News

HDA Media And Political Bulletin – 14 October 2016

Contractor Announcement: PSNC rejects DH proposed funding package

14 October 2016, PSNC

 

PSNC has rejected the funding package proposed by the Department of Health for 2016/2017. The plans include cuts to pharmacy funding which would result, if implemented, in a loss of services detrimental to patient care. Next steps, the Department of Health will either propose a revised funding package or impose their proposed funding changes on community pharmacies in the UK. PSNC noted that the changes would result in a 12% cut to funding from December 2016 to March 2017 forcing pharmacies to reduce staffing and cut back on services.

Claire Ward, Chair of Pharmacy Voice, was speaking this morning on the BBC Radio 4’s Today programme at 8:20am. She explained that the Department of Health’s pharmacy funding proposals would result in 12% cuts in the next four months, and 7% in 2017. She argued that this would mean pharmacies will have to take radical measures to reduce costs such as reducing staff, decreased quality of services or even closing. Claire also made the point that community pharmacy is the most efficient NHS service and has the ability to relieve pressures on other services such as A&E. The presenter challenged this assumption, asking why pharmacy should not be making efficiencies and cost-savings like other NHS services. Claire concluded by stating that the proposed measures will mostly put at risk pharmacies located in areas already deprived of GP and A&E services.

This was also reported by BBC NewsChemist & DruggistP3 Pharmacy

 

PSNC Statement: Response to Minister’s announcement on urgent care role

13 October 2016, PSNC

 

PSNC has released a statement in response to an announcement made by David Mowat, the Pharmacy Minister, in regards to the role community pharmacy can play in urgent care. The PSNC acknowledged the role that pharmacies can play in the provision of urgent care in order to relieve some pressure from the NHS urgent care services. However, the PSNC also expressed its disappointment that the proposed community pharmacy urgent care pilot scheme comes amid planned cuts to funding. The proposed community pharmacy cuts will have a significant impact upon the quality of patient care if pharmacies are forced to scale back their services, lay off staff or close local practices.

The announcement was also covered by Pharmacy VoicePharmacy Business and P3 Pharmacy.

 

Drugs to face new NHS affordability test

13 October 2016, Health Services Journal, Will Hazell

 

NICE and NHS England have announced the launch of a consultation for the introduction of an affordability test as part of the authorisation process for new treatments. Under the new plans the introduction of a drug that would cost the NHS more than £20m a year would trigger a budget impact threshold, if this occurs then the manufacturer and NHS England would enter a commercial negotiation on the pricing. If an agreement cannot be reached then NHS England will be able to apply to NICE to allow a longer period of phased introduction of the drug. Currently, drugs are subject to a value for money assessment however, their affordability for the NHS is not considered.

This launch of the consultation was also covered by the ABPI

 

Parliamentary Coverage

 

House of Commons Questions; Pharmacy Finance, 13 October 2016

Health

 

Tom Brake: What assessment he has made of the effect of changes to pharmacy funding on the availability of essential medicines.

Department of Health

David Mowat:

The Government’s proposals for community pharmacy in 2016/17 and beyond, on which we have consulted, are being considered against the public sector equality duty, the family test and the relevant duties of my Rt. hon. Friend, the Secretary of State for Health, under the National Health Service Act 2006.

Our assessments include consideration of the potential impacts on the adequate provision of NHS pharmaceutical services, including the supply of medicines, access to NHS pharmaceutical services, supplementary hours, non-commissioned services, individuals with protected characteristics, impacts on other NHS services, health inequalities, individuals with restricted mobility and access to healthcare for deprived communities.

An impact assessment will be completed to inform final decisions and published in due course.

Our proposals are about improving services for patients and the public and securing efficiencies and savings. We believe these efficiencies can be made within community pharmacy without compromising the quality of services or public access to them.

Our aim is to ensure that those community pharmacies upon which people depend continue to thrive. We are consulting on the introduction of a Pharmacy Access Scheme, which will provide more NHS funds to certain pharmacies compared with others, considering factors such as location and the health needs of the local population.

