News

HDA Media And Political Bulletin – 24 October 2016

BREAKING: PSNC CONSIDERING LEGAL ACTION AGAINST GOVERNMENT OVER CUTS
21 October 2016, Pharmacy Business, Neil Trainis

The Pharmaceutical Services Negotiating Committee (PSNC) is considering taking legal action against the Government following the announcement of cuts to community pharmacy funding. The Chief Executive of the PSNC, Sue Sharpe, has said that the PSNC is reviewing its position and examining options for a legal challenge. She stressed that whatever decision the PSNC makes will be what is best for contractors.

This was also reported by Chemist & Druggist

Community pharmacists ‘will need support’ after pharmacy cuts announcement, says RPS
21 October 2016, The Pharmaceutical Journal, Julia Robinson

The Royal Pharmaceutical Society (RPS) has pledged its support for their members. They have also called for widespread support from pharmacy organisations following the announcement of cuts to community pharmacy funding. The PRS expressed disappointment that the pharmacy integration fund (PhIF) is also losing funding from December 2016, in a statement made on 20 October 2016. The RPS also says it remains to be seen how effective the proposed Pharmacy Access Scheme (PAS) will be in preventing pharmacy closures.

The community pharmacy funding cuts were also reported in Pharmacy Business

The future of established payments was also reported in The Pharmaceutical Journal

The Governments Pharmacy Access Scheme was also reported in Chemist & Druggist and The Pharmaceutical Journal 

Pharmacy integration fund will total £42m over next two years
21 October 2016, The Pharmaceutical Journal

NHS England has announced that the pharmacy integration fund (PhIF) will total £42 million over the next two years. The scheme was proposed earlier in 2016, amounting to a total of £300 million by 2021. The aim of the PhIF is to assist the development of clinical pharmacy practices for a more integrated NHS primary care for patients. In order to decide how this funding will be spent Keith Ridge Chief Pharmaceutical Officer for England has commissioned an independent review of community pharmacy clinical services report, which is due at the end of 2016.

This was also reported by Pharmacy Business

What is the Falsified Medicines Directive?
20 October 2016, The Pharmaceutical Journal, Julia Robinson

The Falsified Medicines Directive (FMD) has been designed in response to concern about the increasing threat of counterfeit or ‘falsified’ medicines to public health and safety. The FMD will help to protect patients as it will minimise the chances of a counterfeit medicines entering Europe’s established supply chains. The FMD will introduce a Europe-wide system to track legitimate medicines from the manufacturer to the patient due to the obligatory safety features on each pack.

 

Parliamentary Coverage

There is no Parliamentary coverage today.

Full Coverage

BREAKING: PSNC CONSIDERING LEGAL ACTION AGAINST GOVERNMENT OVER CUTS

21 October 2016, Pharmacy Business, Neil Trainis

 

The PSNC is considering legal action against the government over its cuts to community pharmacy funding.

 

Sue Sharpe, the chief executive of the PSNC, told Pharmacy Business it was reviewing its position after the government said it would impose a 4% and 7.5% reduction in pharmacy funding in 2016-17 and 2017-18 respectively.

 

“PSNC will study the government’s imposition carefully to inform our decisions about next steps. Our decisions must be based on what is best now for contractors. PSNC will be examining the options for a legal challenge,” Sharpe (pictured) said.

 

“Over the coming months we will be working closely with LPCs and the other pharmacy organisations  to plan the next stages of the campaign, as well as to help the sector to adapt to the changes.

 

“We must also continue to build on the phenomenal support we now have among politicians from all parties and the general public to make the case for pharmacy’s long-term future.”

 

The government announced in its final funding package that community pharmacy will receive £2.687 billion for 2016/17 and £2.592 billion for 2017/18.

 

NPA to look into ‘legal avenues’ over pharmacy funding cuts

21 October 2016, Chemist & Druggist, Grace Lewis

 

The National Pharmacy Association (NPA) is “urgently” seeking safeguards against the impact of the cuts, after the government’s confirmation of a 12% drop in funding.

Chairman Ian Strachan vowed to carry on the lobby group’s anti-cuts fight “with renewed conviction”, in an emergency Facebook chat with members last night (October 20), as pharmacists came to terms with the government’s “modernisation” plans for the sector.

 

Mr Strachan reassured community pharmacists that the battle against the cuts “is far from over”. The NPA is considering “a range of options” for its next steps, including “legal avenues”, he said.

 

“The government has made its intentions clear; let’s make ours,” Mr Strachan said in the Facebook announcement. “We will continue to campaign because it is the right thing to do.”

 

Speaking to C+D today (October 21), NPA head of communications Stephen Fishwick said the association is “taking professional advice – including political, regulatory and legal – on all the options available to us.”

