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Payment scheme for pharmacy urgent supply service revealed

Pharmacies will be paid for any referral from NHS 111, regardless of whether a supply is made

NHS England has confirmed how much community pharmacies will get paid for providing emergency medication, and in which areas its pilot service will be rolled out first.

Under the 'Pharmacy Urgent Care' pilot programme announced by the Department of Health last month, patients who call NHS 111 for urgent repeat medication will be directed straight to a community pharmacy, instead of an out-of-hours GP surgery.

Those community pharmacies taking part in the programme will be paid a total of £12.50 for any request for urgent medicine received from NHS 111, regardless of whether or not a supply is made, the Pharmaceutical Services Negotiating Committee (PSNC) confirmed yesterday (November 29).

This consists of a £10 consultation fee and a £2.50 administration fee “to reflect the additional work and documentation required”, PSNC said.

A supply fee of £1.50 will be paid for the first item provided, and an additional 50p for each additional item.

PSNC said “a phased introduction” of the scheme will take place from December 2016 to March 2017, with the pilot ending in March 2018.

The four phases of the roll-out are:

Phase 1 – December 2016 – Brighton and Hove clincial commissioning group (CCG); Guildford and Waverley CCG; Blackpool CCG; Fylde and Wyre CCG; Nottingham City CCG; Cambridgeshire and Peterborough CCG

Phase 2 – January 2017 – East of England; North East; North West

Phase 3 – February 2017 – South East Coast; West Midlands; East Midlands; South West

Phase 4 – March 2017 – London; Yorkshire and Humber; South Central; Isle of Wight

All contractors in England will be able to sign up to provide the service from tomorrow (December 1) via the NHS Business Services Authority website.

However, this sign-up process is only to “register contractors’ intention”, PSNC said. “Most” contractors will not be able to start providing the service immediately, it added.

Details not agreed with PSNC

When the pilot scheme was first announced, the National Pharmacy Association branded it a "smoke screen… clearly timed to draw attention away” from the cuts to pharmacy funding.

PSNC said yesterday that while it supports the commissioning of an emergency supply service “in principle”, the final details of the programme “have not been agreed by PSNC”.

“PSNC is pleased to see recognition of how community pharmacies can help patients and the NHS, but we are disappointed that the scheme has only been commissioned as a pilot,” it said.

“We are also disappointed that the service will not cover patients who have been referred by other health professionals or come to pharmacies in the first instance themselves.”

More expensive than planned?

In its initial assessment of the programme’s funding, PSNC said it would be more expensive to run the service than NHS England has suggested.

The volume of referrals from NHS 111 to contractors “is likely to be relatively low...based on information provided by NHS England", it added.

“The maximum number of potential referrals is in the region of 200,000 per annum. Based on the experience of similar locally commissioned services, it is unlikely that it will be possible to transfer all of these patient requests to community pharmacy, at least to begin with,” the negotiator said.

The lack of funding to provide IT support for the service is “regrettable”, PSNC said, and will incur additional “bureaucracy” and costs for contractors in the long-run.

The negotiator suggested the Pharmacy Integration Fund – a £300 million fund designed to assimilate pharmacy into the NHS and other care settings, which is being used to fund this pilot service – should also be used to provide the IT infrastructure needed for the scheme.

Get an insider's view on the funding cut negotiations below:

25 Comments
Question: 
Will you sign up to provide the urgent supply service?

Paul Garcia, Student

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Paul Garcia, Student

 

Lets start from the beginning... 80 - 90% of patients in UK receive their medications FREE of charge - I say, how this is possible... there is nothing you can get these days for free...

All patients should pay for their drugs... we say 1, 2, 3 pounds / item... whatever...  Nobody should be titled to receive FREE OF CHARGE medication in these days and we know NHS financially barely cope... there is not other system in the world which supplies medications with such ease and free of charge.

I believe patients would start to care a little bit more about drugs they take and hopefully they would adjust their everyday health related behaviours.  In these days pharmacy stands for "candy shop" – I do not care much how I eat, what I eat; If I get fat or not... and my GP without questioning (as they got 6 minutes/patient) will prescribe for me Orlistat some PPIs and of course SSRI as I got depressed... everything free of charge ! 

who pays for those FREE of charge supplies ? we pay... everybody pays... those are our taxes !

Have a closer look to other health care systems around the world... British system is sick and it should be treated ASAP... it doesn’t promote healthy behaviours... it promotes free of charge pill for everything patient needs... I have never seen in my life so many drug returns to pharmacy… so many expensive items! And number of unopened boxes!

Now, new service will be introduced... NHS will be charged 12.50 ! for sake of people laziness’... because it is too difficult to remember to reorder free of charge regular medication; and You don’t even have to go to surgery… You can reorder it online or just call pharmacy – its as easy as that! 

