HDA UK Media And Political Bulletin – 19 April 2017

Media Summary

Judge dismisses High Court pharmacy cut claims

Chemist and Druggist, Anabelle Collins, 18 May 2017

The National Pharmacy Association’s (NPA) and the Pharmaceutical Services Negotiating Committee’s (PSNC) cases against the funding cuts have been dismissed by a High Court judge. Judge Justice Collins recognised that the evidence presented by the NPA and PSNC suggests there is a “real risk” there will be “less access because of the inability to keep some pharmacies open for as many hours”. One further example given was free delivery services, which may have to cease due to cuts.

Concessions Announcement
PSNC, 17 May 2017

The Department of Health have announced the following price concessions for May 2017:

 

Drug Pack size Price concession
Buspirone 10mg tablets 30 £9.95
Buspirone 5mg tablets 30 £9.95
Clindamycin 150mg capsules 24 £4.85
Dapsone 50mg tablets 28 £46.19
Diamorphine 30mg powder for solution for injection ampoules 5 £16.52
Ethosuximide 250mg/5ml oral solution 200ml £173.00
Exemestane 25mg tablets 30 £12.00
Leflunomide 10mg tablets 30 £8.50
Leflunomide 20mg tablets 30 £8.50
Mefenamic acid 500mg tablets 28 £59.99
Mirtazapine 15mg tablets 28 £3.00
Mirtazapine 45mg tablets 28 £3.00
Nitrofurantoin 100mg tablets 28 £11.93
Nitrofurantoin 50mg tablets 28 £20.50
Oxazepam 10mg tablets 28 £7.97
Oxazepam 15mg tablets 28 £7.97
Pramipexole 88microgram tablets 30 £11.24
Ropinirole 5mg tablets 84 £165.00
Sodium cromoglicate 2% eye drops 13.5ml £5.99
Spironolactone 50mg tablets 28 £5.20
Tranexamic acid 500mg tablets 60 £11.50
Valsartan 160mg capsules 28 £17.10
Valsartan 40mg capsules 28 £8.80
Valsartan 80mg capsules 28 £11.43
Zolmitriptan 2.5mg orodispersible tablets sugar free 6 £15.22
Zolmitriptan 2.5mg tablets 6 £14.99

No endorsements are required as these prices will automatically be applied to this month’s prescriptions.

When any NCSO or price concession announcements are made, these appear on the Generic Shortages page (psnc.org.uk/ncso) and are emailed to those subscribed to this mailing list.

Parliamentary Coverage

There is no Parliamentary Coverage

Full Coverage

There is no full coverage.

PSNC seeks Judicial Review of consultation on community pharmacy

PSNC, 1 December 2016

 

PSNC is seeking a Judicial Review of the Secretary of State’s October decision to implement cuts to community pharmacy funding and other changes.

 

PSNC has sought permission from the High Court to apply for the Judicial Review on the grounds that it believes the Secretary of State failed to carry out a lawful consultation on the proposals for community pharmacy.

 

An ‘expedited hearing’ has been requested, so that if permission to seek Judicial Review is granted, the hearing will take place as soon as practicable.

 

PSNC accepts the need for the NHS to achieve efficiencies within the community pharmacy sector and is not challenging this principle, but it does not believe that the consultation process on the proposals that are now being implemented complied with the requirements of a lawful consultation.

 

PSNC believes that the Department of Health (DH) has used poor data which it did not disclose as a basis for its decision, rather than updating existing high quality data.

 

PSNC’s application raises a number of concerns about the consultation, including:

 

  • The DH’s failure to disclose the fact that it had carried out an analysis of pharmacies’ profitability based on Companies House data as part of its Impact Assessment.
  • The delay in providing this analysis to PSNC after the publication of the Impact Assessment.
  • The validity of the DH analysis including the sample size and the use of accounting returns, rather than economic returns, as the basis for the assessment of pharmacies’ economic viability and how they might be affected by the changes.
  • The DH’s failure to analyse what the levels of pharmacy closures may be.

 

PSNC has been taking legal and other expert advice since the letter of December 17th 2015 and in recent weeks working closely with other pharmacy organisations also exploring legal options. The National Pharmacy Association is named as an interested party in PSNC’s application.

 

PSNC Chief Executive Sue Sharpe said:

 

“PSNC’s role is to represent community pharmacy contractors. We have always sought to do this by working positively with the NHS to ensure that community pharmacies can do their best to meet the needs of the NHS, patients and local communities, and that the NHS recognises and acknowledges the value they provide.

 

PSNC has spent the past twelve months trying to work constructively with the Department of Health and NHS England to enable community pharmacy to help the NHS to meet the increasing challenges that it faces. We have sought to avoid taking legal action and very much regret that the process the NHS has followed has made this impossible.”

 

ABPI gives evidence to Exiting the EU Commons Select Committee on Brexit priorities

ABPI, 2 December 2016

 

Dr Virginia Acha, ABPI’s Executive Director of Research, Medical and Innovation has told MPs on the Exiting the European Union (EU) Committee that for the UK pharmaceutical industry a primary objective for Government in Brexit negotiations should be to secure alignment and cooperation with EU medicines regulation.

 

​​The UK is currently part of the European Medicines Agency (EMA), a network that facilitates the harmonisation of medicines regulation for more than 25% of global pharmaceutical market and over 500m patients. This includes EU member states, and non-EU members of the European Economic Area (EEA), Iceland, Liechtenstein and Norway.

 

Robust and internationally aligned medicines regulation, has been essential for protecting and improving the health of patients, has ensured effectiveness and safety, and has brought forward advances in medical innovation to large patient populations in a way that minimises delays and cost.

 

The UK having an aligned framework in place for medicines regulation ‘from day one’ of leaving the EU would be important for maintaining drugs availability and supply.

 

Dr Acha also told the Committee that recently announced Government funding for science and innovation was extremely welcome. In order for this to be maximised, enabling UK researchers and academics to continue global collaboration should be a goal of Brexit negotiations. In line with other leading UK business sectors, she also highlighted that maintaining the ability to trade and move goods and capital across borders, and prioritising ease of movement of global talent for high-value industries, are important for pharmaceutical companies in the UK.​

 

Mike Thompson, ABPI’s Chief Executive commented:

 

“As we lay the foundations for leaving the European Union, last week’s Autumn Statement sent a clear message that a productive high-wage, high-skill economy of the future can be built through investing in UK science and innovation.

 

To make this a reality, maintaining the strength of the UK’s pharmaceutical industry should be a Brexit priority.

 

Government has indicated that they are looking to achieve a bespoke Brexit deal for Britain. As part of this, there are several options for the regulation of medicines. This critical area has a significant impact on the pharmaceutical industry, and we are working with Government to outline the mutual benefit in striking a deal for the benefit of patients in the UK and patients across Europe.

 

UK alignment and cooperation with the EU framework for medicines regulation can be a common goal for our Government and for member states, and should be a priority objective in Brexit negotiations.”

 

​Find out more about our work on what Brexit means for the pharmaceutical industry and our work with Government to maintain and grow of a world-leading Life Sciences environment in the UK outside of the EU.

Obscene drug profits to be outlawed

25 October 2016, The Times, Billy Kenber, Alexi Mostrous

 

Under new legislation proposed by the Department of Health, drug companies will be banned from generating large profits from the NHS. The Health Service Medical Supplies (Costs) Bill is being introduced following an investigation by The Times that uncovered several pharmaceutical companies exploiting a loophole in NHS rules. Some companies are thought to have raised prices of generic medicines by up to 12,500%. Under this new legislation drug companies will be required to provide the Government with information on the profit margins of their medicines. The Government will have the power to enforce a lower price if they have cause to believe the NHS is being overcharged.

 

NHS drug suppliers investigated over prices

26 October 2016, The Guardian

 

The Competition and Markets Authority (CMA) has begun investigating drug companies believed to have been overcharging the NHS for medicines. If these companies are found to have broken the law they may be fined up to 10% of their turnover. The CMA began the investigation after an article in The Times revealed that several drug companies were taking advantage of a loophole in NHS rules to excessively raise the price of generic medicines.

 

Will Wales follow England’s lead with pharmacy funding cuts?

24 October 2016, Chemist & Druggist, Beth Kennedy

 

Vaughan Gething, the Cabinet Secretary for Health, Wellbeing and Sport in Wales, has said that the Government has no current plans to reduce community pharmacy funding. However, he did say that the cuts in England provide an opportunity for the Welsh Government to appraise whether the investment they are making in the pharmacy sector will benefit the Welsh people in the future. However, Vaughan Gething clarified that the Welsh health and social services budget does not currently contain proposals for the reduction of community pharmacy funding.

 

The community pharmacy funding cuts in England were further reported in Pharmaphorum

 

Parliamentary Coverage

 

House of Commons Questions, Drugs: Wholesale Trade

Health

Tom Brake: What measures his Department has in place to (a) monitor and (b) limit the amount of profit which pharmaceutical wholesalers are able to make from the NHS each year.

David Mowat:

The Department introduced the Health Service Supplies (Costs) Bill on 15 September. This Bill is intended to enable my Rt. hon. Friend the Secretary of State to make regulations to obtain information from across the supply chain to assure itself that all parts of the supply chain provides value for money to the National Health Service and the taxpayer. We expect everyone in the NHS and the supply chain should play its part in achieving efficiency savings.

 

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House of Commons Questions

Health

Tom Brake: What assessment he has made of the potential merits of making savings in the pharmaceutical supply chain instead of reducing funding to community pharmacies

David Mowat:

The Department introduced the Health Service Supplies (Costs) Bill on 15 September. This Bill is intended to enable my Rt. hon. Friend the Secretary of State to make regulations to obtain information from across the supply chain to assure itself that all parts of the supply chain provides value for money to the National Health Service and the taxpayer. We expect everyone in the NHS and the supply chain should play its part in achieving efficiency savings.

 

Full Coverage

Obscene drug profits to be outlawed

25 October 2016, The Times, Billy Kenber, Alexi Mostrous

 

Drug companies will be blocked from extracting “obscene profits” from the health service under new legislation welcomed by MPs.

A bill preventing pharmaceutical companies from massively increasing the cost of common medicines was introduced after The Times revealed in June that several were exploiting a loophole to deprive the NHS of £262 million last year alone.

The companies acquired the marketing rights for old medicines long out of patent and increased prices by up to 12,500 per cent.

They were able to circumvent profit caps imposed by the Department of Health by dropping the brand name.

Under new legislation, drug companies would be forced to provide information on how much money they are making from medicines and the government would be able to impose a lower price if it felt the health service was being overcharged. Introducing the second reading of the bill last night, Jeremy Hunt, the health secretary, said: “We cannot allow this practice to continue unchallenged.”

 

NHS drug suppliers investigated over prices

26 October 2016, The Guardian

 

The competition watchdog has launched an investigation into drug companies accused of charging the NHS excessive prices.

If the companies are found by the the Competition and Markets Authority to have broken the law, they could face fines of up to 10% of their turnover.

The CMA said: “The investigation relates to suspected unfair pricing by way of charging excessive prices in the supply of certain pharmaceutical products, including to the National Health Service.”

The health secretary, Jeremy Hunt, called in the CMA in June after an investigation by the Times suggested companies were exploiting a loophole in NHS rules to raise prices of medicines.

The newspaper alleged that companies faced limited competition on long-established, off-patent drugs, bought from large pharmaceutical firms. It was also claimed that the prices of 32 drugs had risen by more than 1,000% in the past five years.

Concordia International said it was one of the companies being investigated. A spokesman said: “We are working co-operatively to better understand the CMA’s position and we will continue to work constructively to resolve the matter.

“Although Concordia has also had past discussions with the CMA regarding the supply of certain of its products in the UK, this is the first interaction with the CMA regarding the company’s pricing.”

 

Will Wales follow England’s lead with pharmacy funding cuts?

24 October 2016, Chemist & Druggist, Beth Kennedy

 

Cuts to funding in England provides the Welsh government an “opportunity to reflect” on its own investment in community pharmacy, a health minister has said.

Cabinet secretary for health, wellbeing and sport Vaughan Gething reassured pharmacists in his country that the government has no current plans to reduce community pharmacy funding, despite England’s pharmacy budget being cut by £113 million from December.

However, the “changes” in England provide an opportunity to reflect on whether the “considerable investment” the Welsh government makes in the sector “will meet the needs of people in Wales in future”, he said in a statement on the day the cut was finalised (October 20).

Mr Gething acknowledged that English funding cuts, would be “of concern” to Welsh pharmacists, because the community pharmacy contract has been the same for Wales and England since 2005.