 

“We don’t want to show our hand just yet, but there are still things to play for and avenues to explore,” he stressed.

 

Mr Strachan said “the recent concession on hub and spoke dispensing showed that it is possible to get politicians to change course”. He added he is hopeful that with a “united front” from the sector, “there is still a chance to influence government thinking”.

 

‘Could have of been worse’

 

Many pharmacists contacted the NPA overnight, “angry” at the government’s announcement but also seeking “practical support” on what to do next, Mr Fishwick told C+D.

 

“Just think how much worse the situation could have been if we rolled over at the beginning and accepted all this nonsense,” he said. “The determined efforts of the sector and of patients has certainly been worthwhile and it is important to keep together and keep pushing back against this direction of travel.”

 

The NPA advised community pharmacists to “examine your numbers and review your wider business affairs, to make sure you are fit for the future”.

 

It will be producing a number of business “proposals and resources” to support the sector in the comming weeks.

 

The RPS response

 

In a statement yesterday, the Royal Pharmaceutical Society’s English pharmacy board chair Sandra Gidley said “we know that the profession needs more from us at this time”.

 

“It remains to be seen if the [pharmacy access scheme] will lessen the impact on opening hours and staffing levels in vital community pharmacies,” she added.

 

She added the society was “dismayed there is now less certainty about the long term status of [the pharmacy integration fund]”.

 

Ms Gidley said the RPS is making sure community pharmacists receive “practical support to plan for the change that will begin on December 1st”.

 

Community pharmacists ‘will need support’ after pharmacy cuts announcement, says RPS

21 October 2016, The Pharmaceutical Journal, Julia Robinson

 

Royal Pharmaceutical Society pledges to support its members throughout overhaul to community pharmacy framework, details of which were announced on 20 October 2016.

 

The Royal Pharmaceutical Society (RPS) says community pharmacists will need widespread support from pharmacy organisations after health minister David Mowat announced community pharmacy funding cuts will be implemented from 1 December 2016.

 

Speaking at the House of Commons on 20 October 2016, Mowat confirmed that funding for community pharmacy will be cut by 4% in 2016–2017 from 1 December 2016, and a further 3.4% will be slashed in 2017–2018.

 

Mowat’s announcement concludes months of discussions between government and pharmacy organisations, including: the Pharmaceutical Services Negotiating Committee, the negotiating body for community pharmacy contractors in England; Pharmacy Voice, a trade association which represents community pharmacy in England; and the RPS.

 

“The profession has spoken with one voice on this issue,” says the RPS in a statement, published on 20 October 2016. “We have consistently asked how the government’s aspiration for the future of community pharmacy to be at the heart of the NHS can be squared with large reductions in funding.

 

“We recognise the NHS is under huge financial pressure, with colleagues in public health and hospitals at the sharp end of squeezed budgets too. There is a broader case for all of us in health to make about investment in a service that is dealing with unprecedented demand and expectations.”

 

The RPS also expressed dismay that the pharmacy integration fund (PhIF), which aims to support the development and integration of clinical pharmacy practice in a wide range of primary care settings, has been reduced from £300m over five years to £42m over two years.

 

“We are committed to working with NHS England on the best use of this fund but are dismayed that there is now less certainly (sic) about the long-term status of this work,” the statement says.

 

In his speech, Mowat also described plans for a pharmacy access scheme, whereby additional funding will be made available for the 1,356 pharmacies in deprived areas across England to shield them from the impact of the cuts. However, the RPS says that it will take time to find out whether the scheme will lessen the impact on opening hours and staffing levels in these pharmacies.

 

“We know that many pharmacists, whether they own a pharmacy or work for a pharmacy business, will be hugely concerned about the future,” says the RPS. “We have been very clear about our opposition to funding reductions, but we know that the profession needs more from us at this time.

 

“[We] will make sure we offer pharmacists practical support to plan for the change that will begin on 1 December 2016.”

 

PHARMACY SPITS BLOOD AT GOVERNMENT OVER FUNDING CUTS

21 October 2016, Pharmacy Business, Neil Trainis

 

The fall-out from the government’s cuts to community pharmacy funding continues with the profession spitting blood at ministers’ decision to reduce its budget over the next two years.

 

National Pharmacy Association chairman Ian Strachan described the government’s package, announced yesterday and which includes a 4% and 7.5% reduction in funding in 2016-17 and 2017-18 respectively, as a “slap in the face for hardworking pharmacy teams and for concerned patients.”

 

“The government’s approach shows a complete disregard for the community pharmacy sector and the wellbeing of patients,” he said.

 

“Millions of worried patients have asked the Department of Health to think again. Politicians from all parties are against the cuts. It is abundantly clear that the current policy approach is flawed and universally unpopular.

