News

HDA UK Media and Political Bulletin – 25 May 2021

Media Summary

Pharmacy funding: Simon Dukes says “feet dragging by HM treasury is scandalous”
Pharmacy Business, Nozia Sayyed, 24 May 2021

Pharmacy Business reports that over 30 parliamentarians have called on the Chancellor of the Exchequer, Secretary of State for Health and the Chief Secretary to the Treasury to write off the £370 million in emergency Covid-19 loans provided to community pharmacies.

The call was initiated by Chair of the All-Party Pharmacy Group (APPG) Jackie-Doyle Price, who is supported by the Pharmaceutical Services Negotiating Committee (PSNC) and other national pharmacy organisations.

Industry leaders have warned that if high street pharmacies are forced to shut the Covid-19 vaccination rollout and the autumn flu jab campaign will be in at risk.

Simon Dukes, Chief Executive of the Pharmaceutical Services Negotiating Committee, was quoted: “Pharmacy teams have never worked harder than in the past year, and they have never been relied on more by patients and the rest of the NHS.”

He said that negotiations on Covid-19 costs have been going on since last year and pharmacies need to be viewed as “the critical healthcare providers that they are.”

Reported number of full-time PCN pharmacists grows to almost 2,000
Chemist and Druggist, Valeria Fiore, 24 May 2021

The Chemist and Druggist reports that the number of full-time equivalent (FTE) pharmacists reported to be working for primary care networks (PCN) was 1,929 as of March 2021.

According to data from NHS Digital, there were 153 FTE PCN pharmacists in March 2020, however, only 15% of active PCNs were sharing their workforce data at the time.

The provisional data shows that the reported number for FTE pharmacy technicians increased from three in March 2020 to 373 a year later.

Pharmacists were added to the Government’s ‘shortage occupation list’ earlier this year, a decision that was welcomed by the Association of Independent Multiple Pharmacies, which said “community pharmacies continue to lose experienced pharmacists to PCN-related activity”.

‘Hub-and-spoke: Why modern doesn’t necessarily mean machines’
Chemist and Druggist, Laura Buckley, 24 May 2021

An opinion piece in the Chemist and Druggist reports that the hub-and-spoke dispensing model has created divisions in the pharmaceutical sector.

The hub-and-spoke model is designed to free up time for pharmacy teams and minimize costs of employing staff.

The article raises concerns of a large-scale rollout of hub-and-spoke and how it will impact jobs and patient access to community pharmacy. Smaller chains and independent pharmacies may struggle to develop or rival models like the hub-and-spoke.

Laura Buckley, the author, a locum and a pharmacist at a PCN in East Yorkshire suggests community pharmacies offer a more personalised and safer form of care. She is skeptical about the impact of hub-and-spoke and identifies the potential drawbacks of hub-and-spoke as it relies on robotics and technology.

 

 Parliamentary Coverage

There was no parliamentary coverage today.

 

Full Coverage

Pharmacy funding: Simon Dukes says “feet dragging by HM treasury is scandalous”
Pharmacy Business, Nozia Sayyed, 24 May 2021

Over 30 parliamentarians from all political parties have called on the Chancellor of the Exchequer, Secretary of State for Health and the Chief Secretary to the Treasury to urgently write off the £370m in emergency Covid-19 loans granted to community pharmacies last year.

In a letter sent last weekend, they have also been urged to deliver a “more sustainable” long-term funding solution for the sector.

The call was initiated by chair of the All-Party Pharmacy Group (APPG) Jackie-Doyle Price, who enjoys an strong support from PSNC and other national pharmacy organisations.

The Sunday Times reported on May 23 that local pharmacies were facing closure because the Treasury was demanding repayment of emergency loans it gave them to help stay open during the Covid pandemic.

Ministers have been warned by industry leaders that the Covid vaccination rollout and the autumn flu jab campaign will be in jeopardy if high street pharmacies giving them out were forced to shut, industry leaders warned this weekend.

