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Contractors 'highly stressed' awaiting 'so many' concessionary prices

The Pill Box pharmacy's Dipak Pau: As a professional, I can't go on like this
The Pill Box pharmacy's Dipak Pau: As a professional, I can't go on like this

Contractors in England have reported being “highly stressed” waiting for concessionary prices for several items, including levetiracetam, amlodipine and felodipine.

These are just three items that readers have flagged with C+D today (see tweets below).

Graham Phillips, superintendent pharmacist of Manor Pharmacy Group in Hertfordshire, suggested that the actual list of items contractors are waiting on concessionary prices for could be “endless”.

“There must be 100 common generics we can't obtain at drug tariff prices,” Mr Phillips tweeted today.

Waiting for “so many” items

Dipak Pau, owner and superintendent pharmacist of The Pill Box pharmacy in Chelmsford, said there are still “so many” products he is waiting on concessionary prices to be agreed for, including packs of 28 bicalutamide 50mg tablets, and 60 quetiapine 300mg tablets.

“As a professional, I cannot carry on like this,” he told C+D today (December 1). “All of this is happening in the climate of low dispensing fees, savage cuts in category M and the pharmacy funding cuts [in England]. No doubt there will be more in the pipeline.”

Mr Pau said he has contacted the Pharmaceutical Services Negotiating Committee (PSNC) “more than once in the last few days”.

Another contractor – who wishes to remain anonymous – said they are struggling to submit month-end finances “without knowing what I am being paid for”.

“I was advised that this can be fixed retrospectively, but that isn’t good enough,” they added.

PSNC “continuing to press” DH

In a statement on its website, PSNC said it is “continuing to press” the Department of Health (DH) on the 97 price concessions it requested for November.

Just 38 of these items have so far been granted a concessionary price, although PSNC said today that as of November 27, the DH had indicated it is “still considering” the remaining 59 items.

“We are hoping to receive a reply soon and well before November prescription pricing is finalised.”

PSNC said it is unable to name the other 59 items it has requested concessionary prices for.

PSNC director of pharmacy funding Mike Dent told C+D that the negotiator has “a significant evidence base for November prices”.

It has “stressed the need for certainty” in the lead-up to the “busy Christmas period” and has urged contractors to continue to report supply issues encountered in December, he added.

“In these unprecedented times, we would recommend that contractors seek professional advice, from their accountant in the first instance,” Mr Dent added.

PSNC has set up a specific email address for pharmacy teams to contact regarding the outstanding November price concessions: [email protected].

"The list goes on"
Are there any items that you are waiting to receive concessionary prices for?

Amal England, Public Relations

If you are a contractor either close your Pharmacy and walk out and take evasive action or shut up. Close now, momentarily to send a message or you may well end up closing for good. Yes you look after people's health, but who is looking after your health? For years you (along with the multiples) let this unfold, with a weak and naive Sue Sharpe as the head of the PSNC, which I understand to mean negotiating a price for a service where you earn a profit. The best hope contractors have now is to dissolve the PSNC and reform something different- with balls.

NHS cleansing of pharmacy

Farhat Ahmed, Locum pharmacist

I have three children, who for the correct fee are willing to give the negotiating team at the PSNC lessons in the art of negotiation. 



Amal England, Public Relations

It is so simple that your kids could well do a better job.
When I order a cab, there is a minimum charge. When I call the plumber thru hav a call out fee, whether or not they fix the problem. I took my car to the garage last month and they found the fault which led to water leaking into the car, it took 5min and they charged me for finding the fault. I had a document countersigned by a solicitor, took them 1second, I was charged £30. Charging for a service you provide at a profit is the norm..... No doubt if Sue Sharpe became a private pharmacy consultant, she would charge for every snip of service.

SydBashford Sold&Retired&DeRegistered, Community pharmacist

It’s impossible to continue like this... the stress of handing out £60 packs and worrying whether we will get paid for it... rediculous.... PSNC sort this nightmare out..... we are literally losing multiple £1000’s to dispense Rx’s that we don’t know if we will get paid!! Something MUST be done about it and pronto. 

Amal England, Public Relations

Yes, something needs to be done pronto.... If you are a contractor, get the ball rolling by starting a protest group and target the PSNC, the gov, etc. The big boys like Boots and Lloyds with their own supply chain are rather quiet, they are most likely get preferential treatment.

Mr CAUSTIC, Community pharmacist

Shouldn't we be informed  why the manufacturer's involved were stopped from supplying their products ? If it was really serious shouldn't all the products have been withdrawn immediately? Did the person who actioned the ban realize the financial implications for the NHS ? The psnc should demand the reintroduction of ncso immediately on any product not available at tariff prices . but as they are useless at negotiating effectively on behalf of contractors they will not achieve anything.

I have waited for 40 years for broken bulk on dressings and that sums them up. With the number of contractors being reduced all the executives salaries should be reduced pro rata to contractor numbers not increasing the levy on the remaining contractors. Thinking of entering pharmacy ? Join London transport as a driver or better still southern rail ! Less stress and better remuneration.

Paul Brett, Community pharmacist

Would we be at liberty to refuse to dispense a medication if it were not possible to obtain at or below tariff price? If so, then wouldn't the DoH's tardiness potentially be responsible for putting patient's health at risk?

Stephen Eggleston, Community pharmacist

Hi Paul

I believe that would put us in breach of contract, since the issue is not "lack of availability" but "lack of availability at the right price". However, you are correct that at some point the patient will suffer - already we have had terrible stock shortages for all sorts of everyday items resulting in patients being referred back to prescribers for an alternative, increasing the workload and stress for all concerned. I fear it is only a matter of time before something catastrophic happens (as if the cut in funding wasn't enough!)



Graham Morris, Design

I am retired, so please excuse me if I'm out of date, but in my time we had to supply with "reasonable promptness". Unless you have the business acumen of a prospective bancrupt, it would only be reasonable to supply at item if it could be bought at or below tariff prices. It would be totally unreasonable to plan to bancrupt your pharmacy and so reduce your service to your community. (Tongue in cheek, but from what I read, those who negotiate Tariff prices make me think that not all lunatics are locked up.)


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