 

“Yet elements within government seem determined to press ahead with this damaging experiment, deaf to the nationwide protests. It is clear that they believe there are too many pharmacies and want closures.”

 

Strachan added: “But this is far from over. We will fight on in the light of (this) announcement. What gives us grounds for hope is the unprecedented level of public awareness and active political support that has been generated over the past months.

 

“This will form the basis of an ongoing effort to fundamentally shift the direction of government policy, so that pharmacies are seen as a solution to deep-seated problems in the NHS, not as a problem.

 

“Our most urgent task now is to defend against the most damaging potential consequences of the cuts.  We owe it to the millions of patients who have supported us to continue to safeguard the pharmacy services they rely on.”

 

Rob Darracott, the chief executive of Pharmacy Voice, said: “We have only just seen the government’s response to the PSNC but, on first inspection, it doesn’t appear that the Department of Health has been listening.

 

“We have spent the last 10 months explaining to them the value of community pharmacy, the pressure we take off other parts of the NHS and the money we save the Government by keeping patients out of GP surgeries and A&E.

 

“The public have made it clear to them that they expect their local pharmacies to expand their role in the community and MPs from every party have outlined how cuts will harm the interests of their constituents.

 

“Yet, despite this opposition, the government appears hell-bent on pressing ahead with this incoherent, self-defeating and wholly unacceptable policy and have replaced previous warm words with increasingly aggressive rhetoric.”

 

John D’Arcy, the managing director of Numark, said the cuts were “an outrage to the sector” and warned they “will have a devastating impact on pharmacies and the services they provide to their local community, especially on independent community pharmacies.”

 

“There is a real imbalance in government thinking here – funding is being cut, while at the same time pharmacies are being asked to do more,” he said.

 

“For example, the new NHS 111 service was put in place to take pressure off GP and accident and emergency departments, but this is looking increasingly likely to fail in light of these new cuts.

 

“It’s simply short-sighted for the government to make these cuts as they will hit areas with the greatest health inequalities the hardest.

 

“It’s estimated the cuts could also lead to many pharmacies being closed, causing huge job losses. In any other situation, imposing this sort of pay cut without any formal consultation would lead to an employment tribunal.

 

“The fear now of course is that not only will the livelihood of community pharmacy be affected, but so will patients and their ability to access essential healthcare services.”

 

D’Arcy said the government’s reward system for pharmacies providing a high quality service was “small relief from the cuts.” Up to £75 million will be made available for the quality scheme in 2017/18 and that will be funded from that year’s funding package of £2.592 billion.

 

“Sadly, announcement (of the cuts) flies in the face of public opinion as has been evidenced by the huge amount of public support and endorsement of community pharmacy through recent petitions,” D’Arcy said.

 

Norman Lamb, the Liberal Demoncrats health spokesperson, described the plans as “myopic” and accused the Conservatives of caring more about cutting costs than patient care.

 

“The government’s belief that cutting funding for community pharmacies will improve efficiency in the NHS is a complete false economy,” he said.

 

“These myopic plans will further increase pressure on GP surgeries and hospitals that are already buckling under the strain of limited resources and unprecedented demand for services.

 

“More people will be forced to take unnecessary trips to their GP and even A&E, which is completely counter to NHS England’s vision in the Five Year Forward View.

 

“If the government wants to ensure that health service is more efficient and focused on preventing ill health, then surely we should be investing more, not less, in pharmacies and other preventive services.

 

“This was the latest in a chain of fig-leaf consultations from the Conservative government, which is more concerned about cutting costs in a desperate attempt to make ends meet than creating an NHS that meets the needs of patients.”

 

Cormac Tobin, managing director of Celesio UK, accused the government of being “grossly disingenuous” over its intentions for community pharmacy.

 

“To say that the details of the final package are disappointing is a huge understatement,” he said.

 

“When the government’s intentions were first laid out at the start of the process, the proposed financial arrangements were couched as part of a wider plan to transform community pharmacy.

 

“The ambition for community pharmacy for 2016/17 and beyond all seems grossly disingenuous given that the only thing we’ve really got to show is a reduction in funding.

 

“With very little consultation undertaken and even less listening, proposals to save the NHS money dismissed out of hand and an apparent lack of consideration of the bigger picture, the stealthy and short-sighted manner in which the cuts have been handed down leaves a bitter taste for us all, and we must start to bear the impact and consider the future.”

 

The Royal Pharmaceutical Society, more measured in their response, said: “Community pharmacists will need support from RPS and other organisations following (the) announcement by the Department of Health that they will reduce total funding for community pharmacy, both this year and next.

