UPDATED: Halt PQS until pharmacy funded fairly, PSNC tells government
The government must press pause on the rollout of the upcoming Pharmacy Quality Scheme (PQS) unless it invests more money into community pharmacies, PSNC has urged.
The Pharmaceutical Services Negotiating Committee (PSNC) has told the government that it must not launch either the PQS for 2023/24 or any other “new or expanded” clinical services unless it starts to fund pharmacies properly, it announced last night (March 13).
This includes the “much anticipated” national pharmacy contraception service, which was due to launch earlier this year but has been delayed due to a lack of “necessary IT support”.
The negotiator said that community pharmacies in England are already in a "desperate position" and cannot cope with additional workload.
“Without an urgent injection of extra funding there is not enough money to pay for the current services and dispensing being done by the sector; let alone for new things to be rolled out,” it added.
NHS England (NHSE) must also stop directing more patients to pharmacies, PSNC urged.
C+D approached NHSE for comment.
It follows communications from NHSE’s medical director Professor Sir Stephen Powis this weekend (March 11) that patients should use pharmacies as one of their “first ports of call” during this week’s junior doctor strikes.
PSNC added that the Department of Health and Social Care (DH) should “consider” capping existing advanced services “to protect core dispensing funding”.
A DH spokesperson told C+D that it is "continuing to discuss...how the government can best support community pharmacies and the sector to provide services to patients" with PSNC.
It “backs” the sector with £2.6 billion in funding every year, it said, and pointed to £100m in excess margin it agreed to waive as part of its most recent negotiations with PSNC.
It said that as part of its last round of talks with PSNC, the negotiator had agreed to the introduction of the contraception service, referral to pharmacies from urgent and emergency care and the extension of the new medicines service (NMS) to include antidepressants.
Pharmacy First a “good route” to funding
PSNC warned the government that it will be “presiding over the collapse of the community pharmacy sector” if it does not provide more funding.
“We have told ministers that they need to decide what sort of community pharmacy network they want: businesses are failing and this will imminently put medicines supply at risk,” it said.
PSNC is also continuing to push the government for a fully funded Pharmacy First service, which it branded a “good route to get additional funding into the sector quickly, while also delivering on the government’s ambitions”.
“Without this or another funding lifeline, [the government] can expect further primary care crises ahead as pharmacy businesses continue to fail,” it said.
Last week (March 7), Ms Morrison predicted that the “most likely” source of new funding for community pharmacies in England would be a Pharmacy First service, which she believed had been proposed as part of the NHS’s upcoming primary care recovery plan.
Pleas for regulatory easements
The negotiator urged the government to “make good” on a raft of regulatory easements that would allow pharmacy owners “greater flexibility”.
This would give pharmacy owners options including:
permanently reducing their pharmacy's core opening hours by 30%
temporarily reducing their pharmacy's core opening hours by up to one day per week
the option to implement “unlimited closed door working so long as it is notified to the NHS after the event”
the ability to refuse to dispense prescriptions “if pressures are such that dispensing could result in professional standards that are below those generally accepted”
the ability to dispense prescriptions ‘with reasonable promptness’ rather than immediately where there would be no reimbursement for the individual contractor to be dispensed
the ability to dispense prescriptions ‘in a reasonable timescale’ rather than immediately where the reimbursement price is lower than the purchase price .
PSNC is also asking for:
a moratorium on new distance selling pharmacy applications for two years
a limitation on the introduction of hub-and-spoke dispensing, where supply could only be made from NHS contract ‘spokes’
pharmacists to be able to make formulation changes where necessary without having to use a safer shortage protocol (SSP)
a “major” reform to the Drug Tariff
the requirement for pharmacies to take part in health campaigns or to undertake clinical audits to be scrapped
dispensing requirements to be scrapped, including asking patients for exemption evidence and getting patient signatures for paid-for prescriptions.
PSNC added that pharmacies are still looking ahead to the clinical services they are capable of offering patients, but are hampered by capacity constraints.
Its chief executive Janet Morrison said the negotiator’s plea to pause initiatives such as the PQS and the contraception service had not been made because “we don’t want these services”.
“Community pharmacies are incredibly ambitious about the services they could provide to their communities,” she said.
But she warned that “pharmacy owners [don’t] have the capacity under current conditions to properly undertake this work”.
She continued: "Many businesses are now operating at a loss, struggling with drug pricing, staffing, increasing public demand and staying open. We are struggling to keep our lights on and urgently need investment."
It comes as pharmacy bodies have joined forces on a campaign to "save" England's pharmacies.
Last week, the campaign's petition demanding fair pharmacy funding amassed over 1,800 signatures just a day after it was launched. At the time of publication, the petition had garnered 6,400 signatures.
And last month, the negotiator blasted an “irresponsible” and “extremely unhelpful” NHSE advertising campaign that encouraged patients to visit their pharmacy for non-urgent advice on minor ailments.