The paper quoted Simon Dukes, chief executive of the Pharmaceutical Services Negotiating Committee, as saying: “Pharmacy teams have never worked harder than in the past year, and they have never been relied on more by patients and the rest of the NHS. And this hasn’t stopped — pharmacies are still helping the Covid-19 vaccination programme and they’re now a key player in the provision of NHS Covid tests. Why the government would reward them for their loyalty by putting their livelihoods at risk is a question I don’t have an answer to.”

Dukes said: “We’ve been negotiating on Covid costs since July last year, and the feet-dragging by HM Treasury is scandalous.

“The emergency pharmacy loans received last year have been used by some of our most valuable healthcare providers on offering safe services for the NHS to help their patients during a global health crisis.

“This money has been spent. Pharmacy teams have never worked harder than in the past year, and they have never been relied on more by patients and the rest of the NHS,” he said.

Dukes added that the negotiations have been going on since last year and “we are now in for it for the year ahead. Pharmacies want to get on with delivering the new services that we had planned; but we can’t do that with the loans issue still hanging over our heads. Pharmacies need answers, and they need to be treated as the critical healthcare providers that they are.”

Community pharmacies were granted a total of £370m in advance payments to help alleviate cashflow issues at the start of the Covid-19 pandemic. However, negotiations on those loans are still ongoing, alongside negotiations on Year 3 of the five-year Community Pharmacy Contractual Framework (CPCF) deal.

In his video message released a few days ago Dukes said, “Delivering new services under the CPCF will not be possible without a satisfactory outcome on pharmacy’s Covid-19 costs; the Committee is determined that contractors’ Covid costs are covered.”

Furthermore, many MPs who voiced their support for the community pharmacy in a House of Commons debate on the future of NHS and social care held last week (May 19) stressed on the important role pharmacies have played during the pandemic.

One of them James Cartlidge, Conservative MP for South Suffolk, said: “Community pharmacy is doing a huge amount already, but it has earnt its spurs during the pandemic, giving out over 3 million jabs to date.
“This is more than the entire population of Greater Manchester. It is now seen in my constituency how community pharmacies can really make a difference. My constituents have chosen them as their preferred place to receive a jab and it shows what more they can do. We must give them a deeper role in the delivery of healthcare in this country.”

Elliot Colburn, Conservative MP for Carshalton and Wallington, said: “I want to raise in particular the incredible effort throughout this pandemic of our amazing community pharmacists, who are so often left out of the conversation.

“They have demonstrated just how important they are, and we must reward this effort by reviewing their funding model, expanding their roles and giving them a seat at a strategic ICS level to help shape the future of healthcare delivery in their local areas.”

Currently the government has been faced with the challenge of trying to balance the books after spending billions of pounds helping the NHS and other public services to tackle the virus.

“But pharmacy leaders warn that even chemists that manage to stay afloat if forced to pay back the cash will still have to take drastic steps such as cutting staff or stock levels, and stopping unpaid services such as the delivery of items to patients’ homes, which could leave patients waiting much longer to receive vital medicines,” the paper reported.

Reported number of full-time PCN pharmacists grows to almost 2,000
Chemist and Druggist, Valeria Fiore, 24 May 2021

The number of full-time equivalent (FTE) pharmacists reported to be working for PCNs was 1,929 as of March 2021, experimental data from NHS Digital has shown.

There were 153 FTE primary care network (PCN) pharmacists as of March 2020 – when NHS Digital began recording PCN workforce data. However, only 15% of active PCNs were sharing their workforce data at the time, NHS Digital told C+D today (May 24).

As of March 2021, 68% of the existing 1,253 PCNs were using the national workforce reporting system and reported that a total of 1,929 pharmacists were working within a PCN, according to PCN workforce data published by NHS Digital last week (May 20).

The provisional data shows that the reported number for FTE pharmacy technicians increased from three in March 2020 to 373 in March 2021.

291 PCNs employed at least one pharmacy technician

According to the data, 480 PCNs had either not employed or not recorded employing an FTE pharmacist. Meanwhile, 291 had reported hiring at least one FTE pharmacy technician.