But he clarified that the Welsh health and social services budget does not include proposals to reduce community pharmacy funding.

Maintaining current funding levels will be “conditional” on the sector in Wales complying with “new arrangements” from April 2017, including providing more and improved clinical services, reducing medicines waste and using automation to free up pharmacists’ time, Mr Gething stressed.

The government will consult Community Pharmacy Wales over the plans, and Mr Gething will make a further statement once this consultation ends, he added.

 

Government pushes on with pharmacy funding cuts

25 October 2016, Pharmaphorum, Richard Staines

 

The government has announced it is to push forward with plans that could, according to some estimates, lead to thousands of pharmacies closing across England.

In a statement to the House of Commons last week, junior health minister David Mowat, confirmed plans to reduce the £2.8 billion annual pharmacy bill by around £200 million over the next two years.

The government had briefly put the plans on hold because of a public outcry against them, but that wait seems to be over.

The proposals were roundly criticised by a panel of experts in a pharmaphorum/IMS Health webinar earlier this year.

They said the cuts would hit the most vulnerable people the hardest, such as elderly people who rely on their pharmacists for health advice as well as medicines.

Mowat said there are more than 11,500 pharmacies in the country, an increase of over 18% in the last decade.

The overall spend has increased by 40% over the past decade and now stands at £2.8 billion annually, he said in the statement.

He added that on average each pharmacy receives nearly £1 million for the NHS goods and services it provides, of which £220,000 is direct income. This includes a £25,000 fixed sum payment paid to most pharmacies “regardless of size and quality”, said Mowatt.

“There are instances of clusters of up to 15 pharmacies within a 10-minute walk of each other. When the overall NHS budget is under pressure and we need to find £22 billion in efficiency savings by 2020, it is right that we examine all areas of spend and look for improvements.”

Under the plan “Community Pharmacy in 2016-17 and Beyond”, pharmacies will receive £2.687 billion in 2016-17 and £2.592 billion in 2017-18 – a 4% reduction followed by a 3.4% reduction.

Mowat noted in his statement that the government will introduce a review process to deal with unforeseen circumstances affecting access such as road closure, and review cases where areas may need more coverage due to high levels of deprivation.

The government has listed around 1,300 pharmacies that will receive additional payments until March 2018 because they are in areas with deprivation or areas that have poor coverage.

Payments under the scheme will be £11,600 this financial year and £17,600 the following year under the pharmacy access scheme – although there is no commitment for further payments beyond March 2018.

Barbara Keeley, Labour MP for Worsley and Eccles South, noted previous warnings that up to 3,000 pharmacies may close as a result of the cutbacks.

She said: “The government’s plans are not only deeply unpopular; they are short-sighted, and will hit the areas with the greatest health inequalities hardest.”

Dismissing the warnings as “scaremongering”, Mowat responded: “It is possible that none will close. I do not believe that 3,000 will close.”

The Pharmaceutical Services Negotiation Committee (PSNC), which represents pharmacies, has already rejected the proposals.

This year’s negotiations were “not characterised by collaborative working” and the proposals were presented as a “fait accompli” by the government, the PSNC added.

APPG to ‘scrutinise’ Government’s funding reforms

24 October 2016, Chemist & Druggist, Annabelle Collins

 

The All-Party Pharmacy Group (APPG) is planning to investigate the Government’s planned cuts to community pharmacy funding.  The APPG has announced that they want to engage with the Pharmacy Minister, David Mowat, alongside officials from the Department of Health, pharmacy organisations and patient representatives. The investigation will be led by the APPG in order to better understand how the cuts to funding will impact community pharmacies in England.

 

This was also reported by Pharmacy Business

 

Parliamentary Coverage

House of Commons Written Questions; Pharmacy: Competition, 24 October 2016

Business, Energy and Industrial Strategy

 

Tom Brake: Whether he has had discussions with the Competition and Markets Authority on the implications for competition of the vertical integration of pharmacies and pharmaceutical wholesalers; and if he will make a statement.

 

Department for Business, Energy and Industrial Strategy

 

Margot James:

I have had no discussions with the Competition and Markets Authority on the implications for competition of the vertical integration of pharmacies and pharmaceutical wholesalers.

Full Coverage

APPG to ‘scrutinise’ Government’s funding reforms

24 October 2016, Chemist & Druggist, Annabelle Collins

 

The all-party pharmacy group (APPG) will “investigate” and “scrutinise” the government’s planned cut to community pharmacy funding, it has announced.

The APPG will hold evidence sessions to “better understand the impact of the plans”, the parliamentary group announced today (October 24).

It pledged to invite pharmacy minister David Mowat to give evidence, alongside Department of Health (DH) officials, the pharmacy bodies and patient representatives.

The group will investigate how the DH aims to ensure that pharmacies continue to provide health services to keep patients away from GPs and A&E departments, on a “lower funding package”, APPG chair and Labour MP Kevin Barron said.

Sir Kevin also said the group would look at how pharmacies will adapt their businesses and what the funding cut might mean to patients.

“It’s important to me that no community is left without a pharmacy, but also that pharmacies which remain open don’t have to cut back on the services they provide,” Sir Kevin said.

Sir Kevin was among the MPs who questioned Mr Mowat on two occasions last week about the government’s decision to cut the sector’s funding.

During the debate last Thursday (October 20), Sir Kevin questioned Mr Mowat on when regulations would be put in place to enable pharmacies to merge – which the government has suggested as a solution to its belief there are too many pharmacies in some areas.

Mr Mowat responded that the regulations would be in place by December 1.

 

APPG TO CALL ON MOWAT IN FUNDING CUTS INVESTIGATION

24 October 2016, Pharmacy Business, Neil Trainis

 

The All-Party Pharmacy Group has said it will “investigate and scrutinise” the government’s pharmacy funding cuts and invite the community health and care minister David Mowat to answer questions on reforms which pharmacy leaders believe threaten their profession’s existence.

Pharmacy is still reeling from last week’s announcement by the government that its funding will be cut by 4% and 7% in 2016-17 and 2017-18 respectively.

The PSNC and the National Pharmacy Association have indicated they are considering their legal position in relation to the cuts and impact on its members.

The APPG said it will bring together government officials, pharmacy representatives, patient organisations and representatives from the wider NHS to assess the rationale and implications of the cuts.

“The All-Party Pharmacy Group has long called for more health services from community pharmacies to keep people well and away from GP surgeries and hospitals,” said Sir Kevin Barron (pictured), chair of the APPG.

“The Department of Health wants pharmacies to do that within the lower funding package announced. We will investigate how the Department will square that circle, how pharmacies will respond, and what it will mean for patients.

“It’s important to me that no community is left without a pharmacy, but also that pharmacies which remain open don’t have to cut back on the services they provide.”

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.”

The Department of Health has announced a new 2 year funding package for community pharmacy. Read the Government’s full plans here: ‘New plans to modernise community pharmacies’ and here: Community pharmacy reforms.

The parliamentary debate on the announcement can be found here.

Government imposes community pharmacy funding reduction
20 October 2016, PSNC

The Government has announced a 2 year funding package for community pharmacy. The package will see contractors funding cut by 12% from December in comparison to current funding levels. Sue Sharpe, the Chief Executive of PSNC made a statement in response to the announcement. She made it clear that the PSNC could not accept a funding package that had potentially damaging consequences for the sector. Miss Sharpe highlighted that although pharmacy closures will not occur immediately the cuts may result in the reduction of services community pharmacies can offer as owners are forced to reduce costs. The PSNC argues that the NHS relies on community pharmacies to relieve pressure on their services, especially in the winter months. There is now a concern that community pharmacies will no longer have the capacity to provide such services and there will be repercussions for the entire health system.

Why the justification for the cuts is ‘complete nonsense’
20 October 2016, Chemist & Druggist, James Waldron

The Government has announced a funding cuts package for community pharmacy at the same time as announcing a new role for community pharmacy in the emergency supply of medicines. The National Pharmacy Association (NPA) branded the emergency supply care role as a smoke screen for the proposal of the funding cuts. The Department of Health told Chemist & Druggist last week that the funding cuts package should be considered in the context of the Government’s ambition to invest a total of £112 million to create a further 1,500 GP pharmacists by 2020. However, James Waldron, Editor of Chemist & Druggist, highlighted that giving GP’s greater access to pharmacists does not balance out the loss of community pharmacies that will be forced to close across the country as a result of the cuts to funding.

Pharmacy plan ‘could lead to High Street closures’
20 October 2016, BBC News, Nick Triggle

The new pharmacy funding package, due to be implemented from December 2016, places a larger emphasis on performance- related funding than the current system. The pharmacy industry has been lobbying the Government, warning them that the newly announced cuts would be damaging to the capacity of A&E departments and GP surgeries.

NHS pharmacy cuts: Tory ministers accused of piling even more pressure on A&Es
20 October 2016, The Independent, Rob Merrick

Ministers from the Department of Health have been accused of creating more pressure for GP surgeries and A&E departments in England as a result of cuts to community pharmacy. Opposition parties to the cuts have warned that they could result in the closure of hundreds of vital community pharmacies across the country. Norman Lamb, the Liberal Democrat Health Spokesman, has said that the reductions are a false economy as cutting funding for community pharmacies will not improve their efficiency. He stressed that the funding cuts will increase pressure on GP surgeries and hospitals that already have limited resources.

The pharmacy cuts coverage was also reported by the ITV NewsPharmaceutical Journal, the PharmaTimesPharmacy Business and P3 Pharmacy (here and here)

The National Pharmacy Association and the Pharmacy Voice (reported here and here) have commented on the imposition of the cuts.

Establishment payments to plummet 20% from December
20 October 2016, Chemist & Druggist, Annabelle Collins

The Department of Health has announced that established payments for community pharmacies in England will drop by 20% from December. From April 2017 these payments will be reduced by a further 40% from their current levels. Community pharmacies receive established payments if they dispense over 2,500 prescriptions a month, however the Government has announced intentions to phase out these payments over the coming years.

DH publishes pharmacy access scheme details
20 October 2016, Dispensing Doctors Association, Alisa Colquhoun

The Department of Health published the details of the new Pharmacy Access Scheme (PhAS). The PhAS means that pharmacies run by GP practices will receive fewer cuts to their funding. The scheme also means that pharmacies dispensing up to 109,012 prescriptions a year and if they are located at least one mile away from its nearest competition will make a smaller efficiency saving than other pharmacies. These PhAS concessions will continue monthly until the payment for March 2018. NHS community pharmacy funding and PhAS beyond March 2018 will be subject to further consultation. From December 2016 any pharmacies in England that do meet the eligibility criteria for PhAS will be subject to the pharmacy funding cuts announced by the Department of Health on October 20th 2016.

This was also reported by Pharmacy Voice

Brexit will increase drugs shortages and lower value of parallel imports
20 October 2016, Pharmacy Business, Neil Trainis

Rajiv Shah, the Director of Sigma Pharmaceuticals, has warned that one of the implications of Brexit will be a resultant increase in drug shortages in the UK. He explains that Brexit may complicate the process of medicine distribution throughout the UK. He goes on to warn that importation and exportation levies being placed on UK companies will cause inflated drug prices and ultimately increase the likelihood of drug shortages. Shah also explains that a weakened pound will result in a 40-50% drop in the value of parallel imported products.

 

October 2016 Price Concessions

20 October 2016, PSNC

 

The Department of Health has granted the following price concessions for October 2016:

The price concession only applies to the month that it is granted.

Drug Pack size Price concession
Amitriptyline 50mg tablets 28 £3.25
Bumetanide 1mg tablets 28 £2.10
Dapsone 50mg tablets 28 £46.19
Lamotrigine 5mg dispersible tablets sugar free 28 £7.45
Leflunomide 20mg tablets 30 £5.10
Lorazepam 1mg tablets 28 £6.25
Metronidazole 400mg tablets 21 £8.00
Naratriptan 2.5mg tablets 6 £24.55
Nitrofurantoin 100mg tablets 28 £14.02
Nitrofurantoin 50mg tablets 28 £16.00
Ropinirole 0.5mg tablets 28 £14.85
Ropinirole 1mg tablets 84 £56.71
Valsartan 160mg capsules 28 £5.30
Valsartan 80mg capsules 28 £4.14
Valsartan 40mg capsules 28 £4.90

Please note negotiations are still ongoing regarding a number of products.

No endorsements are required as these prices will automatically be applied to this month’s prescriptions.

When any NCSO or price concession announcements are made, these appear on the Generic Shortages page (psnc.org.uk/ncso) and are emailed to those subscribed to this mailing list.

