HDA Media And Political Bulletin – 3 March 2016

RPS backs care home training for pharmacists

2 March 2016, Chemist and Druggist, Annabelle Collins

The Royal Pharmaceutical Society is pushing for a training scheme to support pharmacists taking on a new role in care home. The aim is to keep patients out of hospitals as much as possible. This also highlights a current trend which sees the barriers between community pharmacy and secondary care falling.


GPhC says move to ‘hub and spoke’ dispensing will raise significant issues over liability

2 March 2016, The Good Health Suite

Today’s Pharmacist reports on the General Pharmaceutical Council stating that the move towards decentralised dispensing would raise significant questions of liability. As an independent regulator, the financial settlement and proposals for efficiencies are not matters for the organisation  but that it would affect the delivery of its services.


Parliamentary Coverage

House of Lords Oral Answers, Pharmacies: Funding, 2 March 2016


Asked by  Baroness Walmsley: To ask Her Majesty’s Government what steps they will take to ensure that every community continues to be served by a local pharmacy, in the light of their plans to cut funding to pharmacies in October.


The Parliamentary Under-Secretary of State, Department of Health (Lord Prior of Brampton) (Con):  My Lords, community pharmacies are a vital part of the NHS. The Government believe efficiencies can be made without compromising the quality of services or public access to them. Our aim is to ensure that community pharmacies upon which people depend continue to thrive. We are consulting on a pharmacy access scheme which will provide more NHS funds to certain pharmacies compared to others, considering factors such as location and the health needs of the local population.


Baroness Walmsley (LD):  I thank the Minister for his reply. Has he made any assessment of the value of the services provided by pharmacies to the NHS, local communities and local authorities in assisting with their public health responsibilities? In light of the importance of all these services and the potential for expansion in future, is it not rather arbitrary of the Government to make these cuts that I understand could cause the closure of 3,000 pharmacies? Then they will sit back and wait for the survival of the economic fittest.


Lord Prior of Brampton:  My Lords, it is important that we recognise the fundamental changes happening in the market that community pharmacies operate in. With the growth of online ordering of prescriptions, the large-scale automation of dispensing and the integration of health services within which community pharmacies are absolutely vital, the industry will have to change.


Lord Cameron of Dillington (CB):  My Lords, have the Government rural-proofed this policy? Has detailed thinking gone into how people without transport in remote rural communities can access pharmacies for their local, possibly life-saving medicines? I am sure that there are solutions to be had in IT and so on, but has that thinking and even understanding gone into the process?

2 Mar 2016 : Column 816


Lord Prior of Brampton:  The noble Lord raises an important point. There is no doubt that community pharmacies are vital to all people, but particularly to those living in isolated rural communities. There will be a pharmacy access fund based around isolation and local health needs of the population. We are consulting with the Pharmaceutical Services Negotiating Committee over that issue at the moment. I assure the noble Lord that we are fully aware of the issue he raises.


Lord McColl of Dulwich (Con):  My Lords, the Government’s plans will squeeze all pharmacies, resulting in the closure of the least-viable ones—which are often in the poorest districts where they cannot easily diversify. Why do the Government not undertake a means assessment to find out which pharmacies are essential? Closing pharmacies will put even greater pressure on overworked GPs.


Lord Prior of Brampton:  I assure my noble friend that not all pharmacies will be squeezed equally, as he put it. A pharmacy access fund will ensure that greater resources go to those pharmacies which serve isolated communities in rural areas, and a pharmacy integration fund will ensure that we encourage pharmacies to work more closely with primary care.


Lord Clarke of Hampstead (Lab):  My Lords, does the Minister consider that prisons are communities? If he does, will he give the House an assurance that the NHS pharmacies operating in prisons will not face any cuts because, as I understand it, the pharmacies in some prisons are far below the required standard? Can we be given an assurance that they will be exempt from any cuts?


Lord Prior of Brampton:  The noble Lord raises a very important issue. I do not have the answer to his question. If it is all right with him, I will investigate the matter and write to him.


