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2015-16 funding settlement: National flu service announced

Sue Sharpe: New service shows messages about pharmacy's potential impact are "starting to get through"

PSNC has unveiled the community pharmacy funding settlement for 2015-16, which will see pharmacists deliver an advanced service for flu vaccination from September

PSNC has announced a national flu vaccination service as part of England's 2015-16 pharmacy funding settlement, which has seen no change to the global sum.

The advanced flu vaccination service will start this September and will generate remuneration on top of the global sum, which has remained flat at £2.8 billion after "extremely difficult" negotiations, PSNC announced today (July 20).

Pharmacists will receive £9.14 for every vaccination as well as reimbursement for the cost of the vaccine from NHS England’s national flu budget. This will include remuneration of £7.64 per dose plus £1.50 to cover training and waste disposal .

Under the service, any pharmacy with a consultation room will be to offer jabs to the NHS “at-risk” patient groups over the age of 18, including over-65s, pregnant women and adults with chronic conditions such as diabetes. The scheme will replace any local flu vaccination services commissioned through NHS England area teams.

PSNC said it needed to perform “further work” to prepare for the implementation of the service and pledged to publish a service specification and guidance "in due course". The service had been commissioned on an “ongoing basis” but it would be necessary to demonstrate it was offering "value for money", PSNC stressed.
 

Potential for GP "tension"

PSNC acknowledged that the service could potentially cause “tension” between pharmacists and GPs. It said GP support was “helpful and should be encouraged” but stressed that it was “not necessary” for the success of the service.

Pharmacists will still need to report vaccinations to the patient's GP practice, as is the requirement for locally commissioned services.

Pharmacists can also use the same suppliers as they do for existing local services. There will be no central procurement, and the NHS will simply specify the vaccines pharmacists need to use. 

The negotatior revealed that Public Health England was "coordinating communications and resources" to promote the flu vaccination programme, which pharmacists would be able to make use of. 

PSNC chief executive Sue Sharpe said the new flu service made "absolute sense” for patients and commissioners. “The commissioning of the new service shows that our messages about the impact pharmacy can have are starting to get through, and we must make the most of every opportunity given,” she said.
 

No national minor ailments services

In contrast to the flu service success, PSNC revealed that NHS England had “decided not to pursue" a national minor ailments service. PSNC said the outcome of the negotations for the service, which were underway in May, was “very disappointing” and would have a "negative impact" on the NHS and patients.

In better news, PSNC revealed it had agreed to establish a joint working group with the NHS to review the costs of and service issues with the electronic prescription service. The review would inform “a number of changes to the community pharmacy contractual framework", PSNC said.

The new funding package also includes additional requirements for pharmacists. PSNC had agreed “in principle” that pharmacies would have to publish their earnings from the NHS “in line with requirements on other health professionals and service providers", it said.

Pharmacists will also have to tell patients who claim exemption of prescription charges without evidence that the NHS routinely checks claims and may take action if a false claim has been made.

 


What do you think of the settlement?

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31 Comments

Mumtaz Jivraj, Community pharmacist

Wow! it is brilliant to have another advanced service, added in the agenda for pharmacists. It once again proves the potential, accessibility, flexibility etc we have as a profession, in provision of health services. Well done to all colleagues who already provide the vaccination services locally, and best wishes to those who, are interested to provide the service. Lets all go for it!

John Randell, Non Pharmacist Branch Manager

this has walgreens-boots medelling all over it... good for pharmacy though

John Urwin, Community pharmacist

a. It does? b. Yes it is.

Really? Wow, Superintendent Pharmacist

Is everyone aware of this from pulse website; "GPs are paid a dispensing fee of around £2 per prescription on top of the £7.64 fee, but the GPC said this could still leave GPs out of pocket compared with pharmacists, as they have to carry out more administrative work – including calling and recalling patients and maintaining records for the national programme.' Will we get a dispensing fee on top of the vaccine cost also?

Dave Downham, Manager

So...I like GPs giving me a flu vaccine. But I also like the pharmacy next door giving me one. Who should I use? Which is better? Only one way to find out....FIGHT!!!!