Wake up British Health System! and start to treat adults as adults. And force people to take responsibility for their OWN health! Because is people don’t care; nothing will change it… even suppling medications for free…  

 

 

Piotr W, Community pharmacist

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Paul Summerfield, Community pharmacist

This scheme has been in pharmacies in the NHS Gloucester area since 2014 and it works. They have tried it in other areas in 2015 but will limited sucess. The NHS Gloucester scheme works extremely well and was, and still is, a very forward thinking service which has been well received by pharmacists and, more importantly, patients. 

Valentine Trodd, Community pharmacist

What's to stop pharmacists putting every emergency supply through as a 111 referall and claiming the £12? What's to stop patients saying they called 111 and were referred when they weren't? And if there's some form filling and signatures involved, I predict a fair bit of 'just sign that please sir, and we'll get it sorted for you...'.

N O, Pharmaceutical Adviser

Stupid comment again. Why don't you just visit the PSNC page and read the service specifications. It's all there.

Valentine Trodd, Community pharmacist

https://www.england.nhs.uk/wp-content/uploads/2016/11/numsas-service-specification.pdf

For anybody that comes in for an emergency supply, what's to stop the pharmacist passing them the phone and saying you need to call 111 and get a referral?

Leon The Apothecary, Student

That is a much better question. Do you think that's incorrect in that regard then?

Powerful Locum, Pharmaceutical Adviser

So it'd be best to charge the customer up front and then give them a refund if they can bring an Rx to you ? If you don't then they'll all be taking the p1$$ for Calpol, bit like the Minor Ailment Schemes

 

Valentine Trodd, Community pharmacist

Good luck with that... my customers won't even pay 32p for a box of paracetamol.

SydBashford Sold&Retired&DeRegistered, Community pharmacist

How many patients do you seriously think would contemplate ringing 111 to say they have ran out of meds? They all know they can straight to the pharmacy already! Will hardly be worth having. Maybe we should all start handing out leaflets in advance to inform patients to ring 111 in the event of needing urgent medications and wait for their referral. :-)

Leon The Apothecary, Student

I agree with Kevin here. You should be charging for those supplies, especially if we consider that Pharmacy requesting medication could be something we are no longer able to do if current events are foretelling. Perhaps if you're being asked for emergency supplies so much, you might want to review the reasons why?

Kevin Western, Community pharmacist

....but hopefully you are charging them for emergency supplies, not loaning against a future rx - discuss with your friendly GPhC inspector if so...so they will get it for fee via 111 and you get a fee... so refer them to 111 and everyone wins...except 111 but who cares?

Kirsty Lord, Primary care pharmacist

Why not just refer patients to us without a fee, we process emergency supplies as we always have done and not cut our funding? Judging by the comments on pulse, silly services like this just seem to further our reputation as a profession of money grabbers when in reality they'll probably bring in very little income.

P Stopes, Locum pharmacist

Rather thanwaste tax payers money perhaps the patients should pay the £12.50. How many of the emergency supplies are a genuine emergency? Most of these patients can't be  a***d to order repeats in time and are so used to getting 'loans' they have no incentive to organsie their chaotic lives.

Paul Garcia, Student

that the point! adults are not treated as adults in Health Care System in UK... they all seem to be treated as children for too long; and now they EXPECT that everything will be done for them... for FREE and RIGHT HERE AND RIGHT NOW...

Valentine Trodd, Community pharmacist

Very true. But isn't the NHS obsessed with doing everything for free?

Valentine Trodd, Community pharmacist

£12.50 sounds fair enough to me - for something I already do for free (mind you, I haven't read the details of the scheme). As long as 111 know the limitations of the emergency supply rules and don't make inappropriate referrals e.g. expect us to explain why we can't give them an antibiotic for their cough, or loan them some Zomorph.

Plenty of chat among the GPs over on Pulse  about this and the 'high regard' they hold us in!

http://www.pulsetoday.co.uk/clinical/prescribing/pharmacists-to-hand-out-emergency-medication-supplies-without-gp-approval/1/20033016.article?PageNo=3&SortOrder=dateadded&PageSize=10#comments

Kevin Western, Community pharmacist

Pulse is the Sun of Medical journals and GPs see all the money in the NHS as theirs by right - anything we do is wrong if we get paid, and taking jobs away from them if we dont - best response involves two fingers seperated at the tips...

Locum Pharmacist, Locum pharmacist

Well said Kevin and now they are stopping us posting our comments on Pulse:

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Says it all really!

 

 

 

David Walker, Community pharmacist

But does this £12.50 cover the cost, say, of a Clenil 250 Inhaler?

N O, Pharmaceutical Adviser

The £12.50 is only a fee, on top you will still get paid for the drugs supplied separately.

Valentine Trodd, Community pharmacist

David, as I understand it, the scheme is just a plain old emergency supply  - the same rules apply i.e. you need to obtain a prescription to cover the supply, which of course will cover the cost of the item. It's just now they are paying us for doing it. Why, I don't know, but even I won't complain about this one.

Valentine Trodd, Community pharmacist

How can I get a thumbs down for that comment?!

N O, Pharmaceutical Adviser

Read Before you write. The £12.50 is only a fee, on top you will still get paid for the drugs supplied separately. I don't know why you got so many thumbs up for that question or your explanation.

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