Baroness Greengross (CB):  My Lords—

Lord Mawhinney (Con):  My Lords—

Lord Clement-Jones (LD):  My Lords—

Noble Lords:  This side!


The Lord Privy Seal (Baroness Stowell of Beeston) (Con):  My Lords, we should get out of the habit of shouting “This side” when we are on our feet. I suggest that the Cross Benches would like to go next.


Baroness Greengross:  My Lords, has the Minister considered the relationship between hospital pharmacies and local community pharmacies? At a hospital I know well 56 people are discharged every day. However, they cannot be discharged until their prescriptions are ready from the hospital pharmacy. As people wait up to four hours, beds are blocked 56 times for four hours while they wait. A closer link—which exists in one or two areas—between the two types of pharmacy might remedy that situation. Has the Minister any plans to look at that issue?


Lord Prior of Brampton:  The noble Baroness makes a very important point. There are many delayed discharges from hospital because people are waiting for their medications and many hospitals do not have the automation within their in-house pharmacies to meet the demand to which she refers. The big driving force going through healthcare and community pharmacy today is one of integration, which means that community pharmacies must in future work more closely with their local hospitals and GPs.


Lord Clement-Jones:  My Lords, we all have heard what the Minister has to say, but is not the Government’s policy totally inconsistent in that community pharmacists are being encouraged to do more but, as these drastic cuts are being put into effect, they can only do less?


Lord Prior of Brampton:  I think the noble Lord has misunderstood what I said. Interestingly, 40% of all community pharmacies are in clusters of more than three within 10 minutes’ walk. There has been a proliferation in the numbers of community pharmacies at a time when we want a deeper integration of community pharmacy with primary care in particular.


Lord Mawhinney:  My Lords, talking about the services which pharmacies provide, when do the Government plan seriously to regulate and inspect pharmacies with a view to making sure that their patient record-keeping and consultation facilities for patients are appropriate to the high standards of patient confidentiality which we insist on in every other aspect of the NHS?


Lord Prior of Brampton:  The noble Lord raises an important point which I regret I cannot answer. I will have to write to him on that matter. However, for community pharmacy to play the important role in primary care that we expect it to do, it will have to have access to integrated patient records. The confidentiality that surrounds those records is very important.


Lord Hunt of Kings Heath (Lab):  My Lords, this is all very well but will the noble Lord confirm that one of the ideas of his department is for doctors to prescribe medicines for a longer period so that fewer trips are made to the pharmacy, thereby compensating for the closure of up to 3,000 pharmacies? However, is he aware that it is estimated that £300 million worth of medicines are wasted every year? I understand that a third of that is in medicines that are never opened by patients. Surely it is not cost-effective to extend the length of the prescription time because all you will do is add to wastage of medicines.


Lord Prior of Brampton:  My Lords, there is no intention to extend the prescription time just for the sake of it. But there are many people who have stable long-term conditions, for whom a 90-day prescription period might be appropriate. We are not saying that all prescriptions should be for that length of time but some of them might be.




House of Commons Written Answers, Pharmacy, 2 March 2016


Dr Rupa Huq, MP: What assessment has been made by his Department or NHS England of the effect of minor ailments services provided by community pharmacies on demand for the services of GP practices and other parts of the NHS; and what assessment he has made of the effect of planned reductions in funding for pharmacies on those services.


Department of Health


Alistair Burt, MP: NHS England has taken account of the potential impact of a pharmacy minor ailments service on general practitioner services and other parts of the National Health Service. The findings of the Minor Ailment study (‘MINA’ study), conducted by the University of Aberdeen, in collaboration with NHS Grampian and the University of East Anglia, on behalf of Pharmacy Research UK in 2014, were considered. In addition, evaluations of local minor ailments schemes have continued to inform decision-making about local commissioning of such schemes.


