NHS. The NPA is grateful for the Judge’s recognition of the vital, wide-ranging services delivered by pharmacies, including in some of the most deprived communities in the country. A new legal principle has been established, which will help protect those vulnerable communities. This means that the legacy of this case will influence DH and other decision makers for years to come.”
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 The Judicial Review relating to the changes imposed on community pharmacy on October 20th 2016 were heard in the High Court on the Tuesday 21st March. The review brought by PSNC and the NPA were heard together over 3 days. Today it would seem that the judge has dismissed both cases.
The PSNC have issued the following statement: ------- High Court rules pharmacy funding cut was not unlawfulMay 18, 2017 The funding reduction imposed on community pharmacies on 20th October 2016 and the consultation relating to it were not unlawful and cannot be quashed, the High Court has ruled. PSNC and the NPA had both brought Judicial Reviews of the Secretary of State’s decision to impose the funding reduction. The cases were heard in a joint hearing in March. Mr. Justice Collins, who heard the cases, has concluded that the Secretary of State’s actions and decisions were not unlawful. His judgment was handed down at 10:30am on Thursday 18th May. The Judge considered the case in the context of the need to find £22bn in savings across the NHS, and found that: “The need for saving of money was inevitably driving the decision and careful consideration had been given to the possibly damaging effects.” Mr. Justice Collins said: “I have with some regret concluded that I cannot properly quash the decision”. Despite ruling in favour of the Secretary of State, Mr. Justice Collins was critical of the Department of Health’s failure to provide key analysis to PSNC, calling it “regrettable” and “unjustified”. “There is undoubtedly blame to be placed on the Department for failing to provide the analysis leading to 15% and for not producing as soon as it was known that proceedings were contemplated all the material which JH [Jeannette Howe, Department of Health] has now produced,” he said. The decision means the changes made in the December 2016 Drug Tariff, which implemented a funding cut and introduced a new Single Activity Fee, among other changes, will remain in force. Funding for 2016/17 was set at £2.687bn and for 2017/18 at £2.592bn. Further information on the judgment, along with FAQs, will be available to download shortly. Statement from Sue Sharpe, PSNC Chief Executive “PSNC is disappointed with this result. Our lawyers and QC felt that we had a good case; and there are serious criticisms of the consultation process and of the Department of Health made in the judgment. Unfortunately, the fact that the Secretary of State has very wide powers to decide what is relevant to his decisions, coupled with the Department withdrawing reliance on analysis they had undertaken means that we failed to establish that the inadequacies in the process were sufficient to make the process unlawful. A critical point in the case was the Department of Health’s conduct regarding its analysis of Companies House data which led to a figure of 15% operating margin for community pharmacies. PSNC first saw this figure when the impact assessment was published alongside the imposition on 20th October 2016. The report has since been discredited by experts at PricewaterhouseCoopers. Extraordinarily, although the Minister laid emphasis on this study when announcing the imposition in Parliament and it was repeatedly used in briefing papers disclosed in the litigation, counsel for the Department of Health stated at the hearing that no reliance was placed on it. The judgment also refers to an inaccurate letter sent to the Prime Minister in August 2016, and to the failure of the Department to disclose information immediately after it was clear that proceedings were being considered. A mass of information regarding the policy and thinking behind the funding cuts was disclosed through the legal proceedings allowing us, at last, to see the masterplan behind the 17th December 2015 letter which was devised in mid-2015 and which the Department denied existed. Had we seen this when the letter was published, we would have had the opportunity to interrogate and challenge the Department’s thinking, and the consultation period would have been very different. But it was withheld from us. The Judge noted the ‘hardships’ that would inevitably be suffered with any reduction in remuneration. We know that the impact on community pharmacies and their patients could be severe in some cases, and we will continue to highlight the impact that this will have on patients, as well as on wider health and social care services and livelihoods. As the Judge noted, there is a real concern about the unintended consequences of the imposition in increasing pressure on GPs and A&E departments. On the issue of pharmacy closures, the Judge found that these were a recognised and desired consequence but not the specific intention of the funding cut, noting comments made by the Chief Pharmaceutical Officer about there being too many pharmacies. PSNC could not and still cannot predict the number of closures that will result from the changes – as we all know, community pharmacy contractors, as any business owners, will do anything they can to avoid closures and they will all seek to find ways to survive by reducing costs and services. The Committee voted unanimously in favour of this legal action to challenge the 20th October 2016 funding imposition given the issues at stake and the lack of a fair consultation with us. Our priority now is to ensure that the valuable contribution that community pharmacies make to local communities and the NHS is never again disregarded as it so clearly was in the process leading up to the letter of 17th December 2015.”  The Judicial Review relating to the changes imposed on community pharmacy on October 20th 2016 were heard in the High Court on the Tuesday 21st March. The review brought by PSNC and the NPA were heard together over 3 days. Today it would seem that the judge has dismissed both cases.
The national pharmacy press have reported the following " Both the National Pharmacy Association and the Pharmaceutical Services Negotiating Committee's cases against the pharmacy funding cuts have been dismissed "with regret" by a High Court judge." This is worrying news and we will report more later as the day unfolds. Follow our twitter feed for the latest.  The LPC has been made aware of a problem with EMIS which is causing some green prescriptions to be printed now in certain cases where it previously was sent electronically. This is due to a patch that is being fitted across the Region to the the GP EMIS system and the fact that some medicinal products have been reclassified as an appliance. As a consequence, when the prescription is generated, if there is no dispensing appliance contractor (DAC) nominated for the patient a green prescription is now produced. The expected prescription for these patients may therefore be sitting in the GP surgery as printed green forms…the LPC recognises that this is not ideal, but welcomes the fact that EMIS is working to fix this. Please see the message below which we have received from our GP Colleagues which further details the issue. Message to Pharmacies
EMIS has a drug update which is being implemented across practices (This has been an entirely random process so we cannot say who/when) Items that are appliances in the Drug Tariff (particularly some eye drops and emollients) have a setting for them to go to the nominated Dispensing Appliance Contractor (DAC) not the nominated pharmacy. The default is for this box to be ticked. This was not a problem unless the patient had a DAC nominated. The update is making all such scripts where there is not a DAC nominated print out and not go EPS. EMIS are working to fix this but thought it helpful for you to be aware to cascade messages out to pharmacies that if there are items missing that they could be on paper at the surgery. Practices have been asked to try to highlight to pharmacies that there is a paper script to collect too.  You may have heard in the news that in the last few hours the NHS has been hit but a cyber attack which has resulted in many systems being closed down. We have been informed by our GP colleagues that the N3 spine has been closed down. This will mean that prescriptions issued by doctors today may be locked in the system.
We understand that GP practices can not issue prescriptions via the computer at all. (EPS or not). Only hand written prescriptions will be available. Please ensure that you are aware of this tonight and over the weekend. As always we hope that pharmacies will help patients as much as they can and it may be appropriate to issue emergency supplies to ensure the risk to patients is minimised. Please also bear in mind that the GP phones may be extremely busy and you may not be able to get through to them. We understand that pharmacy PMR's are unlikely to be switched off so you will be able to look at patients histories to determine past repeats. We have been told that out of hours doctors will be affected and hand written prescriptions may be used for acutes.  PSNC Chief Executive Sue Sharpe has informed the committee that she intends to resign from her current position at the end of 2017. Sue has held the role at PSNC since 2001. Sue made the announcement at the May meeting of PSNC, which is being held in London. |
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