 

“The profession has spoken with one voice on this issue. We have consistently asked how the government’s aspiration for the future of community pharmacy to be at the heart of the NHS can be squared with large reductions in funding.

 

“We recognise the NHS is under huge financial pressure, with colleagues in public health and hospitals at the sharp end of squeezed budgets too. There is a broader case for all of us in health to make about investment in a service that is dealing with unprecedented demand and expectations.”

 

The RPS added: “The pharmacy integration fund, originally set at £300 million over five years, has now been reduced to £42 million over two years, with years three, four and five yet to be confirmed.

 

“We are committed to working with NHS England on best use of this fund but are dismayed there is now less certainly about the long term status of this work.

 

“We know that many pharmacists, whether they own a pharmacy or work for a pharmacy business will be hugely concerned about the future. We have been very clear about our opposition to funding reductions, but we know that the profession needs more from us at this time.”

 

Pharmacy integration fund will total £42m over next two years

21 October 2016, The Pharmaceutical Journal

 

NHS England has announced that the pharmacy integration fund (PhIF), originally proposed in December 2015 as part of the government’s plans for community pharmacy, will total £42m over the next two years. This is substantially lower than the initial figure put forward earlier in 2016, which suggested the fund would amount to £300m by 2020–2021.

 

The aim of the PhIF is to support the development of clinical pharmacy practice in a wider range of primary care settings, resulting in more integrated and effective NHS primary care for patients.

 

“NHS England is making this extra money available to help modernise the pharmacy sector and make the most of pharmacists’ skills,” says Keith Ridge, chief pharmaceutical officer for England. “Everyone agrees that community pharmacy is being held back by an old-fashioned view of the pharmacist as someone who simply dispenses medicines at the back of the shop rather than as a trained clinical professional.

 

“We want to work with the profession to change that and, rather than increasing the burden on GPs, the aim is to allow community pharmacists to take a greater NHS role in helping patients.”

 

NHS England says the fund will be directed particularly towards the use of community pharmacists and pharmacy technicians in new, integrated local care models to improve access for patients and to relieve pressure on GPs and accident and emergency departments. Two workstreams already under the PhIF are aimed at integrating community pharmacy into the NHS’s national urgent care system through the urgent medicines supply service and the urgent minor illness care work with NHS 111, and these will run in parallel from December 2016 to April 2018.

 

To determine exactly how the fund will be spent over the next two years, Ridge has commissioned an ‘Independent review of community pharmacy clinical services’, which is due to report at the end of 2016.

 

NHS England Announces £42M Pharmacy Integration Fund

21 October 2016, Pharmacy Business, Neil Trainis

 

NHS England has launched the eagerly anticipated Pharmacy Integration Fund which will support community pharmacy’s development in the wake of swingeing government cuts to the sector’s funding between 2016 and 2018.

 

The Fund is worth £42 million over the next two years and is designed to drive forward clinical pharmacy practice in a range of primary care settings which NHS England hopes will result in a “more integrated and effective NHS primary care.”

 

There is a particular focus on making greater use of community pharmacists and pharmacy technicians in new, local, integrated care models through the Fund.

 

“This will improve access for patients, relieve the pressure on GPs and accident and emergency departments, ensure best use of medicines, drive better value and improve patient outcomes,” NHS England said.

 

Uncertainty persists over how the money will be spent over the next two years but an independent review commissioned by the chief pharmaceutical officer Dr Keith Ridge will report back on the issue by the end of the year.

 

The Fund is also a stark reminder to the pharmacy profession of the need to develop innovative new services through technology and digital platforms in line with a 21st century NHS.

 

“NHS England is making this extra money available to help modernise the pharmacy sector and make the most of pharmacists’ skills. We are not asking community pharmacy to do more, but to work with us over the next five years to develop how we can do things differently,” Dr Ridge said.

 

“There is no doubt that the community pharmacy profession will have to change how it works but we will be working closely with them to support and enable this process.

 

“Everyone agrees that community pharmacy is being held back by outdated working practices and an old-fashioned view of the pharmacist as someone who simply dispenses medicines at the back of the shop rather than as a trained clinical professional who provides specialist advice to patients and doctors from a professionally orientated clinical environment.

 

“We want to work with the profession to change that and rather than increasing the burden on GPs the aim is to allow community pharmacists to take a greater NHS role in helping patients.”

 

Two work streams designed to integrate community pharmacy into urgent care will run in parallel from December 2016 to April 2018; an urgent medicines supply service and urgent minor illness care work with NHS 111.

 

What is the Falsified Medicines Directive?

20 October 2016, The Pharmaceutical Journal, Julia Robinson

 

Aileen Bryson, practice and policy lead at RPS Scotland, speaks to Julia Robinson about the purpose of the Falsified Medicines Directive and how it will affect pharmacists in the UK when the final phase is rolled out in February 2019.

