A five-year funding contract for England was unveiled yesterday (July 22), with the annual global sum remaining at £2.592 billion for the next five years and medicines use reviews (MURs) phased out in favour of new clinical services.
The funding freeze has been described by some pharmacy contractors as “disappointing”, despite a move towards clinical services being welcomed by many in the sector.
“Cashflow problems remain”
Martin Bennett, superintendent at Wicker Pharmacy in Sheffield, told C+D the funding deal “doesn't address any problems with the current funding levels”.
“Nothing is going to change massively come October, so we'll still be in the same cashflow problems that everybody is suffering from.”
While the long-term ideas to introduce more clinical services “aren’t too bad”, Mr Bennett has “real concerns that it can’t be done with the money that’s available”.
There will be further pharmacy closures, he warned, although a “speed up” of payment would help to alleviate some of the current financial pressures faced by contractors, Mr Bennett added.
“Pharmacists must adapt”
Pete Horrocks, superintendent pharmacist at 70-strong chain Knights Pharmacy, said the settlement signals a “commitment” from the Department of Health and Social Care (DH) for the future of community pharmacy, although he is “disappointed that total funding will remain flat”.
“It is clear that contractors and pharmacists willing to adapt to changes will have opportunities to grow,” he added.
Mr Horrocks warned that “those who are resistant to change will suffer further financial pressure”.
“Doctors get a rise, pharmacists get a freeze”
The need for pharmacists to adapt was also highlighted by secretary of North-east London local pharmaceutical committee (LPC) Hemant Patel.
“On a day doctors get a big pay rise, pharmacists get a pay freeze. That says a lot about where we are in terms of relationships and being valued,” Mr Patel said.
The new contract sends a “clear message” to pharmacies that unless they “rapidly transform and become clinically beneficial to the health service”, the dispensing service will continue to become devalued, he continued.
Mr Patel questioned how pharmacists will find the time to carry out more services while “juggling” between dispensing prescriptions and learning new skills.
“This will increase mental stress and ruin people’s health,” he added.
“No major surprises”
The new funding arrangements “did not throw up any major surprises” for chief officer of City and Hackney LPC Hitesh Patel.
“The mood music from PSNC was always more patient-facing services without any new money,” he continued.
Mr Patel said that PSNC has assured him “negotiations are continuing for improving the reimbursement arrangements and a fairer distribution of margin”.
This is where contractors in his area are “being hit hardest” he said, as it is leaving them unable to invest in “premises and staff”.
“There is going to be a huge workforce challenge to successfully take on the new [contract] arrangements,” Mr Patel added.
“DH wants to lose 2,000 pharmacies”
Tony Schofield, owner of Flagg Court pharmacy in South Shields, said the contract makes clear that the DH “wants to lose more than 2,000 pharmacies”.
It is “disappointing” that the funding has not increased, as it “doesn’t acknowledge” the “incredible pressure” pharmacists are already under, he continued.
Mr Schofield stressed that he had yet to work out the implications of the contract for individual pharmacies, but speculated that the model for service remuneration may come “at the expense” of those delivering smaller prescription volumes.
However, he welcomed the move towards the “clinical future” of pharmacy, and in particular drew upon his own experience piloting the Digital Minor Illness Referral Service, which he explained will give pharmacies the “opportunity to get back MUR money”.
Loss of MURs “could be massive”
Although it is too early to predict how badly the settlement may affect his pharmacy, the contract is “in essence a continued cut”, said Nat Mitchell, pharmacist and director at independent pharmacy JWW Allison & Sons, Cumbria.
While the phasing out of MURs is “no lost income” to him, Mr Mitchell said it could be “massive” to some.
Step towards “a service-based contract”
Meanwhile, Richard Brown, chief officer of Avon LPC, was a little more optimistic. The contract was a “good step forward”, he told C+D.
“It moves pharmacy into delivering outcomes and delivering services as the first step towards more of a service-based contract,” he continued.
“Pharmacy now has a contract that helps them to deliver their strategy around long-term health prevention, around patients with common ailments and around improving access to GP services, by getting people seen in the right place at the right time”, Mr Brown added.