The plans, which were first indicated in the Department of Health (DH) letter of 17th December, include a reduction in community pharmacy funding and an expectation of some pharmacy closures. PSNC has insisted that NHS England share further detail of its longer term plans and the analysis underpinning them before engaging in negotiations on the plans.
The additional information published this week has included:
- A Department of Health presentation/briefing document that has been sent to the national pharmacy bodies who received copies of the 17th December 2015 letter to PSNC. The document provides further information on their proposals, including a reference to plans to phase out Establishment payments;
- PSNC has responded in more detail to the DH proposals for community pharmacy, stating that it cannot accept proposals that will jeopardise the services and supplies that pharmacies provide to their patients;
- A summary of a meeting between pharmacy minister Alistair Burt, the Department of Health and the All-Party Pharmacy Group in which the minister suggested that between 1,000 and 3,000 community pharmacies could close and DH confirmed that there will be further funding reductions for community pharmacy in years beyond 2016/17; and
- The Government has responded to an online petition seeking to stop the community pharmacy funding reduction for 2016/17, restating its aim to have a more clinically focused community pharmacy service and its belief that efficiencies can be made in the sector.
PSNC has set out its responses to the specific proposals and has been clear in all its communications with DH and NHS England on where it stands.
Commenting on the latest information PSNC Chief Executive Sue Sharpe said:
“Until this week communications have been silent on how the NHS intends to develop the clinically focussed service that it states as its aim. We have been clear that cuts to pharmacy funding that will force contractors to cut staffing is about the worst way to do it. We have made this point forcefully and are bringing forward our own proposals.
The explanation given today in response to the petition has no credibility in light of their position to date. PSNC had expected that further funding cuts were planned as the DH confirmed in a meeting with the All-Party Pharmacy Group, and as the Chief Pharmaceutical Officer stated his view a few years ago that there 3,000 too many pharmacies we had also feared that they might be seeking to drive closure of many pharmacies.”
As well as the ongoing discussions with the NHS, PSNC this week held a special meeting of LPCs to discuss the implications of the 17th December 2015 letter to PSNC. This meeting has helped to inform PSNC’s ongoing work with the other national community pharmacy bodies to organise a campaign in response to the Government’s plans. The campaign is in the early planning stages but further details will be posted on PSNC’s website as soon as they are available.
The Department of Health presentation/briefing document
This document has been sent to PSNC and to the other consultees who received copies of the 17th December letter to PSNC. It includes further details on the proposals set out in the letter, including a reference to plans to phase out Establishment payments.
PSNC response to the plans for community pharmacy
PSNC responded to the points and issues raised in the 17th December letter last week.
In her letter to NHS England PSNC Chief Executive Sue Sharpe said the Government was ‘ignoring entirely’ the evidence for the value of commissioning community pharmacy services, and that it appeared to have settled on a ‘course of action that will run counter to its stated ambition to develop a clinically focused pharmacy service’.
She said PSNC needed further information on the Government’s plans for pharmacy in the future, including around funding and closures, before it could enter negotiations on them. The negotiations have not yet commenced, but in discussions this week the NHS shared the information contained in its briefing document.
PSNC has responded to the Government’s plans as follows.
The £170m funding reduction
PSNC is committed to protecting a strong, diverse and accessible service offered through community pharmacies and we reject any proposals that would reduce the support they offer their patients. We believe that the reduction in funding in 2016/17 runs counter to the Government’s stated aim to develop a more clinically focused pharmacy service.
PSNC does not accept that there are too many community pharmacies. We agree that there is some clustering of pharmacies and will work with the NHS and Government to facilitate voluntary mergers. We reject their proposals to use blunt instruments based on volume as a crude measure of the care provided by pharmacies.
Online pharmacy services and hub and spoke models
PSNC is committed to the further adoption of online services from the community pharmacy network. But we don’t accept that the development of large warehouse supply operations, removing the need for local community pharmacies, is an acceptable alternative to the services currently provided by those pharmacies. We will not oppose amendment to legislation to support hub and spoke assembly of medicines, but would oppose models for hubs without those community pharmacy spokes. Any revised regulations must prevent misuse of collection point arrangements intended for rural locations as an inferior but expedient alternative.
Periods of treatment
PSNC rejects proposals to transfer funds to CCGs to drive longer periods of treatment, and will insist on effective protection against GP direction of prescriptions. We will commit to developing changes to pharmacy funding delivery that will drive prescribing periods appropriate to patients clinical needs by repeat dispensing and clinical interventions.
PSNC believes the proposals as set out create massive risks to the sustainability of an already fragile supply system and we cannot accept anything that will jeopardise the services and supplies community pharmacies provide to their patients. We want to see positive proposals for the development of a more clinically focussed community pharmacy service as an essential part of the negotiations. PSNC has also called for a five year commitment from the NHS that protects and supports the community pharmacy network and develops the clinically focused ‘contract’.
APPG meeting report
On 13th January the minister Alastair Burt, Jeannette Howe from the Department of Health and officers from the All-Party Pharmacy Group met to discuss the Government’s plans for community pharmacy as set in the letter sent on 17th December.
The conversation covered a number of areas and the Minister and DH confirmed that there will be further funding reductions in future years. The Minister said he could not be certain about the number of pharmacy closures as this would depend in part on the response of the sector to the Government plans, but that it could be between 1,000 and 3,000.
The Minister said that pharmacies would need to reduce their reliance on prescription income, and stressed that protesting the funding reduction would not change it.
Read the full letter on the APPG website.
Government response to the online petition
Following the letter sent on 17th December a petition was launched calling for the funding reductions to be stopped and for support for pharmacy services that can save the NHS money. The petition now has more than 12,000 signatories and the Government has responded to it today, reiterating its position on the future of community pharmacy: https://petition.parliament.uk/petitions/116943
PSNC and the other national pharmacy organisations will consider campaigning tactics as part of their ongoing discussions on a coordinated campaign by the sector on the future of community pharmacy.