 

For several years, the European Union (EU) has been concerned about the increasing threat of counterfeit or ‘falsified’ medicines to public health and safety. In 2011, the European Commission (EC) started work to amend Directive 2001/83/EC to address these concerns under the Falsified Medicines Directive (FMD). The final phase of the FMD is due to be rolled out from 9 February 2019. But what does the FMD entail, how will it affect pharmacists in the UK and how is the Royal Pharmaceutical Society (RPS) involved? Julia Robinson talks to Aileen Bryson, RPS Scotland’s practice and policy lead, to find out.

 

What is the purpose of the FMD?

 

The FMD is designed to protect patients by minimising the chances of counterfeit medicines entering into the established medicines supply chain across Europe. It will enable manufacturers, wholesalers, distributors and everyone who supplies to patients to verify the authenticity of a medicinal product, identify individual packs, and check whether the outer packaging of medicines has been tampered with.

 

How will it work?

 

The FMD will introduce a system to track legitimate medicines from manufacturers to patients. Manufacturers will be obliged to apply safety features to each pack: a tamper-proof security seal and a 2D barcode. The barcode enables each pack to be serialised with a unique randomised number, which will be authenticated before dispensing. This identification data will be stored in a database managed by the European Medicines Verification Organisation (EMVO), and supported at national level in the UK by the UK Medicines Verification Organisation (UKMVO), a not-for-profit organisation also known as SecurMedUk Ltd. Manufacturers will check packs into the database and they will be authenticated, decommissioned or “checked out” in the pharmacy by scanning the barcode. This sends a message to the database, which then considers the authenticity of that pack, sending confirmation back to the pharmacy.

 

What will happen to medicines already in the system?

 

The FMD is not going to be operational until February 2019 and manufacturers are already working on it, so there will be a long transitional period where packs without the barcode will be taken out of the system.

 

How will we know if there is a problem with a pack?

 

If the pack hasn’t been registered by the manufacturer or parallel importer for the UK, or if the system thinks the pack has already been decommissioned (i.e. it could be a counterfeit or faulty medicine or a pack that has been reported stolen) then a warning alert not to supply the pack will be issued. The Medicines and Healthcare products Regulatory Agency (MHRA) — the UK’s regulatory authority for medicines (the national competent authority) — will also be informed.

 

Will the FMD apply to all medicines?

 

In practice, almost all prescription medicines will require a barcode. There will be a few exceptions that will appear on a “white” list. Over the counter (OTC) medicines will only need to be scanned if there is evidence of them being subject to counterfeiting. In these circumstances they will appear on a “black” list. The MHRA will hold and monitor both lists.

 

Who will be affected by the FMD?

 

Operationally, the FMD will affect everyone along the supply chain because they will need to comply with the new legislation. If everything works well, patients should not be affected. But if a counterfeit is found just prior to dispensing there might be a delay in the patient obtaining their medicine. The FMD legislation is deliberately vague about the definition of “point of dispensing”, which it says should be as near to the patient receiving the pack as possible. But there is some flexibility — for example, you could have a two-stage process; scanning to authenticate when the stock comes into the pharmacy and then checking out when the pack is used. Different countries have different ways of doing things.

 

How much is it going to cost?

 

No idea. The manufacturers are only going to pay for the verification system up to the pharmacy door; who pays after that hasn’t been decided.

 

Do pharmacists need to prepare for the new legislation?

 

Pharmacists will need to have an awareness of the new legislation, as with any changes in the law, and they will have to become familiar with the new software. But I don’t envisage that being a heavy burden — some systems already use scanning technology. Whenever any new legislation comes in, the RPS looks at it to see how we can support pharmacists — this won’t be any different. Standard operating procedures (SOPs) will need to be revised to accommodate the new processes, including those for dispensing, reporting exceptional events, business continuity plans and staff training.

 

What other benefits do you think will come from the FMD?

 

The 2D barcode can hold more information than is required by the legislation, and the RPS has suggested that extra safety features could be added. For example, with electronic prescribing you could scan the pack and link it to a prescription as an extra accuracy check and as an expiry date check. There are also many innovative possibilities, such as having patient information videos on use of medicines built in.

 

What are the challenges associated with FMD?

 

The FMD will require changes to be made in the way pharmacists work. For example, there’s a ten-day window for re-entering packs back into the system; so if you scan a pack when a prescription is assembled but the patient doesn’t collect it within ten days you cannot re-enter it into the system. Whereas, if you scan the pack when the patient picks up their prescription you wouldn’t have that problem. There are also questions around how FMD will work with hub and spoke operations.