We want a clinically focussed community pharmacy service that is better integrated with primary care and public health in line with the Five Year Forward View. This will help relieve the pressure on general practitioners and accident and emergency departments, ensure better use of medicines and better patient outcomes, and contribute to delivering seven day health and care services.

The Chief Pharmaceutical Officer for England, Dr Keith Ridge has commissioned an independent review of community pharmacy clinical services. The review is being led by Richard Murray, Director of Policy at The King’s Fund. The final recommendations will be considered as part of the development of clinical and cost effective patient care by pharmacists and their teams.

NHS England is also setting up a Pharmacy Integration Fund to support the development of clinical pharmacy practice in a wider range of primary care settings, resulting in a more integrated and effective NHS primary care patient pathway.

The rollout of the additional 1,500 clinical pharmacists announced by NHS England will help to ease current pressures in general practice by working with patients who have long term conditions and others with multiple medications. Having a pharmacist on site will mean that patients who receive care from their general practice will be able to benefit from the expertise in medicines that these pharmacists provide

 

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House of Commons Questions; Pharmacy Finance, 13 October 2016

Health

Craig Mackinlay: What assessment he has made of the effect of proposed reductions in pharmacy funding on specific patient populations.

Department of Health

David Mowat:

The Government’s proposals for community pharmacy in 2016/17 and beyond, on which we have consulted, are being considered against the public sector equality duty, the family test and the relevant duties of my Rt. hon. Friend, the Secretary of State for Health, under the National Health Service Act 2006.

Our assessments include consideration of the potential impacts on the adequate provision of NHS pharmaceutical services, including the supply of medicines, access to NHS pharmaceutical services, supplementary hours, non-commissioned services, individuals with protected characteristics, impacts on other NHS services, health inequalities, individuals with restricted mobility and access to healthcare for deprived communities.

An impact assessment will be completed to inform final decisions and published in due course.

Our proposals are about improving services for patients and the public and securing efficiencies and savings. We believe these efficiencies can be made within community pharmacy without compromising the quality of services or public access to them.

Our aim is to ensure that those community pharmacies upon which people depend continue to thrive. We are consulting on the introduction of a Pharmacy Access Scheme, which will provide more NHS funds to certain pharmacies compared with others, considering factors such as location and the health needs of the local population.

We want a clinically focussed community pharmacy service that is better integrated with primary care and public health in line with the Five Year Forward View. This will help relieve the pressure on general practitioners and accident and emergency departments, ensure better use of medicines and better patient outcomes, and contribute to delivering seven day health and care services.

The Chief Pharmaceutical Officer for England, Dr Keith Ridge has commissioned an independent review of community pharmacy clinical services. The review is being led by Richard Murray, Director of Policy at The King’s Fund. The final recommendations will be considered as part of the development of clinical and cost effective patient care by pharmacists and their teams.

NHS England is also setting up a Pharmacy Integration Fund to support the development of clinical pharmacy practice in a wider range of primary care settings, resulting in a more integrated and effective NHS primary care patient pathway.

The rollout of the additional 1,500 clinical pharmacists announced by NHS England will help to ease current pressures in general practice by working with patients who have long term conditions and others with multiple medications. Having a pharmacist on site will mean that patients who receive care from their general practice will be able to benefit from the expertise in medicines that these pharmacists provide

 

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House of Commons Questions; Pharmacy Finance, 13 October 2016

Health

Craig Mackinlay: What forecast he has made of the effect of demographic changes on the level of requirement for the community pharmacy network over the next five years; what assessment he has made of the effect of changes in pharmacy funding on the ability of the community pharmacy network to meet that requirement; and what planning his Department has undertaken to ensure that the future level of requirement can be met.

Department of Health

David Mowat:

The Government’s proposals for community pharmacy in 2016/17 and beyond, on which we have consulted, are being considered against the public sector equality duty, the family test and the relevant duties of my Rt. hon. Friend, the Secretary of State for Health, under the National Health Service Act 2006.