 

Parliamentary Coverage

 

The Government has announced a new 2 year funding package for community pharamcy. Read the Government’s full plans here: ‘New plans to modernise community pharmacies’ and here: Community pharmacy reforms

The parliamentary debate on the announcement can be found here.

House of Commons Written Questions; Pharmacy: Finance, 20 October 2016
Health

Ben Howlett: 
What assessment he has made of the potential effect of reductions in 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 dispensing of prescriptions and supply of medicines.

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.

###

House of Commons Written Questions; Pharmacy: Finance, 20 October 2016
Health

Derek Thomas: 
What estimate he has made of the effect on the number of community pharmacies of proposed changes to pharmacy funding.

Department of Health

David Mowat:

Community pharmacy is a vital part of the National Health Service 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 including public access to medicines. Our aim is to ensure that those community pharmacies upon which people depend continue to thrive and so we have consulted 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.

Our proposals are about improving services for patients and the public and securing efficiencies and savings. A consequence may be the closure of some pharmacies but that is not our aim.

 

Full Coverage

 

Government imposes community pharmacy funding reduction

20 October 2016, PSNC

The Government has imposed a two-year funding package on community pharmacy, with a £113 million reduction in funding in 2016/17.

This will take total funding to £2.687 billion for this financial year. This is a reduction of 4% compared with last year, but it will mean that contractors will see their funding for December 2016 to March 2017 fall by an average of 12% compared with current levels.

This will be followed by a reduction in 2017/18 to £2.592 billion for the financial year, which will see funding levels from April 2017 drop by around 7.5% compared with current levels.

Read the Government documents outlining the package, including their impact assessment and a list of pharmacies eligible for the Pharmacy Access Scheme, here.

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

As part of the package the Department of Health (DH) will make changes to the way in which funding is distributed, introducing quality payments and a Pharmacy Access Scheme (PhAS).

Further information on these and on which pharmacies will be eligible for the payments is outlined in PSNC Briefing 057/16: Information for Contractors.

The Government has also recently announced a pharmacy urgent repeat medicines supply pilot along with plans to refer NHS 111 callers with minor ailments to pharmacies. The service specification for this is still under discussion but further details are also available in PSNC Briefing 057/16: Information for Contractors.

The imposition, which was announced by minister David Mowat in Parliament today (October 20th), comes after PSNC unanimously rejected the package last week.

Statement from PSNC Chief Executive Sue Sharpe

Today’s news is extremely disappointing but does not come as a surprise; it became apparent some time ago that the Government was unshaken in its determination to make a massive cut to community pharmacy funding by reducing fees and allowances. Indeed, it has been clear in both the wording of the original letter sent on December 17th and in our discussions with the Government and NHS since then that there was to be no genuine consultation on the total funding sum.

PSNC could not accept a funding offer which was damaging to the sector and which will adversely affect the ability of pharmacies to provide patient care.

In response to the consultation on changes to community pharmacy, PSNC set out the need for the Government to make decisions about community pharmacy services based on a number of principles that put the needs of patients and communities, as well as evidence, at the heart of the process.

Sadly, this has not been the case, and we are instead now seeing the implementation of a decision for which no evidence has been produced and which many people, including patient and GP groups, have warned will have a detrimental effect on patient care and lead to further pressure on other healthcare services. This is a short-sighted and ill-judged approach to take, particularly when alternative constructive proposals that would address the need for the NHS to make cash savings have been put forward by PSNC.

It is a sad reflection on the NHS on which we all rely to see it taking such a rash decision with so little justification. But this is not the first time that we have seen decisions that do not seem to be in the best interest of patients or the NHS being made. NHS England’s decision to walk away from commissioning a Minor Ailments Advice Service last summer was damaging to the NHS and to patients. Such decisions call into question the judgement of those in control of community pharmacy policy.

In the past PSNC was able to have constructive negotiations with the NHS based on a mutual desire for community pharmacy to be commissioned and funded to deliver the best possible service for patients and local communities. These conversations were based on trust and respect that we had built up with policy makers over many years. It is very sad that real consultation with us has now been abandoned, and the approach through the last six months has instead been of an entirely different character; “we can do it, so we will do it”, seems to be the mantra. The lack of real consultation and clarity has been a common theme throughout the consultation period.

PSNC will study the Government’s decision carefully to inform our own decisions about next steps.

The funding cut, combined with the previously announced reductions to Category M prices following a significant over-delivery of margin last year, will have a significant and negative impact on contractors’ businesses. We would strongly advise contractors to make whatever provisions they can for the funding reductions. These will be very challenging times.

PSNC remains keen to work with the NHS on changes to the Community Pharmacy Contractual Framework that will allow the development of clinical community pharmacy services so that patients and the NHS can get the most benefit and best value from community pharmacy.
Pharmacy closures

Although we are unlikely to see pharmacies closing immediately, we expect that pharmacy owners will be forced to take steps 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. We are very concerned about the impact that this will have on patients.

We will encourage LPCs and contractors to get together to consider how they can ensure vital local services are maintained. They may need to approach local commissioners to seek funding for services where they are not able to cover their costs.

Impact on patients

Pharmacies have always met demands for help from their patients, particularly in the winter, acting to relieve pressure on other NHS providers. They have done this readily and willingly, but 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. The NHS must recognise this as winter pressures set in and it turns as usual to pharmacy for help.

The Pharmacy Integration Fund

While we are pleased that NHS England has been able to find £42 million over the next two years to support integration, we strongly believe that this should be spent on supporting national community pharmacy services that will better help patients and reduce demand elsewhere on the NHS and will be seeking clarity about how it will be allocated.

Impact on other NHS services

Lots of big policies could be railroaded by these 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. The removal of Establishment Payments will target for the greatest cuts the low dispensing volume pharmacies in areas with the highest health needs. They would see fee income reduced by around 20% next year, at a time when the NHS has said that efficiency targets of 4% are too high to be achievable, and has reduced targets to 2%.

Why the justification for the cuts is ‘complete nonsense’
20 October 2016, Chemist & Druggist, James Waldron

James Waldron questions if any scheme to promote community pharmacy’s emergency supply role will be undermined by the cuts.

They say a week is a long time in politics, but recently it’s felt like that’s just as true for pharmacy.

A quick recap for those of you who haven’t been glued to the C+D website over the last 10 days: On October 13, pharmacy minister David Mowat announced schemes to promote the sector’s urgent repeat supply and minor ailments roles. But community pharmacists barely had time to react before the Pharmaceutical Services Negotiating Committee dropped the bombshell everyone was fearing: the government is planning to bulldoze ahead with its funding cut in England – which will now amount to a 12% drop for December to March, followed by a further cut for 2017-18.

As I write this, official details of how this funding plan will be implemented remain scarce. But a leaked document suggests a promised “access fund” – designed to offer protection from the cuts for the most-needed pharmacies – will benefit just one in 10 businesses.

The only glimmer of hope: the Department of Health (DH) has exclusively told C+D that a “final decision” on the cuts has still not been made. This lent an added urgency to attempts by pharmacy’s political champions to press the minister to reconsider. But in an autumn that has already seen both Mr Mowat and NHS England chief executive Simon Stevens insist the sector must share the burden of the health service’s £22 billion savings, the outlook is bleak.

A deeper concern is the lack of a coherent policy behind these announcements. Surely any scheme to promote community pharmacy’s emergency supply role – which the National Pharmacy Association rightly branded a “smoke screen” for the cuts – will be undermined if pharmacies are forced to close?

If alarm bells weren’t already ringing, the DH told C+D last week that the funding cut should be seen in the context of its ambition to “invest £112 million to deliver a further 1,500 pharmacists in general practice by 2020”. In the words of one C+D reader, this justification is “complete nonsense”. While there are many benefits to giving GP practices greater access to pharmacists’ expertise, even its most vocal proponents have not suggested that this scheme would be a replacement for community pharmacies closing across the country.

Either the government doesn’t understand the difference, or it doesn’t care. At this stage, I honestly don’t know what is more worrying.

Pharmacy plan ‘could lead to High Street closures’
20 October 2016, BBC News, Nick Triggle

Thousands of High Street pharmacies in England could face closure after ministers confirmed plans to alter the funding system and make cuts.

The Department of Health said it wanted to reduce the £2.8bn a year pharmacy bill by more than £200m over the next two years.

It has been suggested cuts on this scale could lead to up to 3,000 of the 11,700 pharmacies being closed.

Currently, the average pharmacy receives £220,000 a year from the NHS.

This accounts for between 80% and 90% of their income and includes a flat rate of £25,000, which nearly all pharmacies receive.

The changes being announced scrap that and put much more emphasis on performance-related funding, with ministers understood to see the current system as outdated and inefficient.

‘Damaging cuts’

Figures previously provided by the Department of Health – it has been looking into the issue for some months – suggested the number of pharmacies had increased by a fifth in the past 12 years.

And it has said about 40% of community pharmacies are found in clusters – with three or more within 10 minutes’ walk of each other.

The pharmacy industry has been lobbying ministers in recent months, warning the move could put more pressure on GPs and accident and emergency departments, as pharmacists provide advice and support to patients.

But Health Minister David Mowat said the government had decided to press on despite these protests, as the current system was not the best use of “valuable” NHS resources.

“Far from jeopardising services, our modernisation package will help improve them,” he added.

He said special funds would be set up to support pharmacies in isolated areas and to help set up more in GP surgeries and hospitals, which would be “more convenient” for patients.

Ministers believe these two measures will help offset the closure of High Street pharmacies – it expects another 1,500 GP surgeries will have in-house pharmacists by 2020. These are much cheaper to run.

But Sandra Gidley, of the Royal Pharmaceutical Society, said she was “deeply disappointed”.

“We fear for patients, the public and pharmacists who may be significantly affected by changes in opening hours and staffing levels in community pharmacy, as well as the knock on impact on already pressured GP and A&E NHS care.”

And Shadow Health Secretary Barbara Keeley said the move would be “damaging” and lead to increased demand on the health service as well as pharmacies.

“The government’s plans are not only deeply unpopular, they are short-sighted and they will hit areas with the greatest health inequalities hardest,” she added.

NHS pharmacy cuts: Tory ministers accused of piling even more pressure on A&Es
20 October 2016, The Independent, Rob Merrick

Ministers were accused of piling more pressure on overcrowded GP surgeries and A&E departments after announcing cuts to pharmacies.

Opposition parties attacked the announcement that more than seven per cent will be slashed from funding for community pharmacies over the next two years, after weeks of speculation.

They said the reductions could trigger the closure of hundreds, if not thousands, of badly-needed high street pharmacies and were a “false economy”.

There was also anger that health minister David Mowat was unable to say how many would be sent to the wall – even claiming it was possible that none would shut.

Norman Lamb, the Liberal Democrat health spokesman, said: “The Government’s belief that cutting funding for community pharmacies will improve efficiency in the NHS is a complete false economy.

“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.”

The Government has previously suggested that up to 3,000 pharmacies could close as a result of funding cuts.

But, today, Mr Mowat accused critics of “scaremongering”, saying: “It’s possible that none will close, I do not believe 3,000 will close.

“But I would say this – the average operating margin that a pharmacy makes is 15 per cent. That is after salaries and after rent.

“The cuts we’re making, or the efficiencies we’re asking for, is significantly lower than that.”

The announcement will see chemists will lose four per cent of their funding in 2016-17 and a further 3.4 per cent in 2017-18.

Former Conservative minister Michael Gove said: “Can I congratulate the minister for recognising what Labour failed to – that NHS money is taxpayers’ money and the priority should always be patient care, not the profits of private equity firms.”

Establishment payments to plummet 20% from December
20 October 2016, Chemist & Druggist, Annabelle Collins

Establishment payments for pharmacies in England will drop 20% from December, the government has announced.

This will amount to £419 less a month for pharmacies which currently receive the highest monthly payment of £2,092, the Department of Health (DH) said in a document released today (October 20).

The payments will fall by a further 40% on current levels from April 2017 – down to £1,255 a month for these pharmacies, it said.

All community pharmacies which dispense more than 2,500 items a month currently receive an establishment payment, but the DH reaffirmed that these payments will be “phased out” entirely over “a number of years”.

The DH’s document was timed to coincide with confirmation from pharmacy minister David Mowat that the 12% cut to the global sum would go ahead in December as planned.

Despite the DH telling C+D last week that no final decision had been made on the cut, Mr Mowat laid out the plans in the House of Commons today.