Roger Kirkbride, Community pharmacist

I'm looking forward to providing this service - we've been providing private 'flu vaccines for a few years woth some success and I know this will go down well with patients.However the integration with GP services doesn't appear to have been thought through and the backlash has already started; see http://www.gponline.com/gpc-demands-review-pharmacists-paid-gps-flu-jabs...

Really? Wow, Superintendent Pharmacist

Indeed, this was expected. It is not helped that the spec for this service hasn't actually been written before its announced! Do GP's have to pay for their clinical waste disposal?

Super Pharmacist, Community pharmacist

I could be wrong but my understanding is that GPs get effectively double what we will be paid. WHY?!

Sue Per, Locum pharmacist

The latest i have heard is that the one of the multiples wants the locums to provide flu jabs for a bonus of £50.00, when a target of 100 is reached. On that basis they have secured very good package from the Paymasters. I seriously believe the time has come to fight back these slave masters, and fight vigorously for an end to contract limitation, so that one, such as me can set up enjoy the generous offerings from the NHS. Alternatively PSNC please take note of this, and negotiate peanuts for the contractors as they are only prepared to pay PEANUTS for these advanced services (which are not encompassed in the global sum) to locums and employees for the provision of these advanced service!!

max falconer, Superintendent Pharmacist

The overall profit will be roughly the same. Good news, except we have to personally administer, whereas the definition of personally administered for GPs mean that they might know about it but don't have to actually perform the procedure! They get someone much cheaper to do the actual work! Bit like practice pharmacists...........

Matthew Edwards, Community pharmacist

That is not correct. In fact in previous years due to us ordering vaccines in bulk and early enough I have managed to buy vaccines cheaper than the surgery and consequently made more profit/vaccine than them

John Urwin, Community pharmacist

Yes, you are wrong. Any extra profit is due to effective purchasing, something we are also quite good at! In fact the GPs are moaning about the £1.50 we will get for training and waste disposal.

London Locum, Locum pharmacist

Because they have effective negotiators that demand respect and who don't just capitulate and roll over.

Nat Mitchell, Community pharmacist

We need to look upon this as an opportunity. Just have a look on the GP Pulse website at their article about the service and you will find out how useless they think we will be at it. If that is not motivation enough to prove that pharmacists as qualified healthcare professionals, can easily provide what is in essence a very simple service effectively and with a customer focus then I don't know what is. The vaccinations will provide extra income and goodwill for your pharmacy. It undoubtedly gets in the way of your core business, but so does MUR, NMS, NHS Health Checks etc. Pharmacy is what is and I'm afraid we need to adapt.

Matthew Edwards, Community pharmacist

Excellent news, as a small pharmacy group of three shops the flu vaccination over the last four years has been an fantastic new service that has enabled us to strengthen our position with patients. Whilst I take on board that it is extra work, it is an opportunity for all pharmacies to show that we can not only do things that were historically the GPs domain but that we can do it just as well or even better.

P M, Community pharmacist

what has happened to the funding for the small pharmacies ? the PSNC needs to get behind these pharmacies and clarify their funding arrangements .

max falconer, Superintendent Pharmacist

Will the vaccination have to be personally administered by the pharmacist? it has been very frustrating in the past that it has to be done personally by the pharmacist. I have a former HCA who has administered many times the number of vaccination that I have, but is not allowed to do so in the pharmacy.

Clive Hodgson, Community pharmacist

Looks like it Max and that is where the practicalities (and profitability) become shaky.

John Urwin, Community pharmacist

I disagree. By involving the whole staff, to minimise the pharmacist's involvement, flu vaccination can be profitably offered even within an already busy community pharmacy. Last season 94 Cumbrian pharmacies delivered 15700 flu vaccinations. 14 managed over 300 and the three top performers administered 1213, 728 and 530. Oh yes, it is profitable, and patients love the convenience and efficiency of the pharmacy service.

