Pharmacy First funding breakdown: Upfront, monthly and consultation fees
Pharmacies will receive multiple payments for the new Pharmacy First service, which is set to launch on January 31, Community Pharmacy England (CPE) has announced.
Pharmacies signing up to the new Pharmacy First common ailments service will receive a £2,000 upfront payment in addition to monthly and individual consultation payments, the pharmacy negotiator, NHS England (NHSE) and the government announced this morning (November 16).
The advanced service, which CPE said will launch on January 31 subject to IT systems being in place, will allow pharmacies to treat seven common conditions without the need for a GP appointment or prescription.
In a joint letter to contractors published this morning, CPE, NHSE and the Department of Health and Social Care (DH) said that pharmacies will be able to claim an “initial fixed payment of £2,000…from December 2023 up until service launch”.
CPE said that the “hard-won” upfront payment was “a must” to help “pharmacy owners to prepare and build capacity for the new service”.
Monthly fixed payment from February
The letter also announced that from February 2024, pharmacy contractors offering Pharmacy First will also receive a “monthly fixed payment of £1,000”.
Additionally, it said that pharmacies will be able to claim “a £15 item of service (IoS) fee for each Pharmacy First consultation”.
It added that the fee will apply to “any clinical pathways consultation”, defined “as where a patient passes a clinically established gateway point in the pathway”, and any consultations that “would previously have been delivered” under the community pharmacist consultation service (CPCS).
The letter also said that “where a medicine is supplied under Pharmacy First…the reimbursement arrangements set out in the drug tariff will apply”.
The monthly payment was dubbed “really important” by the negotiator’s chief executive Janet Morrison in a press briefing attended by C+D yesterday (November 15).
Fees “recovered” if activity threshold unmet
However, the letter stressed that the £2,000 upfront fee will be “recovered” from contractors if they “have not delivered five clinical pathways consultations” by March 31 next year.
Additionally, pharmacies will need to deliver a minimum number of consultations each month in order to claim the monthly £1,000 fixed payment, it said.
Only one consultation is required to reach this “gateway” in February 2024, but this number is set to increase incrementally until October 2024, it added.
From then, contractors will have to carry out 30 Pharmacy First consultations a month to claim the fixed monthly payment, the letter said.
The letter explained that contractors who do not reach minimum consultation numbers “will only be paid the item of service fee of £15 per clinical pathway consultation”.
It added that “only consultations under the new clinical pathways” launched in Pharmacy First will count towards this number.
Ms Morrison said that CPE had managed to reduce these thresholds and the rate at which they will increase during negotiations and that the announced threshold numbers are “much more achievable” and are not “going to frighten pharmacies about what they were expected to deliver”.
She said that CPE had been “very concerned” about the activity threshold being “a disincentive to pharmacy signing up”.
She added that the negotiator “didn't want to gate people out who might miss targets by one here or there”.
“Cost control” caps
Meanwhile, the letter also highlighted that the new Pharmacy First funding “is sufficient for up to 12 million consultations per year”.
From April 2024, it said that there will be an “initial cap of 3,000 consultations per month per contractor”.
However, from October 1 next year, “new caps will be introduced based on actual delivery of Pharmacy First”, it added.
The letter said that these “cost control” caps, which CPE said will be decided for the second half of 2024/25 by a new “implementation group”, will be designed “to deliver three million consultations per quarter”, with “unused activity rolling forward to subsequent quarters of that financial year”.
CPE said that this “different approach to the cost control mechanism” will allow “successful community pharmacies” to “continue to grow their service offer without losing out on fees”.
The letter said that NHSE, CPE and the DH will publish more details, including details of the registration and set-up fee process, clinical pathways, patient group directions (PGDs) and the service specification “closer to the launch of the Pharmacy First service”.
NHSE today revealed the long-awaited details of its primary care recovery plan reforms – including the launch dates of the new Pharmacy First and pharmacy contraception initiation services - which were first announced back in May.
Check the C+D site for the latest coverage on this developing story