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5-year pharmacy funding deal revealed with greater focus on services

The global sum will remain at £2.59 billion, with medicines use reviews (MURs) phased out in favour of new clinical services, in a five-year funding settlement for England.

The new settlement, unveiled today (July 22) by the Pharmaceutical Services Negotiating Committee (PSNC), NHS England and the Department of Health and Social Care (DH), shows:

  • The global sum will remain at its current level of £2.592bn a year
  • Establishment payments will cease in April 2020, while the MUR service will end in 2021
  • This funding will be replaced with payments for new services, some of which are yet to be decided
  • Overall funding for the new medicine service (NMS), the single activity fee, the Quality Payment Scheme (QPS), the Pharmacy Access Scheme (PhAS) and retained margin will remain the same
  • All pharmacies will be paid to handle referrals from NHS 111 from October
  •  £10m from the global sum has been set as a contingency for pharmacies to dispense medicines under a serious shortage protocol, for which they will be paid £5.35 each time.
  • Funding has been set aside for pharmacies to offer a hepatitis C screening service for this financial year and the next.

Funding will remain at its reduced level of £2.592bn per year for the next five years, said PSNC, which stressed that this is more than the government had originally planned. However, it falls short of the £2.8 billion for 2015-16 – the last year before the government implemented its cuts.

Establishment payments – which the government promised in 2016 to phase out over “a number of years” – will cease completely in April 2020.

Meanwhile, MURs will be phased out by April 2021, with pharmacies only able to receive payment for 250 reviews carried out in this financial year, and 100 for the next. The service will be replaced by “structured medication reviews” carried out by “clinical” pharmacists working in recently created primary care networks (PCNs).

New services in the pipeline

The pharmacy funding lost from these streams will be replaced by payments for new, national clinical services, all of which have yet to be decided.

PSNC said it is planning to: launch a pilot of pharmacies identifying undiagnosed cardiovascular disease; to review a pilot of smoking cessation referrals from primary care; pilot an expanded version of NMS to cover further conditions; pilot discharge medication reviews; and multiple pilots for point-of-care testing, to “support efforts to tackle antimicrobial resistance”.

The Pharmacy Integration Fund – set aside by the government in 2016 to be invested over five years to “transform how pharmacy will operate in the NHS” – will be used to fund these pilots, PSNC said.

Two million pounds has been set aside to pay pharmacists to deliver hepatitis C screening for both this financial year and the next. The service is “time limited”, and no money has been allocated beyond March 2022.

In the meantime, all pharmacies will be paid £14 to deal with each referral from NHS 111 – following pilots across the country – from October, with no cap on the maximum number of consultations they can claim payment for.

“Transitional” payments

There will be a “transitional” payment of £900 for pharmacies who sign up to deliver the Community Pharmacist Consultation Service (CPCS) – which will replace the Digital Minor Illness Referral Service (DMIRS) and NHS Urgent Medicine Supply Advanced Service (NUMSAS) – by December 1, and £600 for those who do so by January 15.

PSNC plans to expand this service over the course of the five years include referrals from GP practices, NHS 111 online, urgent treatment centres and possibly A&E.

There will also be payments to support pharmacies to implement the EU medicine scanning law the Falsified Medicines Directive, a payment of £5.35 for each prescription dispensed under a serious shortage protocol – should the government ever issue one – and to work with PCNs.

Payments for the single activity fee, the NMS and the PhAS will remain the same for the next five years. While overall funding for the QPS will remain the same, it will be renamed the Pharmacy Quality Scheme, with new gateway and quality criteria that pharmacies will have to meet.

Taking a long-term view, PSNC said “discussions will be held on new funding models”.

Savings in the cost of dispensing will “free up funding and resources for value-added service delivery”, the negotiator claimed.

PSNC: Protected funding

PSNC CEO Simon Dukes said: “The NHS fully expected a cut in community pharmacy funding to have been made in 2018-19 – with therefore a funding level in 2019-20 of lower than £2.592bn.

“While we have not succeeded in getting an increase in the overall sum, we have secured a commitment from the government to a protected £13bn over five years,” he added.

“The planned services will enable the sector to transform its offer and I hope community pharmacists will be pleased about the new roles they will be able to offer.”

Commenting on the new funding contract, health secretary Matt Hancock said: “Pharmacists are integral to community health and I want to move towards the French model, where they offer a wider range of services and play a stronger role in the community.

“Community pharmacies are a vital and trusted part of our NHS, and this five-year deal will ensure more people get support in the most appropriate setting, which in turn helps relieve pressure on the wider health service.”

What do you make of the new contract changes?

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