Mr Mowat confirmed the Pharmaceutical Services Negotiating Committee’s (PSNC) announcement last week that funding would drop by 7.4% on current levels for 2017-18, bringing the global sum down to £2.592bn.

Mr Mowat insisted the government “appreciates the value” of the pharmacy sector. But he stressed the current system does not do enough to “promote efficiency or quality”.

The DH also released an impact assessment of the funding plan today, which confirms “there is no reliable way of estimating the number of pharmacies that may close as a result of this policy”.

PSNC “unanimously” rejected the funding package last week.

£42m integration fund announced

Following Mr Mowat’s announcement, NHS England published details of its promised £42m ‘pharmacy integration fund’.

This will support pharmacy to “develop new clinical pharmacy services, working practices and digital platforms”, and result in “more integrated and effective NHS primary care for patients”, it added.

“Wholly unacceptable”

Pharmacy Voice described the government’s plans for significant pharmacy funding cuts as “incoherent, self-defeating and whole unacceptable”.

Chief executive Rob Darracott said the government appears “hell-bent on pressing ahead” with its policy and has “replaced warm words with increasingly aggressive rhetoric.

DH publishes pharmacy access scheme details
20 October 2016, Dispensing Doctors Association, Alisa Colquhoun

GP run pharmacies are on the list of English pharmacies that will see fewer cuts to their funding, according to the details of the pharmacy access scheme published today.

Jeremy Hunt told dispensing GPs of the publication of the details of the scheme today at the Dispensing Doctors’ Association 2016 annual conference, in a speech promising GPs financial and logistical support with developing out of hospital care and workforce development. Details of this speech will appear in our conference news section within a week.

In the pharmacy access scheme (PhAS) pharmacies dispensing up to 109, 012 prescriptions a year (around 9, 084 per month) and located a mile or more from another pharmacy will make a smaller efficiency saving than other pharmacies: 1 per cent in 2016/17 and 3 per cent in 2017/18. According to the DH, 1,356 pharmacies are named on this list, which can be downloaded here.

Pharmacies do not need to apply to the scheme to be eligible; eligibility has been calculated nationally, based on data relating to how many prescription items a pharmacy dispensed in 2015/16, and data relating to the distances between pharmacies.

Eligibility criteria include:

  • The pharmacy is more than a mile away from its nearest pharmacy (measured by road distance)
  • The pharmacy is on the pharmaceutical list as at 1 September 2016
  • The pharmacy is not in the top 25% largest pharmacies by dispensing volume.

Other important details of the scheme include:

  • Eligible pharmacies will see the PhAS concession take effect for prescriptions dispensed in December 2016. These payments will continue monthly until the payment for March 2018
  • If a qualifying PhAS pharmacy subsequently increases the volume of prescription items
  • If a new pharmacy opens very close to a pharmacy receiving the PhAS, the PhAS pharmacy will not lose entitlement, nor will the new pharmacy be eligible for the PhAS
  • The scheme applies in England only, and will run from 1 December 2016 to 31 March 2018. This is in keeping with the overall two year settlement for pharmacies – see below

NHS Community pharmaceutical services funding levels and the PhAS beyond March 2018 will be subject to further consultation, which will include reviewing the PhAS and its effectiveness.

From December 1, 2016, pharmacies not eligible for the PhAS will be hit with a 4 per cent reduction in funding in 2016/17 and a further 3.4 per cent reduction in 2017/18. This equates to funding cuts of £113 million in 2016/17 and takes total funding to £2.687 billion for this financial year. According to PSNC, contractors will see funding for December 2016 to March 2017 fall by an average of 12 per cent compared with current levels.

This will be followed by a reduction in 2017/18 to £2.592 billion for the financial year, which will see funding levels from April 2017 drop by around 7.5 per cent compared with current levels. Dispensing GPs are not affected by the funding cuts, nor are their dispensaries included in the PhAS

Pressure builds on Mowat as Labour and PSNC attack cuts

19 October 2016, Pharmacy Business, Neil Trainis

 

The Community Health and Care Minister, David Mowat is under increasing pressure from both the Labour Party and the PSNC over the proposed plans to reduce community pharmacy funding. The PSNC has rejected a funding package proposed by the Department of Health that would have cut the pharmacy’s budget by 12%. On Monday, David Mowat was asked by the Labour MP Michael Dugher for a statement on community pharmacy’s budget during a debate in the House of Commons. MPs from the Labour Party and the PSNC have tabled responses to David Mowats claims in the House of Commons debate, asking for clarification on multiple statements that they deem misleading.

This was also reported in Chemist & Druggist and PSNC

The PSNC’s full response to the Parliamentary debate on community pharmacy can be found here.

 

Parliamentary Coverage

 

Prime Ministers Questions; Community Pharmacy, 19 October 2016

Health

Stephen Pound (Ealing North) (Lab):  I am much obliged, Mr Speaker. Can there be a single Member of this House who does not have reason to be grateful to those heroes of our high street, community pharmacists? Can there be any member of the public who is not as bemused as I am that the Government are proposing a 12% cut in the community pharmacy budget, potentially leading to 3,000 closures? Will the Prime Minister express her support for community pharmacies and have another look at this divisive, corrosive and destructive proposal?

The Prime Minister

Everybody in this House recognises the role and contribution of community pharmacies up and down the country, but it is also right that we look at how we are spending NHS money. That is why the Government are looking carefully at this whole issue. If the hon. Gentleman supports community pharmacies, perhaps he ought to have a word with the Leader of the Opposition, because his right hon. Friend’s policy is to nationalise the health service completely, lock, stock and barrel—GP surgeries, Macmillan nurses and community pharmacies.

 

Full Coverage

 

Pressure builds on Mowat as Labour and PSNC attack cuts

19 October 2016, Pharmacy Business, Neil Trainis

David Mowat, the community health and care minister, is coming under increasing pressure to reveal details on the amount of money to be taken out of community pharmacy’s budget as Labour MPs and the PSNC intensify their attacks on the government over its intention to reduce the sector’s funding.

Details on the government’s reductions to pharmacy’s budget for 2016-17 and 2017-18 have been absent since Mowat’s announcement at the start of September that the cuts, originally placed at £170 million for the next year, would be delayed.

Rejecting proposals on 2016-17 funding by the Department of Health last week, the PSNC claimed ministers were planning to reduce pharmacy’s budget by 12%, although official confirmation of that from the government was also conspicuous by its absence.

A fundnng package was supposed to be formally announced by mid-October and the government’s continued silence has only exacerbated anger and confusion within the pharmacy profession.

On Monday Mowat (pictured) was asked during a debate in the House of Commons by the Labour MP Michael Dugher for a statement on community pharmacy’s budget. Mowat said the government would “expect to be in a position to make an announcement to the House shortly.”

In a letter to Mowat, Dugher and the shadow health secretary Jonathan Ashworth accused the community health and care minister of “several glaring factual inaccuracies” during the Commons debate which were “at odds with existing government policy.”

In that letter, seen by Pharmacy Business, Dugher and Ashworth accused Mowat of sending out mixed signals over the roll-out of a national minor ailments scheme by April 2018. Mowat had told the Pharmacy Business Awards on October 13 that the government was committed only to launching a national pilot of the scheme.

Dugher and Ashworth also asked Mowat to explain how, in his words to the Commons, “no community will be left without a pharmacy” when the cuts will force pharmacy closures.

“How are you in a position to make this commitment at the same time as pushing through a package of cuts that could force an unspecified number of community pharmacies to close in areas that you are also unable to specify?” they wrote.

Dugher and Ashworth asked Mowat for an estimate on the number of pharmacies that will close as a result of the cuts and, again accusing him of mixed messages, wrote: “You said in your remarks that ‘nobody is talking about thousands of pharmacies closing’, yet it was your predecessor, Alistair Burt MP, who estimated that up to 3,000 community pharmacies could close because of government cuts.”

They also asked Mowat to withdraw his remark that each pharmacy receives establishment payments of £25,000 “just for being open and for being a pharmacy.” Establishment payments, which the government has pledge to phase out, are received by pharmacies dispensing 2,500 or more prescriptions each month.

“You claimed that every community pharmacy received £25,000 of government funding per annum, but this is not true. There are at least 560 community pharmacies which do not qualify for the establishment payment. Will you take this opportunity to withdraw this remark?” Dugher and Ashworth said in the letter.

The PSNC was also quick to criticise Mowat’s performance in the Commons, particularly his suggestion that “each establishment now receives an average £220,000 of margin over and above the cost of drugs disbursed.”

In response the PSNC said: “The £220,000 figure used by the minister has to cover the costs of delivering those services including rent and other property costs as well as bills, staff and all other operating costs.

“The £25,000 establishment payments to which the minister refers are a mechanism through which some of that funding is delivered to pharmacies dispensing more than a minimum number of prescriptions; it does not represent a payment over and above the agreed funding for the sector for its NHS activities.”

Mowat’s suggestion that the Pharmacy Integration Fund, worth £300 million over five years, “will be used entirely to provide services and pay for pharmacies to provide them” was also questioned by the PSNC who said: “Its value is £20million in 2016/17, growing in future, and until now the government has been clear that it would not be entirely used for community pharmacy services.”

The PSNC added: “We understand that the £300million fund will be used over a five-year period with initial spending covering the costs of the urgent medicines supply pilot. NHS England has said that it intends to use some of the fund in later years to fund pharmacists working in care homes and urgent care centres; neither of which will necessarily benefit community pharmacies.

“NHS England has also committed to spending at least 10% of the fund on the evaluation of services.

The PSNC attacked Mowat’s suggestion that “the proposals we are setting out in the round are expected to make pharmacy access better than it is now.”

The PSNC responded: “The proposed funding reductions will have a significant impact on some pharmacies and their patients. Funding for 2017/18 will be set at £2.592billion, a reduction of 7.4% on the current level. Funding for 2016/17 will reduce from December 2016 to March 2017 to £2.687billion, cutting average pharmacy funding by 12% compared with the present levels for those four months.

“The removal of Establishment Payments will target for the greatest cuts the low dispensing pharmacies in areas with the highest health needs. They would see fee income reduced by around 20% next year, at a time when the NHS has said that efficiency targets of 4% are too high to be achievable, and has reduced targets to 2%.

“We expect that pharmacy owners will be forced to take steps to reduce costs. These are likely to include reducing opening hours and staffing, and stopping the provision of services they provide free today, such as home delivery of medicines and the supply of medicines in compliance aids. We are very concerned about the impact that this will have on patients.”

 

Mowat goes head-to-head with MPs over pharmacy budget

19 October 2016, Chemist & Druggist, Annabelle Collins and Grace Lewis

 

Pharmacy minister David Mowat was forced to defend the planned cuts to the sector’s funding from opposition MPs during a parliamentary debate this week.

Labour MP Michael Dugher tabled an urgent question in parliament on Monday (October 17), following the government’s proposals to slash pharmacy funding in England by 12% for December 2016 until March 2017.

During the debate, MPs questioned Mr Mowat (see box) on how many pharmacies could close as a result of the cuts, how the drop in funding could impact the sector’s ability to ease NHS pressures, and how vulnerable patient groups could be affected.

Mr Mowat emphasised the government has spent “the past ten months trying to get this right”, and referred to the GP pharmacist scheme, as a way the government intends to “embrace the pharmacy profession”.

On Tuesday (October 18), the Pharmaceutical Services Negotiating Committee (PSNC) raised a number of questions in response to the minister’s remarks during the debate. It called Mr Mowat’s denial that 3,000 pharmacies could be at risk of closure “not credible”.

“Most recently the government has retreated from its previously stated aim and said that there is no intention to close pharmacies although they ‘recognise pharmacies may close as a consequence of their proposals’,” the negotiator said.

“We do not believe this change of position is credible in the face of the approach taken in the proposals,” it added.

Labour MPs Mr Dugher and shadow health secretary Jonathan Ashworth penned an open letter to Mr Mowat on Tuesday (October 18) calling for him to clarify the “glaring factual inaccuracies” he made during the debate.

The Department of Health had to clarify Mr Mowat’s comments on the minor ailments scheme funding, after the minister alluded to a “nationally commissioned service”.

Here are some of the questions Mr Mowat faced on Monday, and his responses:

Jonathan Ashworth, Labour MP for Leicester South and shadow health secretary

Q: As the minister knows, his predecessor talked of the potential for up to 3,000 pharmacies to close. Is that correct?

A: We do not believe that the number will be anything like that big. In some areas, there are 10 or 11 pharmacies within half a mile of each other. Leicester, Birmingham – we can talk more about this. It is quite possible that at the end of the review, some of those pharmacies will merge.

