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PSNC hits back as DH ploughs ahead with reduced PQS amid 'imposed' changes

The pharmacy negotiator has hit back at the government over "imposed changes" to the pharmacy contract, including a "reduced" pharmacy quality scheme (PQS).

The Pharmaceutical Services Negotiating Committee (PSNC) yesterday announced (April 27) that the Department of Health and Social Care (DH) has indicated its “decisions on the community pharmacy contractual framework (CPCF) for 2023/24”.


The government has also “laid regulations affecting community pharmacy contractors”, including around temporary closures, PSNC said.


Read more: UPDATED: Halt PQS until pharmacy funded fairly, PSNC tells government


The raft of changes – which PSNC said “have been imposed on the sector” – include a “reduced PQS compared to the scheme originally planned last year”.


PSNC said:

  • There will be a reduced list of activities for contractors with a value of 60% of the originally planned PQS - £45m

  • The remainder of the PQS funding (the additional £30m) will be used as an alternative to reducing fees to help ensure that there is no over-delivery of fees in this financial year

  • As the reduced PQS contains a clinical audit, the DH and NHS England (NHSE) have agreed to PSNC’s request to remove the clinical governance requirement for contractors to undertake two clinical audits in 2023/24



“Unaffordable”



While the 2023/24 scheme is reduced, PSNC said that the decision to go ahead with it at all this year “without an urgent injection of extra funding is in contradiction of our warnings to ministers”.


“There is not enough money to pay for the current services and dispensing delivered by the sector; let alone for new activities to be rolled out”, it added.


However, it said that it recognises “the importance of some elements of the PQS” and “the fact that the scheme continues to demonstrate pharmacy’s commitment to, and exceptional performance on, quality”.


Read more: ‘No assessment' of funding impact on pharmacy closures, says DH


It also noted the “concessions” that ministers made in response to its submissions in reducing the scope of the PQS to “reduce the burden on contractors” and a reduction in the single activity fee (SAF) that was “previously mooted”.


PSNC said that the “safeguarding” of PQS funding while reducing activity required is “an improvement on their original position”.


Read more: Pharmacy leaders make funding plea as contraception service launch date looms


But it added that it believes the “funding and capacity constraints” in the sector “mean the scheme is currently unaffordable”.


Last month, PSNC urged the government to press pause on the rollout of the PQS unless it invests more money into community pharmacies.



Expanded CPCS will go ahead



Meanwhile, PSNC announced that the government has also ploughed ahead with the expanded community pharmacist consultation service (CPCS) – which will include referrals from urgent and emergency care from May 15.


It said that the changes have been made “in contradiction of our warning to ministers that no new or expanded services can be rolled out in 2023/24 unless extra funding is put into community pharmacies”.  


Read more: Only two-thirds of GPs referring to pharmacies via CPCS, minister reveals


Regulatory changes will also come into force on May 25, allowing some “flexibilities” for contractors to “close for rest breaks” and “manage closures” through integrated care boards (ICBs), PSNC said.


They will also allow 100-hour pharmacies to reduce their core hours – which is “not matched… by equivalent easements for 40-hour pharmacies” – and will require all pharmacies have business continuity plans in place for temporary closures, it added.


Read more: ‘Bleak outlook’: PSNC survey highlights temporary closures and staff shortages


PSNC said that it “opposed” the “divisive” changes on the basis that they are “wholly inadequate” to address “crippling pressures”, adding that it had made more than 30 suggestions for regulatory easements to help improve the operating environment.

“We believe that it is unwise for the NHS to interfere with the level playing field for contractors in such a crushing economic climate,” it added.


“Run out of money”



PSNC said that its “clear view remains that the sector’s finances and capacity are in a critical state” and that it “[does] not think contractors will have the capacity to take on additional services or work”. 

“As reported a number of weeks ago, we have been clear with government and the NHS that their money has run out – there is simply not enough funding available for pharmacies to deliver new services in year five [of the contract]”, PSNC chief executive Janet Morrison said.

“It’s incredibly frustrating that these warnings are not being heeded – there is simply no point in NHSE rolling out services that pharmacies cannot afford to provide or deliver to the standard patients deserve,” she added.

Read more: CCA: At least 720 English pharmacies permanently closed since 2015

Recognsing the “helpful concessions” made on the PQS, she added that “in reality it is far too little to help ease the crippling pressures that contractors are grappling with”.   

A DH spokesperson stressed that in September, PSNC agreed to the introduction of urgent and emergency care referrals to the CPCS, as well as the introduction of the contraception service and the new medicines service’s extension to antidepressants over the following 18 months.

 

“We are supporting pharmacies to provide a range of clinical services and we are increasing the services pharmacists…can provide to their community including managing oral contraception”, they said.


Primary care recovery plan



PSNC said that the changes announced yesterday “do not reflect any changes that might be negotiated” pending the outcome of the primary care recovery plan.


The long-awaited plan has been “considered by government separately” to the contractual framework and is “likely to be published soon”, it added.


Read more: PSNC ‘still awaiting news’ on Pharmacy First service amid October launch hints

 

The negotiator reiterated calls for the plan to urgently deliver a fully funded Pharmacy First service or “another funding lifeline” to community pharmacies.


The DH spokesperson said it will shortly be setting out its primary care recovery plan.

 

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