Our assessments include consideration of the potential impacts on the adequate provision of NHS pharmaceutical services, including the supply of medicines, access to NHS pharmaceutical services, supplementary hours, non-commissioned services, individuals with protected characteristics, impacts on other NHS services, health inequalities, individuals with restricted mobility and access to healthcare for deprived communities.

An impact assessment will be completed to inform final decisions and published in due course.

Our proposals are about improving services for patients and the public and securing efficiencies and savings. We believe these efficiencies can be made within community pharmacy without compromising the quality of services or public access to them.

Our aim is to ensure that those community pharmacies upon which people depend continue to thrive. We are consulting on the introduction of a Pharmacy Access Scheme, which will provide more NHS funds to certain pharmacies compared with others, considering factors such as location and the health needs of the local population.

We want a clinically focussed community pharmacy service that is better integrated with primary care and public health in line with the Five Year Forward View. This will help relieve the pressure on general practitioners and accident and emergency departments, ensure better use of medicines and better patient outcomes, and contribute to delivering seven day health and care services.

The Chief Pharmaceutical Officer for England, Dr Keith Ridge has commissioned an independent review of community pharmacy clinical services. The review is being led by Richard Murray, Director of Policy at The King’s Fund. The final recommendations will be considered as part of the development of clinical and cost effective patient care by pharmacists and their teams.

NHS England is also setting up a Pharmacy Integration Fund to support the development of clinical pharmacy practice in a wider range of primary care settings, resulting in a more integrated and effective NHS primary care patient pathway.

The rollout of the additional 1,500 clinical pharmacists announced by NHS England will help to ease current pressures in general practice by working with patients who have long term conditions and others with multiple medications. Having a pharmacist on site will mean that patients who receive care from their general practice will be able to benefit from the expertise in medicines that these pharmacists provide.

 

Full Coverage

 

Contractor Announcement: PSNC rejects DH proposed funding package

14 October 2016, PSNC

 

PSNC has rejected the Department of Health’s proposed funding package for 2016/17. The proposed package includes reckless cuts to pharmacy funding that will, if implemented, see patients suffer as services are withdrawn. The Department will now have to propose a revised package, or impose their proposed funding changes on England’s community pharmacies.

Rejecting the offer, PSNC noted that the proposals:

  • Would reduce funding from December 2016 to March 2017 by 12% on current levels, to set funding for this year at £2.687bn;
  • Would reduce funding for 2017-18 by 7.4% on current levels, to set funding at £2.592bn for that year;
  • Would force pharmacies to reduce staffing and cut back on services; and
  • Are rooted in the government’s professed aim to close pharmacies.

Community pharmacy has offered the Department costed alternative proposals to reduce the NHS medicines bill that would save the NHS money equivalent to the cuts demanded.

Community pharmacy also proposed new community pharmacy services that would save the NHS money by reducing demand in A&E and GP surgeries. All of these proposals were rejected out of hand.

Unlike all previous negotiations between community pharmacy and the Department of Health, this year’s negotiations were not characterised by collaborative working. From the start, the proposals were presented by the Department as a fait accompli.

David Mowat MP, Minister for Care and Support at the Department of Health, told community pharmacy in September 2016: “I think it is right that we spend the time, particularly me as an incoming minister, to make sure that we are making the correct decision and that what we do is going to be right for you, is going to be right for the NHS and right for the public more generally.” Despite this, and the emergence of significant evidence of the financial benefits of community pharmacy services to public spending elsewhere, there is no substantive difference between the current proposal and the proposal announced in December 2015.

The Department has not published evidence in support of its plan to reduce pharmacy funding. It has not responded to research showing that twelve pharmacy services create an annual £3bn net benefit for the NHS and others by community pharmacies, or research that suggests its approach would hit areas with greatest health inequalities hardest. The proposals will lead to free health services being withdrawn from community pharmacies.

The proposals are founded on ignorance of the value of pharmacies to local communities, to the NHS, and to social care, and will do great damage to all three.

 

PSNC Statement: Response to Minister’s announcement on urgent care role

13 October 2016, PSNC

 

PSNC understands that an announcement will be made this evening by pharmacy minister David Mowat MP regarding community pharmacy’s role in urgent care.