Kevin Barron, Labour MP for Rother Valley and all-party pharmacy group chair.

Q: You said that an impact assessment will be published, so that it would inform the final decision. Can the minister tell us when that will be published? Will it be shared with representatives of community pharmacists?

A: As my predecessor [Alistair Burt] said, an impact assessment is being produced, and when these proposals are published in their entirety, that will be published at the same time.

Stephen Pound, Labour MP for Ealing North

Q: We cannot keep loading, even on to the willing shoulders of the community pharmacies, more and more responsibility while we are draining away the financial lifeblood. Would the minister care to become the most popular minister on the high streets of our nation by saying that he is going to have another look at this nonsense?

A: I am always keen to be popular, but I am also keen to do the right thing. Nobody is talking about thousands of pharmacies closing and I do not believe that will happen, but we have talked about hiring 2,000 more pharmacists in the GP sector.

 

PSNC response to Parliamentary debate on community pharmacy funding

19 October 2016, PSNC

 

Community pharmacy teams may have seen some of the continued national media coverage of community pharmacy following PSNC’s rejection of the Department of Health’s proposed funding package last week.

This week Michael Dugher, MP for Barnsley East who has been supporting the campaign for community pharmacy, raised an urgent question on community pharmacy in the House of Commons on Monday.

PSNC and the other national pharmacy organisations worked together to brief MPs very quickly on the day and this led to around 20 MPs asking pharmacy minister David Mowat MP questions on pharmacy. There was support from MPs across the spectrum of political parties. The minister’s responses raised a number of questions and PSNC has now contacted all MPs who took part in the debate asking them to follow up on these.

The key points made by the minister have been set out in a PSNC Briefing along with PSNC’s responses to them. The responses cover topics such as clustering and pharmacists working in GP practices and may be of interest to contractors and LPCs.

‘No final decision’ made on funding cut, says government
18 October 2016, Chemist & Druggist, Grace Lewis and Annabelle Collins

The Department of Health are still considering the implementation of proposed 12% cuts to pharmacy funding in England. A spokesperson for the Department of Health confirmed that no final decision had been made on the matter. This followed the rejection of the Government’s proposals by the Pharmaceutical Services Negotiating Committee (PSNC). Sue Sharpe, Chief Executive of the PSNC said there had been no real consultation between the two parties around the funding package.

Pharmacy Minister signals concessions on pharmacy cuts, under fire from MPs
18 October 2016, National Pharmacy Association

During a Parliamentary debate, Members of Parliament from both sides of the House of Commons spoke out against the proposals to cut pharmacy funding by 12%. Under intense questioning Pharmacy Minister, David Mowat, made a commitment to ensure that no community in England will be left without a community pharmacy. National Pharmacy Association Chairman, Ian Strachan, called for a detailed analysis that can back up the commitments David Mowat made to the Members of Parliament. Mr. Strachan also said that a change of heart from the Department of Health towards a more positive course of action would be welcomed by the pharmaceutical industry.

This was also reported by the Dispensing Doctors Association

 

Parliamentary Coverage

House of Commons Questions; Pharmacy, 18 October 2016

Health

 

Michael Dugher: (a) on how many occasions during the most recent negotiation period Ministers and officials of his Department met with representatives from the Pharmaceutical Services Negotiating Committee and (b) when he plans to announce a funding package for community pharmacy for 2016-17.

Department of Health

David Mowat:

Since 9 September 2016, when a revised package of measures was put to the Pharmaceutical Services Negotiation Committee (PSNC), the Department, supported by NHS England, has met the PSNC on four occasions. I have met PSNC three times since 30 August 2016, including on 6 October 2016.

Ministers are still in a process of considering a proposed package for the community pharmacy sector and are expecting to make an announcement shortly.

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‘No final decision’ made on funding cut, says government

18 October 2016, Chemist & Druggist, Grace Lewis and Annabelle Collins

 

Ministers are still considering whether to implement the 12% cut to pharmacy funding, according to the Department of Health (DH).

“No final decision has been taken” on the proposed funding “package” for the sector, a DH spokesperson told C+D last Friday (October 14).

The DH spoke to C+D after the Pharmaceutical Services Negotiating Committee (PSNC) rejected the government’s proposals to slash pharmacy funding in England by 12% for December 2016 until March 2017.

“Preposterous” proposals

In a letter sent to the DH’s head of pharmacy Jeannette Howe last week (October 13), PSNC chief executive Sue Sharpe Sharpe said the decision to give pharmacists just six weeks’ notice to prepare for a 12% cut to their funding is “preposterous”, and the government’s proposals “were and remain, founded on ignorance”.

Ms Sharpe also said there had been “no real consultation” around the funding package between the two parties.

However, the DH told C+D it had “worked collaboratively” with PSNC and had “listened to [its] suggestions and counter proposals”.

“We are committed to offering more help to those pharmacies people most depend on‎ compared to others,” the DH spokesperson added.

The DH also told C+D that the government aims to “modernise the pharmacy sector”. “That’s why we are investing £112m to deliver a further 1,500 pharmacists in general practice by 2020,” it said.

A leaked document shared with C+D on Sunday (October 16) revealed that just one in 10 pharmacies in England will be given financial support as part of the government’s planned fund to provide relief from the cuts.

Three days earlier, the National Pharmacy Association said government plans to allow pharmacists to supply emergency medication without GP approval were a “smoke screen” for the funding cuts.

 

Pharmacy Minister signals concessions on pharmacy cuts, under fire from MPs

18 October 2016, National Pharmacy Association

 

MPs from both sides of the House of Commons savaged proposals to cut pharmacy services, during a parliamentary debate this week (Monday 17 October).  Under intense questioning from his own colleagues as well as Labour and Liberal Democrat MPs, Pharmacy Minister David Mowat appeared to make a series of significant concessions.

Amongst other commitments was an assurance that no community in England will be left without a pharmacy and that people will, at worst, need to travel only “tens of metres” further to access pharmaceutical care, under his plans.

Pharmacy leaders moved quickly today to seek details from the Department of Health, based on the assurances given to the House of Commons.

National Pharmacy Association Chairman, Ian Strachan, said:

“The Minister made a number of startling claims about the likely effect of his policies.  We will hold him to his assurances about access to pharmaceutical care, including for people in deprived communities.  We want to see the detailed analysis behind the commitments he made to MPs.  If by his assurances he is signalling a change of heart, we welcome it.  Even at this late stage, he can seize the opportunity to take a new and positive course of action, to work with the sector and do what’s right for patients and the NHS.”

 

Pharmacy minister under pressure over cuts

18 October 2016, Dispensing Doctors Association, Ailsa Colquhoun

 

Pharmacy minister David Mowat was unable to rule out the closure of pharmacies on GPs’ doorsteps in a highly pressured question time in Parliament yesterday.

In a 40-minute session he came under intense pressure from cross-party MPs and at times was seen to stumble over accusations that his policy on pharmacy funding was “inchoate”, “indefensible” and “all over the place”.

Stephen Pound, Labour MP for Ealing North, said the minister had been “sold a hospital pass” by his predecessor in charge of pharmacy policy, Alistair Burt.

He described Mr Mowat’s performance in the House that day as “courageous”.

In the session, which followed an urgent question asked by Labour MP Michael Dugher (Barnsley East), the minister was held to account over his refusal to rule out cuts to pharmacies’ funding. These were described by the MP as “massive” and “arbitrary”. A document widely leaked to the national press states that as many as 1,620 pharmacies in rural areas face closure following the new financial package for pharmacies. This package is not expected to affect the remuneration for the GP dispensing service.

Ministers are expected to unveil a large cut in community pharmacy funding in the next few days, as well as details of the access fund that will support pharmacies deemed essential, including those in rural areas. It is understood that the access scheme will support only 1,380 pharmacies across England’s deprived and rural areas.

Despite intense pressure to reveal the details of the planned closures, the minister said that he was not “in a position to announce [its] final form or shape” but that he could confirm that “no community will be left without a pharmacy”.

Mr Mowat said the intention of the pharmacy funding package was to move the profession from a dispensing model to one based on services. As part of this pharmacies in England would be commissioned to provide a minor ailments service by 2018, he pledged.

But PSNC, which negotiates the NHS funding for pharmacies in England, described the funding offer as “reckless” and “will see patients suffer as services are withdrawn”. It has rejected the offer.

According to PSNC, the proposals:

  • Reduce funding from December 2016 to March 2017 by 12 per cent on current levels, to set funding for this year at £2.687 billion
  • Reduce funding for 2017-18 by 7.4 per cent on current levels, to set funding at £2.592bn.

Anna Soubry, Conservative MP for Broxtowe, and a former health minister, told the minister that if ever there was an argument to increase the role of pharmacies – “it’s now”.

The minister responded that the NHS had a duty to reduce it’s spend on pharmacies that were all located in the same area. He told the House: “There won’t be anything like 3,000 closures” and he said the Government fully understood “the situation in rural communities.” He said: “The central part is that everybody has a baseline distance to travel to a pharmacy and everyone can access a pharmacy within a reasonable time”. Although he would not define “reasonable” he said that no one would have an appreciably longer distance to travel to a pharmacy than they do now: “perhaps, tens of metres more, if any”, he said.

Cost of Spain’s pharma industry to adapt production lines to medicines verification system
17 October 2016, The Pharma Letter

Spain’s pharmaceutical industry has plans to invest roughly 200 million Euros over the next two years into the adaption of its production lines. This investment is being used to incorporate the technical requirements of a new medicine verification system, as part of the European Falsified Medicines Directive and its delegated regulation. It is thought that in Spain this verifiable system will require an investment of 10 to 13 million Euros and annual support of between 5.5 and 8 million Euros.

Breaking: Just 1,380 pharmacies will be supported by Pharmacy Access Scheme
17 October 2016, Pharmacy Business, Neil Trainis

A leaked document from the Department of Health has revealed that the Government is intending to help 1 in 10 community pharmacies in England following the implementation of proposed cuts. The support will come through the Government’s Pharmacy Access Scheme which is designed to protect pharmacies from closure if they are situated in an area under-populated with community pharmacies. If a pharmacy qualifies for the scheme they will receive a top-up payment from the Government that will help ease the effect of the funding cuts. However, Labour MP Michael Dugher, believes that even with the Pharmacy Access Scheme there will be a large number of community pharmacies forced into closure if the proposed funding cuts are implemented.

This was also reported by Chemist & Druggist

You can follow the latest news and reactions to the pharmacy funding cuts at the Pharmaceutical Journal

 

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There is no parliamentary coverage today.

 

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Cost of Spain’s pharma industry to adapt production lines to medicines verification system

17 October 2016, The Pharma Letter

 

The pharmaceutical industry based in Spain will invest around 200 million euros ($220 million) over the next two years in order to adapt its production lines thus incorporating the technical requirements of the new system for the unitary verification of medicines.

These are the economic estimations of the sector, based on an average cost of 300,000 euros per line, according to an announcement by the Spanish trade group Farmaindustria, noting that this is an initial investment which only looks at the adequacy of the machinery and the start up process.

Unit verification of medicines in Europe is a requirement originating from the European Falsified Medicines Directive and its delegated Regulation. Its aim is to avoid the risk of falsified drugs entering the legitimate supply chain of medicines dispensed in pharmacies, further strengthening for the patient the full guarantee of medicines dispensed in pharmacies. Spain has adapted to this European regulation, even when the current manufacturing, distribution and dispensing system in our country today makes it barely impossible for falsified medicines to enter this legal channel.

Could amount to half a million euros

These investments in production lines are the first step in attaining the full operation of the verification system taking into account that, afterwards, companies will have to face a series of diverse expenses, such as the ones derived from the maintenance and printing of datamatrix and serialization, the latter representing a figure which could amount up to half a million euros per production center.

On the other hand, each laboratory will have to take on the appropriate fee in order to develop and maintain the Spanish Drugs Verification System (SEVeM), which should be at full capacity, as in other countries of the European Union from February 2019. Thus, the launch of the verifiable system requires between 10 and 13 million Euros of investment and an annual support of between 5.5 and 8 million Euros from this year.

According to European regulations, adaptation of the production lines will work in a way so that packaging will incorporate closures to allow for verification that it has not been tampered with, and a new two-dimensional code (Datamatrix) containing a unique and random serial number for each package. These serial numbers will be placed in a European repository and pharmacies, before dispensing the medication to the patient, will need to verify the authenticity of the package by a corresponding telecommunications link with the national repository, managed by the SEVeM.

