The Company Chemists’ Association (CCA) today (June 2) issued a warning that “bundling” requirements for the hypertension case-finding (HCFS), pharmacy contraception (PCS) and Pharmacy First services may “lead to unintended consequences”.
The bundling, which came into force yesterday, was first announced by Community Pharmacy England (CPE), NHS England (NHSE) and the government in November and aims to “incentivise pharmacies to offer a broad range of services”, it said.
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But the CCA has cautioned that requiring contractors to provide all three services to receive a fixed monthly payment could lead to “lost threshold payments” or pharmacies “[stopping] providing the Pharmacy First service altogether”.
In new analysis published today, the membership body found that “less than a third (30%) of pharmacies currently meet the new threshold requirements to access the full funding”.
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As of January, 90% of community pharmacies provided Pharmacy First and 77% provided blood pressure checks, but only around half (52%) provided the PCS, it said.
It explained that pharmacy teams can “continue to provide and be paid for delivering only one or two of the three services” but this would mean they would be “ineligible for threshold payments”, it added.
“Stopping” services
“If threshold payments are consistently missed, pharmacies may reconsider the sustainability of offering Pharmacy First [and] this could lead to pharmacies stopping this important element of primary care,” the CCA said.
And it pointed to the Pharmacy First threshold requirement increase last August, which resulted in “15% of pharmacies” missing the new threshold that month.
Read more: Pharmacy First, contraception and BP check services ‘bundled’ from 2025
The CCA also warned that “the challenge of providing regular ambulatory blood pressure monitoring (ABPM) checks” – which will be required from October – “could prove insurmountable for many pharmacies”.
“Providing at least one ABPM every month is expected to be challenging” as there is low demand and a “wide variance in current use of [the] testing”, it said.
“Stay afloat”
The membership body has instead recommended that the government “change the requirement for ABPM, allowing home blood pressure monitoring (HBPM) as an alternative to support patients who do not wish to have ABPM”.
It also called for the government to “share details of the upcoming emergency contraception service as soon as possible, giving pharmacies sufficient time to prepare”, and to “expand the range of conditions covered by Pharmacy First”.
CCA chief executive Malcolm Harrison said that “the premise of bundling makes absolute sense for patients” but creates the risk that pharmacies will “not meet threshold payments in the future” and will have to “rethink delivery of the three services”.
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“We urge the government to ensure there is flexibility in the HCFS,” he stressed, adding that this “simple change will ensure more pharmacies are able to...receive threshold payments that are vital to ensuring [they] are able to stay afloat”.
It comes after CPE revealed in March that “bundling” requirements had been delayed as part of the new 2025/26 contract arrangements, and would be rolled out via a “phased introduction”.
And as new Pharmacy First payments and bundling requirements came into force this weekend, pharmacies must also adapt to consultation caps that could, in some cases, lead to them making £10k less per month.
