HDA Media And Political Bulletin – 26 January 2016

Minister highlights efficiency potential of 90-day scripts

26 January 2016, DDA, Ailsa Colquhoun

Dispensing Doctors’ Association reports on a shareholder information document published by the Department of Health reviewing potential areas for efficiencies such as the duration of a prescription. When questioned, pharmacy minister Alistair Burt explained that the government would not decide which pharmacies should close but that it would be their decision if they were viable after the funding cut.

Pharmacy Biz and Chemist and Druggist also report on the news here.

Further details on the document and update from PSNC can be found here.


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Minister highlights efficiency potential of 90-day scripts

26 January 2016, DDA, Ailsa Colquhoun

Ninety day prescriptions are among the models being considered as part of the government’s drive to secure efficiencies from community pharmacies in England.

In a stakeholder information document, the Department states that many prescribers already prescribe 90-day repeat prescriptions where it is clinically appropriate. Where there is no clinical need for a 28-day repeat prescription, this represents inconvenience to the patient and an avoidable cost to the taxpayer. It says: “We will be looking at steps to encourage optimising prescription duration, balancing clinical need, patient safety, avoidance of medicine waste and greater convenience for patients.”

The effect of the measures on rural pharmacies has also been discussed. In a report from the All-Party Pharmacy Group, the minister is cited as saying that between 1,000-3,000 pharmacies could close, as a result of financial measures including the phased withdrawal of the establishment payment. This is worth around £25,000 per year to a pharmacy. And, when asked specifically about rural pharmacies, pharmacy minister Alistair Burt is quoted as saying: “The Pharmacy Access Scheme [funding] could apply to pharmacies after taking account of their location and local health needs”.

But, he also made clear that the government could not decide which pharmacies would close. A formula approach could have ‘hard edges’, and local decision-making may be more appropriate, he said. And, as for compensation, he added:  “Pharmacies would need to decide whether they were viable in light of the change to the funding level. Multiples are likely to have more resilience. Smaller pharmacies will be ‘squeezed’ and that was a matter of concern, so the government would look at that.”

The document, which is open for consultation until February 12, also reiterates Government support for ‘hub and spoke’ dispensing across different legal entities. The minister announced that there will be consultation on changing legislation intended to allow independent pharmacies to capture the efficiencies stemming from automated dispensing and reduced stock holding, and the economies of scale in purchasing and delivery of stock to the hubs. “These efficiencies could help pharmacies lower their operating costs and enable pharmacists and their teams to provide more clinical services and to improve and support people’s health,” the minister said.

The community pharmacy funding proposal, announced in December, looks to reduce pharmacy funding by 6% to a maximum of £2.63bn in 2016/17. Explaining the reduction, the minister said: “Efficiencies can be made without compromising the quality of services or public access to them because there are more pharmacies than are necessary to maintain good patient access. Most NHS funded pharmacies qualify for a complex range of fees, regardless of the quality of service and levels of efficiency of that provider.”


Between 1,000 and 3,000 pharmacies could close, Burt tells APPG

25 January 2016, Pharmacy Biz, Neil Trainis

Alistair Burt, the minister for community and social care, told the All-Party Pharmacy Group during a high-level meeting that between 1,000 and 3,000 pharmacies could close as a result of the government’s swingeing cuts to pharmacy funding.

Fears that many pharmacies will be forced to close in the wake of ministers’ decision to slash the pharmacy budget by £170 million, as indicated by the chief pharmaceutical offfcer Dr Keith Ridge following news of the revenue reduction, were exacerbated by Burt’s admission.

When asked by Paul Sherriff of the APPG whether he expected as many as 3,000 pharmacies to shut, Burt was reported by the APPG to have said during the meeting at the Department of Health that “between 1,000 and 3,000” could close but that “much would depend on the response of the multiples.”

“AB (Alistair Burt) noted that pharmacy numbers had increased by around 20% in the last 10 years. He could not be certain how many would close but suggested it could be between 1,000 and 3,000. Much would depend on the response of the multiples,” the APPG said.

Jeannette Howe from the DoH who was also at the meeting said because the government did not have access to the accounts of individual pharmacies, it “could not be sure about precise numbers of closures.”

Burt did however address the question of whether the government would use a formula to decide which pharmacies would survive by insisting the Pharmacy Access Scheme, which takes into consideration the location and local health needs of pharmacies, might serve such a function.

“(Burt) added that a formula approach could have ‘hard edges’ and that local decision-making may be more appropriate,” the APPG said.

“(APPG chair Kevin Barron) asked whether there would be compensation arrangements. (Burt) noted that the government could not decide which pharmacies would close.

“Pharmacies would need to decide whether they were viable in light of the change to the funding level. Multiples are likely to have more resilience. Smaller pharmacies will be ‘squeezed’ and that was a matter of concern, so the government would look at that.”

The APPG also said Howe confirmed there “would be further reductions in future years,” an unsurprising admission but one which will nonetheless cause great anxiety within community pharmacy.

“(Howe indicated) the October timing was intended to give pharmacies time to prepare. The government may be willing to consider phasing,” the APPG said.

“Paula Sherriff asked how the government had arrived at the figure of 6%. (Burt) replied that this was the figure that was settled upon after negotiations with the Treasury. He emphasised his earlier point that the government feels the market can withstand such change.”

There have been concerns around the commissioning of community pharmacy services but Howe said the Pharmacy Integration Fund would help that process.

“Oliver Colvile (APPG vice-chair) asked how the government could speed up plans to increase the services that community pharmacies provide,” the APPG said.

“(Howe) replied that this was the government’s intention and that the Pharmacy Integration Fund, together with local commissioning, would assist. (Howe) confirmed that the Integration Fund would be £20 million in year one and was expected to rise to £100 million by year five.

“Asked about the value of the Access Scheme, (Howe) stated that this would be set at whatever value was necessary to meet ministers’ objectives.”

The Pharmacy Integration Fund however has not alleviated the anxieties of the PSNC, whose chief executive Sue Sharpe expressed her concern in a letter to NHS England and the DoH that it was not designed specifically for community pharmacy.

“Given the current drive to develop the role of pharmacists working in general practice we expect that this will overwhelmingly be directed towards increasing opportunities for those other than community pharmacies,” she wrote earlier this month.

HDA Media And Political Bulletin – 26 January 2016

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