During this adaptation period of these new requirements, it is expected that the Administration will regulate certain aspects that European legislation leaves at a purely national level. In this sense, Farmaindustria maintains a close relationship with the Spanish Agency for Medicines and Health Products (AEMPS) that will contribute to the industry allowing for them to adapt to the new requirements in an environment of ongoing dialogue.

However, the high costs involved for the production centers introducing technical requirements and maintenance derived from a system of drug verification, which responds to a request from a European character, would justify the adoption of measures supported by administrations.

In this sense, Farmaindustria says it is working on different proposals so that the economic impact of the verification system is acceptable, especially for small and medium-sized enterprises, because in some cases they will have serious difficulties in coping with the expenditure required to get it up and running.

 

BREAKING: JUST 1,380 PHARMACIES WILL BE SUPPORTED BY PHARMACY ACCESS SCHEME

17 October 2016, Pharmacy Business, Neil Trainis

 

A leaked ministerial document seen by Pharmacy Business has revealed the government intends to support just 1,380 community pharmacies in England through its Pharmacy Access Scheme despite promising to help pharmacy thrive through the initiative in the wake of swingeing funding cuts.

The document, originally obtained by the Labour MP Michael Dugher, uncovers the extent to which community pharmacy will benefit from the scheme, which was designed to protect pharmacies situated in areas that are not overpopulated by other pharmacies from closure as a result of the government’

The government was supposed to decide which pharmacies would benefit by creating a national formula identifying pharmacies which, geographically speaking, are most important for patient access.

Other factors were to be considered, including distance and travel times to pharmacies and population size and needs based on age, disability and deprivation. The government has been criticised by pharmacy bodies for a lack of clarity around the scheme’s formula.

The leaked document reveals that 1,380 pharmacies, equating to 11.8% or one in 10 of the total number of pharmacies in England, will receive support through the scheme.

In the document, the government says pharmacies one mile or more from another pharmacy “will be automatically eligible” and having assessed population travel times and needs, ministers say measures are in place to “ensure that no populations with high needs levels will slip through the net in terms of access.”

The document also said that pharmacies benefiting from the Access Scheme will receive a top-up payment taking them back to their 2015-16 remuneration levels minus a 3% efficiency saving.

“Taking all of these design elements together, we estimate that the scheme will support 1,380 pharmacies, at a cost of £12 million in 2016/17 and £27 million in 2017/18,” the document said.

“From our initial calculations, the vast majority of qualifying pharmacies will be opted in through the first rule (the ‘mile or more’ rule) and only a handful will be opted in through scoring highly on the index.

“As a rough indication, we would expect the estimated average payment per pharmacy to be £8,500 in 2016/17 and £19,500 in 2017/18.”

The document contradicts a promise made in December last year by Alistair Burt, the former minister responsible for pharmacy, who said: “Our aim is to ensure that those community pharmacies upon which people depend continue to thrive and so 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.”

Dugher, who has campaigned vociferously against the cuts to pharmacy funding, accused the government of breaking its promise on the scheme.

“Ministers promised they would listen and consult widely on their planned cost-cutting, but the government is set to force through a brutal package of cuts that could leave many frail and vulnerable patients forced to walk a mile or more to get medicines they need,” he said.

“And we now find they are planning to arbitrarily impose a relief scheme that could still see the closure of many local pharmacies.

“These ill-judged cuts are bad for our communities and bad for our NHS because community pharmacies help to save money by providing free advice and dispensing medicine before patients head to their GP or A&E.

“Ministers must think again and recognise the vital role that community pharmacies play in frontline healthcare before they sound the death knell of thousands of local chemists.”

 

Only 1 in 10 pharmacies to benefit from cuts relief fund

17 October 2016, Chemist & Druggist, Annabelle Collins

 

Just one in 10 pharmacies will be given financial support as part of the government’s planned fund to provide relief from the cuts, a leaked document has revealed.

The Department of Health (DH) estimates its pharmacy access scheme – first proposed to ensure “geographically important” pharmacies are not forced to shut their doors as a result of a cut to the sector’s funding – will only support 1,380 of  the 11,674 in England, according to a leaked government document seen by C+D.

The document – obtained by Labour MP Michael Dugher and shared with C+D yesterday (October 16) – states that the scheme would cost a total of £12 million in 2016-17 and £27m in 2017-18.

It details two categories of eligibility for pharmacies to qualify for the funding. Pharmacies located a mile or more from another pharmacy will be “automatically eligible”, while a “handful” will also receive the funding if “population mapping” shows they are needed to provide care to a “high-need” patient group, according to the document.

The top 25% of pharmacies – based on dispensing volume – will be automatically excluded, as those with “greatest potential to remain viable” should not receive support, the DH stressed in the document.

It estimates that the average payment per pharmacy from the funding will be £8,500 in 2016-17 and £19,500 in 2017-18.

In January, the DH announced plans to “phase out” the current system of establishment payments completely “over a number of years”.

Efficiencies needed by all

According to the document, even pharmacies that are eligible for the fund will have to make efficiencies.

While the top-up payment is designed to bring the funding of eligible pharmacies back up to 2015-16 levels, they will still be required to make a 3% efficiency saving.

The DH said in the document that it “is keen” to discuss the proposals in further detail and called for the Pharmaceutical Services Negotiating Committee’s (PSNC) input.

Last week (October 13), PSNC outlined its 16 objections to the pharmacy access scheme in a letter to the DH’s head of pharmacy Jeannette Howe. The following day, the negotiator rejected the government’s plans to slash the sector’s funding by 12% from December.

The DH declined to comment on the leaked document.

Pharmacy organisations quickly respond to announcements

14 October 2016, P3 Pharmacy

 

Last week the Department of Health announced proposed cuts to pharmacy funding as well as a new urgent repeat medicines pilot. This will give community pharmacies the authority to make supplies of medicines needed urgently on referral by NHS 111.  Pharmacy organisations however, have come out to speak against the proposed cuts and expressed their beliefs that the announcements made in regards to new pharmacy services have been timed to drive attention away from upcoming cuts. NPA Chairman, Ian Strachan has spoken out highlighting the contradiction in asking pharmacies to develop new roles and services whilst cutting the funds that would allow this to happen.

 

NPA: Emergency supply proposals a ‘smoke screen’ for cuts

14 October 2016, Chemist & Druggist, Annabelle Collins

 

The National Pharmacy Association (NPA) has alluded to the Government’s plan to enable pharmacists to supply emergency medication without GP approval as a smoke screen for upcoming funding cuts. The Department of Health announced that the pilot scheme would be launched in areas of England from December. NPA chairman Ian Strachan has said that the announcement of this new pilot scheme has been strategically times to draw attention away from the impending cuts. He added that community pharmacies will struggle to provide these services if they are forced to cut back on staff.

 

NPA and Pharmacy Business (here and here) have published articles about the implementation of the new urgent repeat medicines pilot.

 

Emotions run high in response to the DH’s funding package

15 October 2016, Chemist & Druggist, Grace Lewis & Annabelle Collins

 

Pharmacy organisations have expressed their shock that the Governments proposed funding package will go ahead in December. Claire Ward, Chair of Pharmacy Voice said that the cuts are a bitter blow to community pharmacy. Royal Pharmaceutical Society England Board Chair Sandra Gidley, also commented saying that the pharmacy community are deeply disappointed and alarmed that the Government has not altered their approach to funding cuts this year. She called upon the Government to keep the promise made to bring pharmacy closer into the wider primary care and community health system.

 

Community pharmacy sector rejects government plans to implement 12% funding cuts

14 October 2016, The Pharmaceutical Journal, Ingrid Torjesen

 

The PSNC has rejected the Department of Health’s proposals to cut back community pharmacy funding by 12%. The PSNC believe that these cuts could result in the closure of a quarter of pharmacies and force the removal of free health services from community pharmacies across England. A spokesperson for the Department of Health says that the Government has worked closely with the PSNC, listening to their suggestions and counterproposals over several months.

 

Pharmacy Voice and NPA, have further commented on the proposed funding package for community pharmacy.

 

The full ministerial response to the PSNC can be found here

 

The full ministerial announcement concerning the New pharmacy service for urgent repeat prescriptions and minor ailments can be found here

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There is no Parliamentary coverage today.

 

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Pharmacy organisations quickly respond to announcements

14 October 2016, P3 Pharmacy

Pharmacy organisations have been responding to the threat to pharmacy funding, PSNC’s rejection of a proposed funding agreement and new pharmacy schemes announced by the Department of Health.

 

Here are their statements in full.

 

A joint statement from PSNC, Pharmacy Voice, National Pharmacy Association, Company Chemists’ Association and Association of Independent Multiple Pharmacies:

 

Announcement on services has been timed to draw attention away from looming cuts

 

“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 stripping 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.”

 

Comment from Pharmacy Voice chair, Claire Ward:

 

Anger and disappointment and a bitter blow to community pharmacy

 

“Pharmacy Voice has reacted with anger and disappointment at today’s news that the Government has failed to agree the funding package for community pharmacy contract for 2016-17, and that the sector now faces an imposition of dramatic cuts over the next 18 months.

 

“With the sector now facing cuts of hundreds-of-millions of pounds from December, the Government risks putting patient care, services, local businesses and jobs at risk.

“The news of the scope and scale of the cuts follows a series of delays in decision-making from the Department of Health as it was forced to shelve key aspects of the reforms and struggled to respond to concerns raised by community pharmacists, MPs from all parties and the 2 million people that signed the largest health related petition in the country’s history.

“Pharmacy Voice Chair, Claire Ward, said: “This is a bitter blow to community pharmacy after all our hard work to demonstrate the value we bring to the NHS, public health system and wider society.

 

“Through the counter-proposals and the Community Pharmacy Forward View, the sector has advanced a future for the sector that will not only enhance efficiency but will also ensure its long-term future, with patients at its heart. The fact that Government currently appears to be unwilling to match our ambition ­– despite the evidence, its own warm words for the sector and the out-pouring of support from pharmacy users – is extremely disappointing.

“Nonetheless, we remain committed to working in partnership with national and local colleagues, and to playing our part in relieving pressure on our hard pressed GPs and A&E departments

 

“Attempts to justify these cuts with superficial arguments about pharmacy clustering, inefficiency and investment in ‘pilot schemes’ have been misleading, and are quite simply not supported by the facts. I fear that the burden of these changes will now fall on those least able to bear it. We will be closely monitoring and highlighting the impact the cuts have on pharmacy teams and their patients over the coming months.

 

“At the same time, we will continue to work with our members and other national pharmacy bodies to support the ongoing campaign and to advocate for the long-term plan for the sector within the Community Pharmacy Forward View. We will build on the enormous good-will we have generated within Parliament, amongst the public and with NHS and Local Government colleagues in support of an expanded role for pharmacy within primary care and public health.

“In the meantime, I continue to urge the Government to halt these damaging and costly plans, and instead take up the sector’s offer to work in collaboration and partnership to secure the clinical services, employment opportunities, and community support that pharmacy teams across the country are uniquely placed to deliver.”

 

National Pharmacy Association chairman, Ian Strachan:

 

A contradiction in asking pharmacies to develop new roles and services while stripping away the investment necessary to make it happen

 

“The announcement is clearly timed to draw attention away from the looming cuts planned by the Department of Health. In reality it highlights the flat contradiction at the heart of the Department’s position – asking pharmacies to develop new roles and services whilst stripping away the investment necessary to make it happen.

 

“Pharmacies cannot deliver these services if they have to cut back staff. They cannot deliver a service if they have been forced to close.”

 

“The schemes look to fall far short of a properly funded nationwide scheme that would have transformational benefits for patients and the NHS. It’s a smoke screen. I don’t sense any conviction in it”.

 

“The Government has now acknowledged the unique potential of community pharmacies in urgent care. Health Ministers should follow that logic and back pharmacies more fully to take pressure off stretched GPs and hospitals.”

 

The Government’s approach is a betrayal of its promises and shows a complete disregard for the wellbeing of patients, who have made their views known through their response to the petition

 

“The National Pharmacy Association (NPA) has reacted with fury to the news that pharmacy funding talks have broken down, following confirmation that the Department of Health wants to press ahead with massive cuts.

 

“Earlier this year, a decision was delayed after a record breaking two million petition was delivered to Downing Street.

 

“The Pharmaceutical Services Negotiating Committee (PSNC) has rejected the Department of Health’s proposed funding package for 2016/17. The proposed package includes cuts 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.