 

A lot of thought is going to have to be given to the practicalities of implementation to make sure that access to medicines is not hampered in any way for patients. If there are any gaps in the system that’s where the counterfeiting will take place.

 

The MHRA has been meeting with stakeholders to prepare for this. We understand that there’s going to be an impact assessment and a consultation in 2017.

 

Will Brexit have any effect on how the FMD works in the UK?

 

No. Coming out of Europe, we have questioned whether, longer term, we would need to comply with the FMD in exactly the way that we have to at the moment. But, as far as we can see, Brexit will not make any difference as the Directive is already in UK legislation. This is a pan-European system; if we don’t comply then we become a weak link within the system.

 

How has the RPS been involved?

 

The RPS has been engaged at UK and European level. We’ve responded to several consultations and engaged with all stakeholders. We’ve had an expert working group across sectors and spoken with European Commission staff in Brussels to try to ensure that the FMD will be fit for pharmacy practice in the UK — we’ve been successful in getting many changes to the legislation. One change related to the ten-day rule. We realise that having a ten-day window for re-entering packs back into the system is not ideal but, originally, they wanted the window to be 72 hours. This would have presented lots of challenges in practice, with potential for huge increases in NHS waste. The EC have also made allowances for the fact that we still split packs in the UK because pharmacies don’t do that in most other European countries.

 

On the industry side, we’ve worked with manufacturers to strengthen the security of prescription and patient data. No patient details will be stored in the UK hub, enabling links with patient medication record (PMR) systems. This will allow all processes related to dispensing to be operated through one workstation and to have all information in one barcode. We argued for safeguards for when IT systems fail so that normal dispensing isn’t adversely affected, including ensuring uploaded data doesn’t crash a system; the system does not slow down at peak periods; and that barcodes are stored until transmission is possible and packs have a human readable code for emergency use.

 

Establishment payments to be phased out in pharmacy funding overhaul

21 October 2016, The Pharmaceutical Journal, Ingrid Torjesen

 

The UK government has outlined further changes to fees and allowances for community pharmacies in proposals dubbed a “slap in the face” by industry bodies.

 

Establishment payments will be gradually phased out from December 2016, the Department of Health announced on 20 October 2016.

 

The end of the payments, which are worth around £25,000 per year and are paid to pharmacies provided they dispense a certain number of prescriptions, was revealed in documents, including a report entitled ‘Community pharmacy in 2016/17 and beyond: final package’.

 

This was published after health minister David Mowat delivered a statement to the House of Commons on 20 October 2016 confirming that community pharmacy funding will be cut by 4% in 2016–2017 to £2.687bn, and by a further 3.4% in 2017–2018 to £2.592bn.

 

The documents outline a range of changes to community pharmacy fees and allowances, which will be reflected in the Drug Tariff from 1 December 2016, the date that the budget cuts will be implemented.

 

From December 2016, establishment payments will be cut by 20% compared with 2015–2016 levels — equivalent to a 6.7% reduction in 2016–2017 as a whole. Then, on 1 April 2017, they will be cut by a further 20%.

 

As such, a pharmacy currently receiving the top level establishment, equivalent to £2,092 per month, can expect it to be cut to £1,673 per month in December 2016 and to £1,255 per month by April 2017. The payment will be phased out completely by the end of 2019–2020.

 

In his address to the House of Commons, Mowat said establishment payments were “an inefficient allocation of NHS funds when 40% of pharmacies are now in clusters of three or more which means two-fifths are within ten minutes walk of two or more other pharmacies”.

 

Also from 1 December 2016, a new single activity fee will be implemented as part of the overhaul. The fee will encompass the professional fee (dispensing fee), practice payment, repeat dispensing payment, and the monthly electronic prescription service (EPS) payment. It is anticipated this will be worth £1.13 per prescription item.

 

Additional fees paid for dispensing prescriptions for specific types of product, such as unlicensed medicines, appliances and controlled drugs, will remain, as will the one-off set-up payment for ‘EPS release 2’, the second phase of the transmission of electronic prescriptions, although this payment will cease from April 2017.

 

In addition, a new pharmacy access scheme will be introduced alongside the changes to protect the viability of pharmacies. Mowat reassured that the scheme will be put in place from December 2016 until March 2018, to protect patient access in areas of deprivation or where community pharmacy provision is sparse.

 

Furthermore, the proposals say that up to £75m of the £2.592bn community pharmacy budget for 2017–2018 will be allocated to a new quality payment scheme from April 2017. However, pharmacies will have to meet four criteria before they will be considered for the payment, including provision of least one specified advanced service and use of the electronic prescription service.

