‘Very positive’ but ‘not perfect’: Contractors on recovery plan reforms
Despite generally welcoming the raft of upcoming changes to community pharmacy services in England, contractors who spoke to C+D raised concerns about consultation thresholds, IT developments and core funding.
NHS England (NHSE), the Department of Health and Social Care (DH) and Community Pharmacy England (CPE) last week (November 16) announced that England’s national Pharmacy First service will be launching from “early next year”.
It was also revealed that the pharmacy contraception and blood pressure check services will be expanding from December 1 as part of a raft of reforms ushered in by the primary care recovery plan, first published in May and backed by a £645 million cash investment into community pharmacy services.
The long-awaited details of how the funding will be spent and further details about the services were broadly welcomed by pharmacy leaders last week, who deemed the reforms a “huge vote of confidence”.
But what do pharmacy contractors think? C+D spoke to three contractors to get their opinions on the news.
“A great step” but “very challenging”
Hitesh Patel, chief executive of Pharmacy London – which represents the majority of contractors in the capital – hailed the announcements as “the first bit of good news that we've had [about] the community pharmacy contractual framework (CPCF)” in recent history.
When C+D spoke to him last week (November 17), he welcomed Pharmacy First as “a great step” and said that he was “really looking forward to pharmacies being able to finally show what they can do [and] get some funding for it”.
However, he highlighted that “the timelines are very tight” for contractors to get “the right systems in place” before the services launch.
Mr Patel told C+D that while he thought “most of the IT systems will be ready” to carry out consultations for each of the three services, he had other questions about the technology.
He warned that “connectivity might not be there straightaway” for automatic payments from the NHS Business Service Authority (NHSBSA) and digital communications with GP surgeries.
“There's a lot of threads to bring together. It's going to be very challenging,” he said.
CPE chief executive Janet Morrison noted that each of the service start dates "will depend on the availability of IT and digital systems", with none of these set to go live until "basic criteria and conditions" have been met.
C+D has contacted the DH and NHSE for comment.
“Not the best time” to announce new services
Martin Bennett, contractor and managing director of Wicker Pharmacy in Sheffield, told C+D last week (November 17) that he was “really pleased that [Community Pharmacy England] managed to get an agreement”. But he warned that “it's not perfect”.
He believes that it’s “not the best time to announce” changes “in the middle of the winter season” with “Christmas coming up”.
Mr Bennet noted that there is “undoubtedly a lot of work to do before the strange date of January 31 – a Wednesday”, when the national Pharmacy First service is due to be rolled out.
He said that timings being “a little bit on the odd side… make it very difficult to plan anything properly”.
Ms Morrison said that it was "clear" the government wanted "to launch Pharmacy First during the winter despite the challenges". "We are very aware that winter is a demanding time for community pharmacies, but we also heard from business owners that they wanted to access the new money as soon as possible," she added.
And she confirmed that there "is already a lot of work going on to support the launch during this period", including the preparation of "a series of webinars" for which more details will follow "shortly".
Core funding "still a problem"
Mr Bennett also stressed “that core funding is still a problem, regardless” of Pharmacy First funding.
Ms Morrison said that the organisation's negotiating team had been forced to "manage the very difficult balance between the need to get vital funds flowing into pharmacies as quickly as possible and the importance of getting funding on the right terms, setting down markers for what will be needed now and for the future".
She added: "We are also under no illusion that this is the end of the road, and we know there is a huge amount of information to absorb and prepare for. The final deal took longer to agree than we would have liked, necessitating that timelines were pushed back and implementation, especially over winter, will be extremely challenging."
Ms Morrison said that the £645m funding injection, although a "welcome vote of confidence... will not solve pharmacy’s funding crisis". "We have been clear on that throughout this complex negotiation, and we continue to press for further investment," she added.
She said that CPE "hopes to be back in the negotiating room soon" to start discussing what the next CPCF will look like, and is continuing to push for increased core funding to the sector.
Olivier Picard, contractor and managing director at Newdays Pharmacy, told C+D yesterday (November 22) that he was similarly feeling “very positive” about the announcement.
“I think it's got huge potential to create millions of appointments, which will certainly be in the NHS’s interest,” he added.
However, he said that he anticipated issues “down the line”, when pharmacies will need to deliver a minimum number of consultations each month in order to claim the monthly £1,000 fixed Pharmacy First payment.
He questioned whether pharmacy teams will be able to meet those thresholds without “the support of the NHSE team to drive people through the door”.
When asked about the alternative option of pharmacies being overrun with patients, Mr Picard suggested pharmacies could use “a booking system” to direct patients to other pharmacies with capacity when they are full.