 

“The Government’s approach is a betrayal of its promises and shows a complete disregard for the wellbeing of patients. Millions of worried patients have asked the Department of Health to think again. Politicians from all parties are against the cuts. Yet elements within Government seem determined to press ahead with this damaging experiment, deaf to the nationwide protests.

 

“There is a flat contradiction at the heart of the Department’s position – asking pharmacies to develop new roles and services whilst stripping away the investment necessary to make it happen. Pharmacies cannot deliver more if they have to cut back staff. They cannot deliver a service if they have been forced to close.

 

“This is a dangerous experiment. We have seen no official assessment from Government of what the consequences will be for patient care, although we know full well that people will suffer, including some of the most vulnerable people in our society.

 

“The Pharmacy Minister said this week that final decisions have yet to be made. If that is the case, he has to seize this final opportunity to change course. If he does not, he should know that we will not accept this meekly. We owe it to the millions of patients who have supported us to continue to safeguard the pharmacy services they rely on – including the most vulnerable of the patients and communities that we serve.”

 

Royal Pharmaceutical Society England Board Chair, Sandra Gidley:

 

The NHS emergency medicines supply service is already tried and tested and there is no need for further piloting – it should go live across England without delay

 

“We are deeply disappointed that the Government has not changed its approach to funding cuts this year and alarmed that further cuts have been announced for next financial year.

“Funding cuts will not improve the quality of care for patients delivered through community pharmacy. Pharmacists will not be reassured by this two-year deal, which guarantees less resource for front line care. We fear for patients, the public and pharmacists who may be significantly affected by changes in opening hours and staffing levels in community pharmacy, as well as the knock on impact on already pressured GP and A&E NHS care.

 

“How the Pharmacy Access Fund, which the Government says should guard against reduced public access to pharmacy and increased health inequalities, will operate, is still unknown. We would expect certainty around which pharmacies will receive support from the Pharmacy Access Fund before the scheme is implemented.

 

“The lack of news on the promised Pharmacy Integration Fund defies logic at a time when greater integration of primary care services to improve patient care is such a priority for the NHS. We call on the Government to make good on its promise made in the original letter of December 2015 “to bring pharmacy even closer into the wider primary care and community health system”, so we can see improved patient care through better use of pharmacists in care homes and urgent and emergency in the years to come.

 

“Patients and the public expect and deserve high quality care from community pharmacy, the drive for efficiency from community pharmacy that the Government is looking for is in danger of becoming a race to the bottom, where only those offering low cost, rather than high value services, survive. We want to see greater investment in direct patient care to enable community pharmacists to deliver responsive health services face to face with their patients.

“The intention for the implementation of a national NHS emergency medicines supply scheme through pharmacy is good news for patients. However, the NHS emergency medicines supply service is already tried and tested, with fantastic results that have both improved patient care and freed up time for GPs. There is absolutely no need for further piloting of a service that is badly needed as we head towards winter. This needs to be implemented across England without further delay.

 

“We also need assurance that the Government is serious about a national NHS funded minor ailments scheme through pharmacy. Any NHS minor ailments scheme needs to be true to the founding principles of the NHS and be free at the point of use. Patients and the public need a fully integrated NHS service, only then will we see people change behaviour, and pressure be taken off GP out of hours and A&E.

 

“Our job at RPS is to ensure as many community pharmacists as possible will be able to make the transition from the current arrangements to a future that will put community pharmacists at the heart of primary care. We will need to prepare the profession for new roles, with new skills and a new focus on one-to-one consultations. We will make sure our professional development programmes provide full support for RPS members for the increasing number of roles available.

 

“We will support members through the difficult time ahead. We have built stronger links with patient groups, local government and NHS England during the consultation phase. We have well advanced plans to support the profession through our professional development programmes, the RPS Faculty and RPS Foundation programmes, which are designed to help pharmacists gain recognition as well as skills for new roles in community pharmacy and elsewhere as they come on stream. The Government has said it wants to develop new models of care and is minded to incentivise change and we will help ensure that these promises become a sustainable reality.

 

“Although the focus right now will be on the funding announcement we have not lost focus on our strategic aim to gain a commitment from Government and NHS England that community pharmacy and pharmacists are integral to the future plan for the NHS.”

 

Celesio UK managing director, Cormac Tobin:

 

As winter pressures reach crisis point in the coming weeks community pharmacy is part of the solution, but they can’t do this without adequate funding

 

“Whilst the DH has recognised that community pharmacy has a role to play, this does, however, feel like a cynical attempt by the government to divert attention away from the imminent swingeing cuts to our sector. The Community Pharmacy Forward View outlined our vision and although this announcement acknowledges the potential role pharmacists can play in alleviating the burden on our health service, it does not go nearly far enough.

 

“The NHS is about to hit crisis point as we head towards the winter months; queues at GP surgeries, a social care system on its knees and A&E departments woefully over stretched. Community pharmacy is part of the solution to increasing capacity in other parts of the system, yet we cannot do so without adequate funding. There is still uncertainty as we await the cuts announcement.

 

“Pilots, as we know, can come and go and don’t give pharmacists the assurance that these services will become a permanent feature or that sustainable funding will follow. We can’t change patient behaviour unless we commit to long-term changes and locally commissioned services do little to raise public awareness nationally.

 

“We know how much money community pharmacy currently saves the NHS – we can save it more. But not if it’s very future is undermined. Pharmacists are accessible, clinically trained experts, passionate about the health and wellbeing of their patients. But their genius needs to be released by government, not constrained by it.”

 

Well chief executive, John Nuttall:

 

Urges government to revisit the evidence put forward in the reports ‘The value of community pharmacy’ and the ‘Community pharmacy forward view’ and work with the sector

 

“We are disappointed that the PSNC has been forced to reject the government’s proposal for community pharmacy funding. We believe the government has failed to fully consider the evidence put forward by the sector, that demonstrates the substantial social and health value of pharmacy.

 

“The NHS is experiencing unprecedented financial pressure, however community pharmacy has consistently delivered efficiency savings to the NHS, and the proposed cuts are simply not achievable. Currently pharmacy plays an integral role in supporting health and wellbeing. We are concerned that the scale and timing of the intended cuts would cause massive disruption and be detrimental to the wider NHS, putting A&E departments and GP practices, in particular, under additional strain.

 

“We would urge the government to revisit the evidence put forward in the reports, “The Value of Community Pharmacy”, and the “Community Pharmacy Forward View” and work with us to ensure a sustainable future.

 

“Whilst we have no choice but to prepare in case these cuts are imposed upon us, our priority will continue to be ensuring the highest standards of care for our patients.”

 

NPA: Emergency supply proposals a ‘smoke screen’ for cuts

14 October 2016, Chemist & Druggist, Annabelle Collins

 

Government plans to allow pharmacists to supply emergency medication without GP approval is a “smoke screen” for looming funding cuts, the National Pharmacy Association (NPA) has said.

Under the ‘Pharmacy Urgent Care’ pilot programme announced by the Department of Health (DH) yesterday (October 13), patients who call NHS 111 for urgent repeat medication will  be directed straight to a community pharmacist, instead of out-of-hours GP surgeries.

 

The programme will launch in “pilot areas across England” in December, the DH added.

 

NHS 111 will also develop a “new approach” to refer patients with minor ailments – such as sore throats and bites – to community pharmacists for advice and medication, the DH said. This work will be linked to locally commissioned minor ailments services, it added.

 

However, NPA chairman Ian Strachan said yesteday that the new pharmacy schemes are a “smoke screen…clearly timed to draw attention away from the looming cuts planned by the [DH]”.

 

“Pharmacies cannot deliver these services if they have to cut back staff. They cannot deliver a service if they have been forced to close,” he added.

 

The emergency supply pilot will be funded by the pharmacy integration fund – a £300 million fund designed to assimilate pharmacy into the NHS and other care settings – and the cost of drugs would be recharged to NHS England as an average cost across each clinical commissioning group, the DH told C+D today (October 14).

 

The England-wide minor ailments direction service will be “developed and evaluated” between December 2016 and April 2018, the DH added. It will not receive funding and instead be “undertaken through ‘business as usual’ work”, the DH told C+D.

 

As part of its work looking at options to better integrate community pharmacy into urgent care, NHS England will investigate the impact of patients going to A&E for urgent prescriptions, the DH said.

 

“Modernising the sector”

 

Pharmacy minister David Mowat said yesterday that the DH is “modernising the sector to give patients the best possible quality and care”.

 

“This new scheme will make more use of pharmacists’ expertise, as well as freeing up vital time for GPs and reducing visits to A&E for urgent repeat medicines,” Mr Mowat said.

 

He added it is part of the DH’s drive to meet increasing demand for services, while “transforming” how pharmacists and their teams operate in the community.

 

England’s chief pharmaceutical officer Keith Ridge said the pilot will help pharmacy to integrate into the NHS’ urgent care system and described it as a “step towards the new role for community pharmacy”.

 

NHS England medical director for acute care Keith Willett said directing patients with less serious conditions to pharmacy could reduce the current pressure on the NHS.

 

The Pharmaceutical Services Negotiating Committee has today rejected the government’s plans to slash pharmacy funding in England by 12% for December 2016 until March 2017.

 

NPA response to Department of Health announcement about new pharmacy schemes

14 October 2016, National Pharmacy Association

 

Responding to the announcement on Thursday by Community Health and Care Minister David Mowat, NPA Chairman Ian Strachan said today:

 

“The announcement is clearly timed to draw attention away from the looming cuts planned by the Department of Health.  In reality it highlights the flat contradiction at the heart of the Department’s position – asking pharmacies to develop new roles and services whilst stripping away the investment necessary to make it happen.

 

“Pharmacies cannot deliver these services if they have to cut back staff. They cannot deliver a service if they have been forced to close.”

 

“The schemes look to fall far short of a properly funded nationwide scheme that would have transformational benefits for patients and the NHS.  It’s a smoke screen.  I don’t sense any conviction in it”.

 

“The Government has now acknowledged the unique potential of community pharmacies in urgent care.  Health Ministers should follow that logic and back pharmacies more fully to take pressure off stretched GPs and hospitals.”

 

A further communication is being distributed by the national pharmacy representative bodies jointly, including the NPA.

 

URGENT REPEAT MEDICINES PILOT EXPECTED IN DECEMBER, MOWAT TO TELL PB AWARDS

13 October 2016, Pharmacy Business, Neil Trainis

 

David Mowat, the minister responsible for pharmacy, is expected to use this evening’s Pharmacy Business Awards to announce that the government will launch an urgent repeat medicines pilot in community pharmacy in December.

 

The community health and care minister is expected to reveal a pilot for pharmacies to make supplies of medicines needed urgently on referral by NHS 111.

 

He is also expected to announce a minor ailments framework aimed at encouraging Clinical Commissioning Groups to commission local services.

 

PB AWARDS HAIL PHARMACY AS MOWAT PLEDGES SUPPORT FOR PROFESSION

14 October 2016, Pharmacy Business, Neil Trainis

 

Pharmacy Business paid tribute to community pharmacy’s role in healthcare during its awards event in London last night to the backdrop of ministerial promises about its future role in a creaking NHS.

 

Fourteen awards were handed out on the night, 12 to community pharmacies and one for Sue Sharpe, the chief executive of the PSNC who was given the Editor’s Award for her contribution to pharmacy’s struggle against the government’s funding cuts. There was also a special posthumous award for Kirit Patel, the founder of Day Lewis, who died in July.

 

The awards followed a promise by David Mowat, the community health and care minister, who told an audience of around 900 people at the InterContinental London O2 hotel that the government was committed to a pharmacy supply service for medicines needed urgently on referral by NHS 111 and a national minor ailments pilot between now and April 2018 which he promised would “be resourced and commissioned.”

 

“Roughly speaking, NHS 111 receives 200,000 telephone calls a year requesting repeat prescriptions. Currently, the scripts that the people use direct those requests to GPs, particularly out-of-hours GPs,” Mowat said.

 

“From December 1 nationally, those scripts will be changed and those 200,000 phone calls will be redirected to community pharmacists. That will happen and that’s a commitment.

 

“The second part of that is that we understand fully that you can do more in minor ailments. There’s been a pilot running around minor ailments in west Yorkshire.

 

“That pilot will be rolled out nationally between now and April 2018, again on NHS 111 scripts, a variety of ailments that are judged to be minor ailments will be directed by those scripts not to GPs but to community pharmacists. That will be resourced and commissioned and that will happen. They are not just words, they are going to happen.”

 

Mowat also said the government was “starting the legislation process” on the decriminalisation of dispensing errors and promised to “sort that out later this year.”

