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Pharmacy leaders make funding plea as contraception service launch date looms

Community pharmacy’s funding crisis could hamper the success of the upcoming national contraception service in England, sector leaders have warned.

NHS England (NHSE) revealed on Thursday (April 13) that tier one of the service will commence next week – despite the Pharmaceutical Services Negotiating Committee’s (PSNC) insistence that it had not agreed to the April 24 launch date.

At the time, the negotiator reiterated its view that no new or expanded services should be rolled out this year unless the government provides extra funding for community pharmacies.

Read more: Launch date for national contraception service announced

Since then, sector leaders have warned that years of underfunding means pharmacy teams are more concerned with “keeping their business afloat” than rolling out new clinical services.


Pharmacies at “crisis point”


National Pharmacy Association (NPA) vice-chair, Nick Kaye cautioned that pharmacy owners are currently “being forced to apply most of their energy to keeping their business afloat” rather than implementing new NHS services.

The NPA acknowledged that permitting the repeat supply of oral contraception through pharmacies “will increase choice and improve access”.

But Mr Kaye said the chances of a successful national rollout of the oral contraception service are “much reduced by a decade of chronic underfunding, which has brought pharmacies across England to crisis point”.

And while the Royal Pharmaceutical Society (RPS) welcomed the provision of oral contraception in community pharmacies, it expressed similar reticence about the contraception service’s chances without proper support.

Chair of the society’s English Pharmacy Board, Thorrun Govind, stressed that the roll-out “must be backed and enabled by appropriate funding and technology”.


Can’t “continue on goodwill alone”


Meanwhile, the Company Chemists’ Association (CCA) warned that “pushing through” the contraception service, despite the protestations of the negotiator, representative bodies and contractors, “shows a worrying disregard for the reality within the community pharmacy sector”.

A CCA spokesperson emphasised that England’s five-year funding deal was finalised “before the pandemic, rampant inflation, ever growing workloads, and continuing pressures on businesses”.

And while “many pharmacies will no doubt do their best” to meet patient needs, the funding of community pharmacy is “broken and needs to fundamentally change”, they said.

Read more: When will the pharmacy contraception service launch?

Adding that although community pharmacy has “huge potential” to meet the contraceptive needs of women by “increasing access and creating much needed capacity across primary care”, the CCA stressed that the sector “cannot continue on goodwill alone”.

Read more: Pharmacy contraception service launch delayed over lack of IT support

Association of Independent Multiple pharmacies (AIMp) chief executive, Dr Leyla Hannbeck, has already warned that "the current model where pharmacies are asked to do more for less and services [keep] coming from the same global sum is unsustainable and cannot continue".

“Whether negotiated or imposed, pharmacies need time to understand, plan and integrate new services into the very busy, business-as-usual days”, she said when the announcement was made last week.


"Strategic decision" not to offer service


Community pharmacist Waqas Ahmad – a contractor in Liverpool and managing director at WGA UK LTD – said he would “implore all community pharmacists to not offer” the service.

“Our negotiator hasn't agreed it, and we should not offer any new optional services until our core funding is uplifted to an acceptable level,” he said.

And Hertfordshire contractor Graham Phillips, owner of the Manor Pharmacy Group, was emphatic that his teams do not have capacity to offer the service.

"We have made that strategic decision based on [PSNC's] position on funding], he tweeted, referencing the negotiator's insistence that the sector is not funded well enough "for new things to be rolled out".


What does the service involve?


Under tier one of the contraception service, pharmacy teams will be able to continue providing oral contraception under a patient group direction (PGD) to patients who were first prescribed it via primary care or sexual health clinics.

Read more: Case study: What's it like to offer the pharmacy contraception service?

Participating pharmacies will earn £18 per consultation and a set-up fee of £900, paid in instalments, according to a draft service specification published by the NHS Business Services Authority (NHSBSA) in December.

Under a five-year deal agreed in 2019, community pharmacies in England are allocated a flat £2.6 billion per year in funding, although pharmacy bodies have joined together this year on a campaign to lobby the government for greater investment.

When challenged on pharmacy funding in England last week, the Department of Health and Social Care (DHSC) told C+D it "backs" pharmacies in England with over £2bn in funding each year and has also announced "a further" £100m of investment into the sector.

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