 

The quality payment scheme will be worth at least £6,400 per pharmacy per annum to stores that manage to meet all the criteria and possibly as much as up to £12,800 per pharmacy per annum, depending on how the sector performs as a whole. It is not expected that all pharmacies will meet all the criteria.

 

Also, NHS England’s £42m pharmacy integration fund (PhIF) has been set up to support the development of clinical pharmacy practice in a wider range of primary care settings over 2016–2018.

 

The PhIF is intended to support community pharmacy to develop new clinical pharmacy services, working practices and digital platforms during 2016–2017 and 2017–2018. It was announced on 14 October 2016 that the fund will support two pilot schemes — an urgent medicines supply service and urgent minor illness service — from December 2016 to April 2018. The schemes are being developed to take direct referrals from NHS 111.

 

The PhIF will also be used to support deployment of clinical pharmacists and pharmacy services in community and primary care settings, including groups of general practices, care homes and urgent care settings, such as NHS 111.

 

Responding to the announcements, Sue Sharpe, chief executive of the Pharmaceutical Services Negotiating Committee (PSNC), the body that represents pharmacy contractors, says: “The removal of establishment payments will target… the low dispensing volume pharmacies in areas with the highest health needs. [These pharmacies will] see fee income reduced by around 20% [in 2017], at a time when the NHS has said that efficiency targets of 4% are too high to be achievable, [but it] has reduced targets to 2%.”

 

Sharpe adds that although it is unlikely that pharmacies will close immediately as a result of the pharmacy funding cuts, pharmacy owners will be forced to take steps quickly to reduce costs.

 

“These are likely to include reducing opening hours and staffing, and stopping the provision of services which they are not obliged to provide, such as home delivery of medicines and the supply of medicines in compliance aids.

 

“As they are forced to review their operating costs and consider staff cuts, patients may find that they have to wait longer to receive advice that would previously have been readily available,” she adds.

 

Sharpe also warns that big policies could be railroaded by the community pharmacy proposals, “for instance if social care cannot cope with the increase in people left without support, there could for example, be a rise in hospital admissions”, she says.

 

The PSNC has published indicative income tables to help contractors to predict the impact on their businesses.

 

Ian Strachan, chair of the National Pharmacy Association, which represents independent pharmacies, says that the announcement is a “slap in the face” for hardworking pharmacy teams and for concerned patients.

 

“Millions of worried patients have asked the Department of Health to think again,” he says. “Politicians from all parties are against the cuts. It is abundantly clear that the current policy approach is flawed and universally unpopular,” he says.

 

“Elements within government seem determined to press ahead with this damaging experiment, deaf to the nationwide protests. It is clear that they believe there are too many pharmacies and want closures.”

 

Rob Darracott, chief executive of Pharmacy Voice, a pharmacy trade body, says: “We have spent the last ten months explaining to [the government] the value of community pharmacy, the pressure we take off other parts of the NHS and the money we save the government by keeping patients out of GP surgeries and A&E.

 

“[Members of the] public have made it clear to [the government] that they expect their local pharmacies to expand their role in the community and MPs from every party have outlined how cuts will harm the interests of their constituents,” he adds.

 

In a statement, the Royal Pharmaceutical Society (RPS), the professional body for pharmacists, says: “We have consistently asked how the government’s aspiration for the future of community pharmacy to be at the heart of the NHS can be squared with large reductions in funding.

 

“We know that many pharmacists, whether they own a pharmacy or work for a pharmacy business will be hugely concerned about the future. We have been very clear about our opposition to funding reductions, but we know that the profession needs more from us at this time. The RPS will also make sure we offer pharmacists practical support to plan for the change that will begin on 1 December.”

 

Revealed: Which pharmacies will be protected from the cuts

21 October 2016, Chemist & Druggist, Annabelle Collins

 

A total of 1,356 pharmacies in England – around one in 10 – will receive money from the government’s “pharmacy access fund” to offset the worst of the incoming cut to funding.

 

A C+D analysis of the full list of these pharmacies – published by the Department of Health yesterday (October 20) – revealed that 312 (23%) of those listed belong to the three largest multiples.

 

This figure consists of 124 Boots branches, 56 Well branches, 107 Lloydspharmacy branches, as well as 25 Sainsbury’s branches – which transferred over to Lloyds last month.

 

A total of 36 Asda and Morrisons pharmacies will receive financial protection, as will 47 Rowlands branches and 37 Day Lewis pharmacies.

 

Distance-selling pharmacies were not eligible for the scheme, the DH said.

 

A full list can be found here.

 

Still expected to make efficiencies

 

The payment will amount to “roughly” £2,900 per month for 2016-17 and £1,500 per month for 2017-18, the DH said yesterday.