Kieran Eason, Superintendent Pharmacist

As someone working in Staffordshire, who's local flu vaccination service was being cut back (by restricting to under 65's only) this is brilliant news. Our customers are pretty happy about it too!

James Mac, Community pharmacist

This is a much better idea than the private flu service that's been going for a few years.

London Locum, Locum pharmacist

The Big Con the negotiators fell for or were party to was that commissioned services could be swapped with the supply function. The figures simply do not add up. So all the accolades for such services as flu vacc count for nothing. The vast majority of income comes from green bits of paper and that is why pharmacists chase them like a heroin addict chases their next hit. If logic were to be applied then premiums for pharmacy purchases would be based on services commissioned not turnover(90% of which is NHS scripts).

John Urwin, Community pharmacist

However, in this case, we are told "The advanced flu vaccination service will start this September and will generate remuneration on top of the global sum". The idea that the Global Sum would have increased if we had not agreed to the Flu Service is fanciful. It looks like we are being offered the same fee structure, out of the same pot, as the GPs for seasonal flu vaccination i.e. the level playing field we are always seeking. Good!

SP Ph, Community pharmacist

There is no mention of what happens to the Small Pharmacies ??? It's a shame that PSNC cannot fight for the small pharmacies. While people are talking about putting Pharmacists in the GP surgeries, the Flu scheme is a smack on the face of these people as it will deteriorate the relations between the GPs and the community pharmacies. Not a level playing field but more fights for the money !!! For all employed Pharmacists, a disastrous decision. For employers, one more avenue of increasing their income. This winter is going to be a great one for the sector (pun intended)

London Locum, Locum pharmacist

Everything is going the way of the multiples and once Pharmacy2U, ahem I mean Boots sorts out remote supervision it'll be game over.

Z ZZzzzz, Information Technology

Could Sue please elaborate as to why we are not getting a national minor ailments scheme. We don't want the usual "secret negotiations" excuse, but rather a full, frank and honest expanation. This service would definitely benefit more patients and cause less local conflicts between GPs and pharmacists. I do support the thinking behind this advance service for flu vaccination but at the fee payable I would expect technicians will do the jabbing, don't anyone think anything different. GPs don't actually jab anyone anymore, practice nurses do.

Gareth Rowe, Community pharmacist

I think you'll find that only a 'suitably trained' pharmacist will be able to administer the vaccine, that's how it works in Wales. You can get another member of staff to do the paperwork before hand but I think you'll have to be the jabber!

Ben Merriman, Community pharmacist

A technician (although a health care professional in their own right) cannot work under a PGD so cannot administer a POM to a patient. The way surgeries allow members of staff not allowed to sign a PGD (e.g. appropriately trained HCAs) to administer a POM is with a patient specific direction (PSD). This would require someone with prescribing rights (I know nurse prescribers can authorise these but given recent differences with nurse and other (inc. pharmacist) prescribers such as CD prescribing, I wouldn't know for sure if an IP pharmacist could authorise appropriately trained staff to administer 'flu vaccines to at risk patients.) Minor grumbles aside, it's a start!

Really? Wow, Superintendent Pharmacist

Hi Ben, Here is the info that you require.http://www.cqc.org.uk/content/gp-mythbuster-19-patient-group-directions-...A PSD is basically a prescription, and must be written. The only benefit is that the PSD can include multiple patients. As it is a prescription, it is possible for it to be administered by a non registered person i.e. a HCA. It is not an open order to administer, that is a PGD, and as you say, as far as I am aware, a HCA cannot work under a PGD. It would be interesting to see how GP practices who use HCA's actually work in practice. Depending on how the spec is written (as they haven't done that yet), its legally possible to get patients on booking to fill in the form, pharmacist to review and write the prescription for the day and then could get anyone who is 'suitably trained' to administer them. This is assuming that they pharmacist is a prescriber of course.

THB _B, Community pharmacist

Good. A even playing field. I suggest all pharmacists get behind this asap and make sure we make it a real success. Contact your LPCS and get some planning and marketing sorted pronto.

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