 

Mowat’s announcement was met with little enthusiasm by some within the audience. Graham Phillips, the owner of Manor Pharmacy Group, tweeted: “Bullshit warning. No government investment in the 2 scheme the minister just announced. Meanwhile #pharmacycuts imminent.”

 

Despite the politicking, community pharmacy took centre stage. The Pharmacy Business of the Year award went to Greenlight Pharmacy in London for its excellent service and Chuckery Pharmacy, situated in a deprived area of Walsall, took the Community Award.

 

The Customer Care Award went to Avicenna Pharmacy in Bishopsworth, Public Health Pharmacist of the Year was Award Francisco Alvarez at Regent Pharmacy, the Pharmacy Team Award went to Bedminster Pharmacy in Bristol and Emily Coppin-Harris was named Pre-Reg Trainee of the Year.

 

The Health & Beauty Pharmacy Award winner was Chasetown Pharmacy in Walsall, the Natural Healthcare Pharmacy Award went to Harrod Pharmacy in London, the Innovation Award went to Baxenden Pharmacy in Accrington while Corinne Player from Manor Pharmacy in Sutton was named Pharmacy Assistant of the Year.

 

Chain of the Year were Kamsons Pharmacy and the Enterprise Award went to Pharm Assist’s Ashley Cohen.

 

Emotions run high in response to the DH’s funding package

15 October 2016, Chemist & Druggist, Grace Lewis & Annabelle Collins

 

Pharmacy bodies have described the shock announcement that the government’s proposed cuts will go ahead as a “bitter blow” and “illogical”.

In the wake of the Pharmaceutical Services Negotiating Committee’s announcement that it has rejected the government’s plans to slash pharmacy funding in England by 12% for December 2016 until March 2017, C+D rounds-up the immediate reactions from the sector.

 

“This is a bitter blow to community pharmacy” – Pharmacy Voice chair Claire Ward

 

“This is a bitter blow to community pharmacy after all our hard work to demonstrate the value we bring to the NHS, public health system and wider society.”

 

“The fact that the government currently appears to be unwilling to match our ambition – despite the evidence, its own warm words for the sector and the out-pouring of support from pharmacy users – is extremely disappointing.”

 

“We are deeply disappointed…and alarmed” – Royal Pharmaceutical Society England board chair Sandra Gidley

 

“We are deeply disappointed that the government has not changed its approach to funding cuts this year and alarmed that further cuts have been announced for next financial year.

 

“The lack of news on the promised Pharmacy Integration Fund defies logic at a time when greater integration of primary care services to improve patient care is such a priority for the NHS. We call on the government to make good on its promise made in the original letter of December 2015 “to bring pharmacy even closer into the wider primary care and community health system.”

 

“We will not accept this betrayal meekly” – National Pharmacy Association chairman Ian Strachan

 

“The government’s approach is a betrayal of its promises and shows a complete disregard for the wellbeing of patients.

 

“This is a dangerous experiment…and a flat contradiction at the heart of the department’s position – asking pharmacies to develop new roles and services whilst stripping away the investment necessary to make it happen.

 

“We will not accept this meekly.”

 

“Arbitrary cuts” are “completely false economy” – Michael Dugher, Labour MP for Barnsley East

 

“For all their warm words on community pharmacies…ministers seem committed to pushing through a massive package of arbitrary cuts.

 

“Cuts to community pharmacies are bad for our local communities. But they are also bad for the NHS, which is already in crisis, and are a complete false economy as they will pile even more pressure on already overstretched GP surgeries and A&E [departments].”

 

“We firmly support” the PSNC’s decision to reject the proposals – Boots Spokesperson

 

“We are extremely disappointed that the pharmacy funding discussions have not reached a satisfactory outcome based on a shared understanding of the value of community pharmacy. We firmly support the PSNC decision to reject the government proposal this week and want to ensure community pharmacy remains an accessible point of care for all communities across the UK.”

 

The funding cut will have a “real impact” on community pharmacies – John D’Arcy, managing director, Numark

 

“We fully agree with the PSNC’s rejection of the Department of Health’s proposed cut of 12% this year. It’s essential that the Government recognises the crucial role of community pharmacies and reconsiders the framework through which this can be delivered as well as agreeing sufficient remuneration.”

 

“As any funding cuts would eat into profits provided from prescriptions, focusing on expanded service provision and stocking healthcare related OTC products will ensure pharmacies can continue to protect and grow their businesses.”

 

Community pharmacy sector rejects government plans to implement 12% funding cuts

14 October 2016, The Pharmaceutical Journal, Ingrid Torjesen

 

The Pharmaceutical Services Negotiating Committee has rejected the Department of Health’s proposals to cut community pharmacy funding.

 

The Department of Health (DH) is planning to implement a 12% cut to community pharmacy funding in England from December 2016 that could result in the closure of a quarter of pharmacies and the removal of free health services from community pharmacies, according to the Pharmaceutical Services Negotiating Committee (PSNC).

 

The DH reiterated its plans to forge ahead with the cuts in a confidential letter (dated 9 September 2016) to the PSNC, which negotiates the pharmacy contract with the government.

 

It proposes to reduce funding for community pharmacy by 12% from December 2016 to March 2017, which means funding for 2016–2017 will be £2.69bn, and cut it by 7.4% (compared to current levels for the next financial year), to set funding at £2.59bn for 2017–2018.

 

The PSNC has rejected the DH’s proposals in a letter, dated 13 October 2016. This means that the DH will have to come back with a revised package or it could impose the funding cuts without the support of the sector’s negotiating body.

 

The DH first proposed cuts to community pharmacy funding in December 2015 and since then the pharmacy sector has offered alternative proposals that would save the NHS equivalent sums. The sector has also come back with proposals for new pharmacy services that could save the NHS money by reducing demand in A&E and GP surgeries. However, all of these proposals have been rejected.

 

In September 2016, the PSNC released research showing that 12 pharmacy services generate an annual £3bn net benefit for the NHS and that the proposed funding cuts would hit areas with greatest health inequalities hardest. The DH has not responded to this research and has not provided any published evidence to support its own plans to reduce pharmacy funding.

 

The DH has always acknowledged that its proposals would mean that some pharmacies would become unviable, and estimates have put the number of pharmacies at risk of closure at up to 3,000.

 

A Pharmacy Access Scheme (PhAS) is planned to protect community pharmacies where patient need is greatest, but the PSNC has warned that the proposals for this “do nothing to protect the pharmacies in areas of the greatest health need or those with high ethnic minority populations who often depend on the pharmacist to get advice in their own language”.

 

“The support within the proposed PhAS is directed towards pharmacies in more affluent areas,” it says.

A spokesperson for the DH says: “We have worked collaboratively with the PSNC and have listened to their suggestions and counterproposals over the course of many months.

 

“Ministers are considering a proposed package for the sector and no final decision has been taken, but we are committed to offering more help to those pharmacies people most depend on‎ compared to others.”

 

The spokesperson added that the DH would not be publishing details of that proposed package at the present time.

 

Meanwhile, pharmacy leaders have reacted with anger and disappointment to the news about the cuts.

 

Sandra Gidley, chair of the English Pharmacy Board at the Royal Pharmaceutical Society, says: “We are deeply disappointed that the government has not changed its approach to funding cuts this year and alarmed that further cuts have been announced for next financial year.”

 

Gidley also warns that the cuts will have a detrimental effect on the quality of patient care delivered through community pharmacy. “We fear for patients, the public and pharmacists who may be significantly affected by changes in opening hours and staffing levels in community pharmacy.”

 

Ian Strachan, chair of the National Pharmacy Association (NPA), the trade association for independent community pharmacy in the UK, branded the government’s plans “a dangerous experiment”, and says that the lack of official evaluation “shows a complete disregard for the well-being of patients”.

 

“There is a flat contradiction at the heart of the [DH’s] position — asking pharmacies to develop new roles and services whilst stripping away the investment necessary to make it happen. Pharmacies cannot deliver more if they have to cut back staff. They cannot deliver a service if they have been forced to close,” he adds.

 

Claire Ward, chair of Pharmacy Voice, a trade association that represents community pharmacy in England, says that it was “a bitter blow” that after all the hard work through the counterproposals and the ‘Community pharmacy forward view’ to demonstrate the value community pharmacy could bring, the government appears to be “unwilling to match our ambition”.

 

“Attempts to justify these cuts with superficial arguments about pharmacy clustering, inefficiency and investment in ‘pilot schemes’ have been misleading, and are quite simply not supported by the facts. I fear that the burden of these changes will now fall on those least able to bear it,” she says.

 

“I continue to urge the government to halt these damaging and costly plans, and instead take up the sector’s offer to work in collaboration and partnership.”

 

Pharmacy Voice responds to damaging Government plans to cut sector’s funding

14 October 2016, Pharmacy Voice

 

Pharmacy Voice has reacted with anger and disappointment at today’s news that the Government has failed to agree the funding package for community pharmacy for 2016-17, and that the sector now faces an imposition of dramatic cuts over the next 18 months.

 

With the sector now facing cuts of hundreds-of-millions of pounds from December, the Government risks putting patient care, services, local businesses and jobs at risk.

 

The news of the scope and scale of the cuts follows a series of delays in decision-making from the Department of Health as it was forced to shelve key aspects of the reforms and struggled to respond to concerns raised by community pharmacists, MPs from all parties and the 2 million people that signed the largest health related petition in the country’s history.

 

Pharmacy Voice Chair, Claire Ward, said: “This is a bitter blow to community pharmacy after all our hard work to demonstrate the value we bring to the NHS, public health system and wider society.

 

“Through the counter-proposals and the Community Pharmacy Forward View, the sector has advanced a future for the sector that will not only enhance efficiency but will also ensure its long-term future, with patients at its heart. The fact that the Government currently appears to be unwilling to match our ambition – despite the evidence, its own warm words for the sector and the out-pouring of support from pharmacy users – is extremely disappointing.

 

“Nonetheless, we remain committed to working in partnership with national and local colleagues, and to playing our part in relieving pressure on our hard pressed GPs and A&E departments.

 

“Attempts to justify these cuts with superficial arguments about pharmacy clustering, inefficiency and investment in ‘pilot schemes’ have been misleading, and are quite simply not supported by the facts. I fear that the burden of these changes will now fall on those least able to bear it.  We will be closely monitoring and highlighting the impact the cuts have on pharmacy teams and their patients over the coming months.

 

“At the same time, we will continue to work with our members and other national pharmacy bodies to support the ongoing campaign and to advocate for the long-term plan for the sector within the Community Pharmacy Forward View.  We will build on the enormous good-will we have generated within Parliament, amongst the public and with NHS and Local Government colleagues in support of an expanded role for pharmacy within primary care and public health.

 

“In the meantime, I continue to urge the Government to halt these damaging and costly plans, and instead take up the sector’s offer to work in collaboration and partnership to secure the clinical services, employment opportunities, and community support that pharmacy teams across the country are uniquely placed to deliver.”

 

NPA reacts with fury to news that pharmacy funding talks have broken down

14 October 2016, National Pharmacy Association

 

The National Pharmacy Association (NPA) has reacted with fury to the news that pharmacy funding talks have broken down, following confirmation that the Department of Health wants to press ahead with massive cuts.

 

Earlier this year, a decision was delayed after a record breaking two million petition was delivered to Downing Street.

 

The Pharmaceutical Services Negotiating Committee (PSNC) has rejected the Department of Health’s proposed funding package for 2016/17. The proposed package includes cuts 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.

 

Responding to the news, National Pharmacy Association (NPA) chairman, Ian Strachan, said today:

 

“The Government’s approach is a betrayal of its promises and shows a complete disregard for the well-being of patients.  Millions of worried patients have asked the Department of Health to think again. Politicians from all parties are against the cuts. Yet elements within Government seem determined to press ahead with this damaging experiment, deaf to the nationwide protests.

 

“There is a flat contradiction at the heart of the Department’s position – asking pharmacies to develop new roles and services whilst stripping away the investment necessary to make it happen. Pharmacies cannot deliver more if they have to cut back staff. They cannot deliver a service if they have been forced to close.

 

“This is a dangerous experiment. We have seen no official assessment from Government of what the consequences will be for patient care, although we know full well that people will suffer, including some of the most vulnerable people in our society.

 

“The Pharmacy Minister said this week that final decisions have yet to be made. If that is the case, he has to seize this final opportunity to change course. If he does not, he should know that we will not accept this meekly. We owe it to the millions of patients who have supported us to continue to safeguard the pharmacy services they rely on – including the most vulnerable of the patients and communities that we serve.”

From Factory to Pharmacy

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