Mr Mowat will address the Pharmacy Business Awards tonight and is expected to say that an urgent repeat medicines pilot will start in December 2016, along with work by NHS 111 to develop a referrals process for minor ailments.

PSNC and the other pharmacy organisations have issued the following statement in response to the announcement:

“Although we note today’s recognition of the role that community pharmacy can play in the provision of urgent care and the pilot on the emergency supply of medicines, we are disappointed that this scheme has only been commissioned as a pilot. We are also confused by the references to minor ailments, because we do not believe that what has been set out is in any way the sort of minor ailments service that is needed to really take pressure off urgent care services. Instead the NHS will simply seek to direct people to pharmacies in order to receive advice and to purchase medicines as they would already do.

More importantly, this announcement is being made in the midst of planned funding cuts for community pharmacy. These cuts could have a much more significant impact on patients, leading to a scaling back of pharmacy services and even possible unplanned pharmacy closures. Pharmacies cannot deliver new services or pilots if they have to cut back staff or worse. This announcement has clearly been timed to draw attention away from the looming cuts, but it once again highlights the contradiction at the heart of the Department’s position – asking pharmacies to develop new roles and services whilst striping away the investment necessary to make it happen.

Using community pharmacies to help patients get quick, effective access to care for minor ailments, reducing the demands on general practice, offers less costly, quicker, more effective care, and the refusal of the NHS to commission a national minor ailments advice service from community pharmacies reflects badly on the Government’s concern for our communities and for the NHS.”

 

Drugs to face new NHS affordability test

13 October 2016, Health Services Journal, Will Hazell

 

The National Institute for Health and Care Excellence and NHS England have launched a consultation on introducing an affordability test into the process for authorising new treatments.

Under the test, which would be a major shift in the way NICE assesses new treatments, the introduction of a drug that would cost the NHS more than £20m a year could be subject to a delayed roll out.

This would create an additional hurdle for drugs that are judged to be cost effective but which are expensive, and would have a big impact on NHS England’s budget. Currently, while drugs are subject to a value for money assessment, their affordability to the NHS is not considered.

The affordability of drugs has become more prominent since the introduction of new hepatitis C treatments last year. The drugs are judged to be cost effective by NICE but were subject to unprecedented restrictions on their availability because of their high cost to NHS England.

In the consultation document published today, the two organisations propose a “budget impact threshold” that would be “triggered” if a new drug is projected to cost the NHS more than £20m in any of the first three financial years following its introduction.

If the threshold is triggered the manufacturer and NHS England would enter commercial negotiation.

“When agreement is reached and this brings the budget impact below the threshold, the standard 90 day funding requirement would apply,” the document says.

However, if it is not possible to reach an agreement, NHS England will be able to “make a case for NICE to allow a longer period of phased introduction” of the drug. This would mark a significant departure from existing NICE rules, where NHS England is obliged to commission a treatment 90 days after it has been authorised by NICE.

About 20 per cent of treatments that NICE approved between June 2015 and June 2016 would have triggered the budget impact threshold.

The consultation also suggests introducing a cost effectiveness threshold for the first time to NICE’s “highly specialised technology” process for authorising drugs for very rare diseases. This threshold already exists for most treatments but has never been applied to those for very rare conditions, and could make it more difficult for these drugs to win NICE approval unless companies lower their prices.

The threshold would be set at £100,000 per quality adjusted life year for these drugs, which is more than three times higher than NICE’s standard £30,000 threshold.

If a drug exceeds this bar then it could still receive funding via NHS England’s specialised services prioritisation process, the document says.

The two proposals are likely to be unpopular with the pharmaceutical industry and some patient groups.

The consultation also suggests a new “fast track” appraisal process for drugs that are predicted to be below £10,000 per QALY, with these drugs routed through a “lighter touch” process that could take 10 weeks off NICE’s normal appraisal timescale.

The changes are proposed to come into effect in April.

HDA Media And Political Bulletin – 14 October 2016

From Factory to Pharmacy

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