Most staff employed by PCNs are funded through the additional roles reimbursement scheme (ARRS). Last year, the scheme was broadened to include pharmacy technicians hired by PCNs, for whom they can claim a maximum annual reimbursement rate of £35,389.

In some cases, one role might be covered by more than one person and the working hours might be completed by a group of healthcare professionals employed by another organisation and deployed to work for the PCN as a “contracted service”, NHS Digital said.

In that case, “the PCN provides us with information about the average weekly working hours covered by that ‘contracted service’”, according to NHS Digital.

Regions with the highest number of reported PCN pharmacists

The Midlands was the region with the highest number of reported FTE PCN pharmacists, of which there were 502 as of March this year, according to the NHS Digital data set.

It was followed by London, which had 337, and North East and Yorkshire, which reported 298 FTE pharmacists.

Pharmacists were added to the government’s ‘shortage occupation list’ earlier this year, a decision that was welcomed by the Association of Independent Multiple Pharmacies, which at the time told C+D that “community pharmacies continue to lose experienced pharmacists to PCN-related activity”.

‘Hub-and-spoke: Why modern doesn’t necessarily mean machines’
Chemist and Druggist, Laura Buckley, 24 May 2021

Hub-and-spoke dispensing appears to be the Marmite of the pharmacy world; I’ve seen it divide opinions in a way that only Brexit could rival.

Employing sizeable hubs to dispense medicines on a large scale for redistribution to either pharmacies or direct to patient doesn’t sit right with me, so you could say I’m not a lover of this model.

While freeing up pharmacy teams to provide more services seems to be the aim of the game, I remain unconvinced and concerned about a potential impact on job losses and patient interaction. If we consider the services that the hub-and-spoke model is supposed to be freeing pharmacy teams up for, we need to see them commissioned first and in such a way that ensures a steady income for pharmacies and adequate training provision for those involved. Patients need to benefit in a big way to make this model even worth considering; I’m not so sure a move to hub-and-spoke holds patients’ interests at heart.

For me, it all seems too business-focussed and feels like it benefits the large multiples, allowing them to churn out medicines factory-style, while minimising the costs of employing staff. What should we expect for the smaller chains and independent pharmacies that cannot possibly develop or rival models like the hub-and-spoke?

I’m concerned that the benefits of such a large-scale rollout of hub-and-spoke will be severely outweighed by the negative impact on so many job roles and will risk destroying the infrastructure that underpins patient access to community pharmacy. As more hubs open, are we to expect fewer spokes in the community, thereby reducing the pharmacy/pharmacist-to-patient ratio? Will this reduce local access to community pharmacy?

Are we to see a move to robotics, which is expensive and replaces a workforce? And what of the evidence to support the move in this direction?

As a pharmacist, I very much believe in community pharmacies and their work remaining in the heart of the community. I think building patient relationships and being familiar with their medicinal needs is safer, more satisfying for the patient and a more personalised form of care. There’s comfort in knowing those who prepare your prescriptions and there’s comfort in knowing you can call in at your local pharmacy at any point. Robotics don’t have the same senses that pharmacists do and while you can programme a machine to be efficient, can you instil the sixth sense for concern that pharmacists develop from years of training and experience?

Without adequate commissioning of services and a lack of need to dispense due to hubs, it wouldn’t be economically viable to keep pharmacies open and I fear it would be the end for traditional community pharmacy as we know it. Patients deserve better than this and we as a workforce deserve more than being subjected to a system overhaul to make us more of a factory and less of a pharmacy.

Change is inevitable and we have been clamouring for change in the community pharmacy sector for a long time. But change in the form of developing more hub-and-spoke dispensing, and without evidence to support safety for patients and the safeguarding of jobs and patient access, feels like a rash move. I’m yet to see compelling information to convince me that hub-and-spoke is a positive move for pharmacy; modern doesn’t mean machines and factory settings, it means personalised care for patients without cutting corners to make profit.

HDA UK Media and Political Bulletin – 25 May 2021

From Factory to Pharmacy

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