 

However, these pharmacies must still make efficiency savings of 1% in 2016-17 and 3% in 2017-18, it stressed.

 

To make it onto the list, pharmacies have to be more than a mile away from another pharmacy “by road” and not in the top 25% of pharmacies according to dispensing volume, the DH said.

 

It added: “Pharmacies that might have narrowly missed out on the access scheme through the distance criteria, but are in an area of high deprivation, will be eligible to ask for a review.”

 

“This will cover pharmacies that are located in the 20% most deprived areas in England and are 0.8 miles or more from another pharmacy, and are critical to access,” it added.

 

“Funding for successful reviews will be made available as required from outside of this package,” it added.

 

Government lists pharmacies that will be shielded from full effect of funding cuts

21 October 2016, The Pharmaceutical Journal, Ingrid Torjesen

 

Around 1,300 pharmacies in areas of deprivation or where community pharmacy provision is sparse will receive additional payments under the Pharmacy Access Scheme.

More than 1,300 pharmacies will receive additional payments to protect against the full effects of community pharmacy funding cuts in England. The additional payments will come from the total funding package being offered to the sector.

 

A total of 1,356 pharmacies have been identified as being in either an area of deprivation or an area where community pharmacy provision is sparse, according to a list published by the Department of Health (DH). The pharmacies listed meet three criteria: they are more than a mile away from another pharmacy by road; were on the pharmaceutical list on 1 September 2016; and are not high volume dispensing pharmacies (i.e. they are not dispensing 109,012 prescription items per year or more).

 

The named pharmacies will receive monthly payments under a pharmacy access scheme (PhAS) that will run from December 2016 until March 2018. There is no commitment to continue payments after this date. The average payment will be around £11,600 in 2016–2017 and £17,600 in 2017–2018. The exact payment will be based on the funding the pharmacy received in 2015­–2016, incorporating an efficiency saving of 1% in 2016–2017 and 3% in 2017–2018. This efficiency saving is smaller than the one being applied to the whole sector, which is 4.6% in 2016–2017 and 8.3% in 2017–2018.

 

“While efficiencies are being asked of community pharmacy, just as they are of other parts of the NHS, there is still sufficient funding to ensure there are accessible and convenient local NHS pharmacy services across England,” says Keith Ridge, chief pharmaceutical officer for England.

 

Pharmacies not on the list can apply to NHS England to have their case reviewed. Applications for review will be accepted from 1 November 2016 and must be made within three months of the start of the scheme (by the end of February 2017). NHS England will aim to complete the review process within six weeks.

 

Applications for review can be submitted if the pharmacy is believed to be more than one mile from the nearest pharmacy; if a semi-permanent road or bridge closure means that the nearest pharmacy is more than a mile away; or if the nearest pharmacy is less than a mile but the journey is particularly difficult.

 

Reviews of eligibility will also be granted to some pharmacies that may have narrowly missed out on the scheme through distance criteria (i.e. they are 0.8 miles or more from the nearest pharmacy). The near miss criteria will apply to pharmacies located in the 20% most deprived areas of England. To be successful in the review process, a pharmacy will need “to demonstrate that a local population relies on that pharmacy and would be materially affected by its closing”.

 

If a qualifying pharmacy subsequently increases the volume of prescription items it dispenses, the pharmacy will not lose entitlement to PhAS payments. “This is to ensure that pharmacies are not penalised for becoming more efficient, and seeking to grow their business,” the DH’s document says.

 

On funding beyond 2018, the DH states: “Funding levels and the PhAS beyond March 2018 will be subject to further consultation, which will include reviewing the PhAS and its effectiveness.”

 

In a statement issued on 20 October 2016, the Royal Pharmaceutical Society says: “Today we have heard more detail about the PhAS, with some additional funding for pharmacies in deprived communities. It remains to be seen if this scheme will lessen the impact on opening hours and staffing levels in these vital community pharmacies.”

HDA Media And Political Bulletin – 24 October 2016

From Factory to Pharmacy

As part of our mission to build awareness, understanding and appreciation of the vital importance of the healthcare distribution sector, we developed an infographic explaining the availability of medicines. It identifies the factors that can impact drug supply, as well as the measures that HDA members undertake day in, day out to help mitigate the risks of patients not receiving their medicines.

See the Infographic

Apply to become a Member

Membership of the HDA guarantees your organisation:

  • Access to leading policy and industry forums of debate and discussion
  • Invitations to a range of networking industry events organised through the year, including an Annual Conference and a Business Day
  • Representation on HDA working parties, including the Members’ Liaison Group
  • A daily Political and Media Bulletin and HDA Newsletters
  • Access to HDA policy documents and all sections of the HDA website
  • Branding and marketing opportunities
Apply Now

Already a Member?