Community pharmacy is a vital part of the NHS and can play an even greater role. In the Spending Review the Government re-affirmed the need for the NHS to deliver £22 billion in efficiency savings by 2020/21 as set out in the NHS’s own plan, the Five Year Forward View. Community pharmacy is a core part of NHS primary care and has an important contribution to make as the NHS rises to these challenges. The Government believes efficiencies can be made 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 and so we are consulting on the introduction of a Pharmacy Access Scheme, which will provide more NHS funds to certain pharmacies compared to others, considering factors such as location and the health needs of the local population.


The Government’s vision is for a more efficient, modern system that will free up pharmacists to spend more time delivering clinical and public health services to the benefit of patients and the public.


We are consulting the Pharmaceutical Services Negotiating Committee, other pharmacy bodies and patient and public representatives on our proposals for community pharmacy in 2016/17 and beyond. An impact assessment will be completed to inform final decisions and published in due course.


Local commissioning and funding of services from community pharmacies, such as minor ailment services, will be unaffected by these proposals.


Full Coverage

GPhC says move to ‘hub and spoke’ dispensing will raise significant issues over liability

2 March 2016, The Good Health Suite

The pharmacy regulator has said that Government proposals to reshape community pharmacy services will require careful consideration from a regulatory aspect.

In particular, the General Pharmaceutical Council has said that a move towards centralised dispensing, with a ‘hub’ and a related ‘spoke’ operated by different companies “will raise significant issues of responsibility, accountability and liability, which will need to be worked through.”

The GPhC was responding to the government’s proposals which will impose a 6% cut in pharmacy remuneration from October and a reshaping of pharmacy services.

It pointed out that the financial settlement for community pharmacy in England or the proposed introduction of efficiencies into the pharmacy service are not in themselves matters for the GPhC as an independent regulator. “However, any significant changes to the range or methods of delivery of services provided by our registrants will have implications for our work,” it said.

It was also critical for the GPhC to monitor how services develop across England, Scotland and Wales “and the expectations society places on pharmacy professionals, particularly if there is a continuing shift in public policy towards an increasingly clinical role for pharmacy professionals.”

Among the changes the GPhC will need to consider are:

the implications for its work developing a framework for continuing professional development;

the way it regulates pharmacies if there is a significant change to online pharmacy service deliver;

the way it inspects pharmacies if patients increasingly select ‘click and collect’ for prescription delivery.

“The Council has made clear its view that attempts to address health and care challenges will benefit from an enhanced role for pharmacy in general, as well as pharmacists and pharmacy technicians as regulated health professionals,” said Nigel Clarke, GPhC Chair.

“Changes to health and care delivery and the structure of the contract will need careful consideration by us as we continue to ensure regulation of the pharmacy team and registered pharmacies remains appropriate and effective.”

Last week Community and Social Care Minister Alistair Burt had said that the Government’s proposals represent “big opportunities – a chance for pharmacists and their teams to play an even greater role in helping people with long term conditions and making sure patients get the best from their medicines.”

Speaking at the launch of a Royal Pharmaceutical Society report on optimising medicines in care homes, Mr Burt said he recognised that some of the government’s proposals had caused “uncertainty and concern”. However, he anticipated the introduction of a Pharmacy Integration Fund set at £20 million in 2016-17 and rising by an additional £20 million per year “will help enable clinical pharmacy practice in a range of primary care settings.”

Mr Burt said the government “will consult on amending legislation to allow independent pharmacies to benefit from ‘hub and spoke’ dispensing models which will free up pharmacists to spend more time delivering personal advice and support.”

He added: “I know there are some that say that this signals the end of community pharmacy as we know it. I utterly reject this. What it is about is ensuring that we move towards a sustainable long-term future for pharmacy in all its guises.”

The National Pharmacy Association has taken its petition challenging the proposals to the streets. Last Friday it joined with the British Pharmaceutical Students Association and other national pharmacy bodies to run events at Elephant & Castle Shopping Centre in London and at university campuses encouraging people to support community pharmacy.

“Nearly 1,000 signatures were collected at the shopping centre event alone. Over 20,000 signatures have already been collected in total, a week since launch,” said the NPA afterwards.

HDA Media And Political Bulletin – 3 March 2016

From Factory to Pharmacy

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