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Government wants online pharmacy services, to save NHS cash

Department of Health: Changes would contribute to NHS England's search for £22 billion in savings

The government wants to ensure patients have access to delivery and click-and-collect pharmacy services


  • Government unveils aim for health service to “keep pace with digital revolution” 

  • Pledges to review sector's payment and regulation systems

  • Competition watchdog criticises regulations that restrict “number and location” of pharmacies

The government will ensure patients have access to more online and click-and-collect pharmacy services in an attempt to save the NHS money, it has said.

It also pledged to examine the sector's payment and regulation systems to ensure they are "efficient [and] encourage competition and innovation", in a policy document on Monday (November 30).

The health service must "keep pace with the digital revolution" by ensuring patients can access their medicines “at the touch of a button”, the Treasury and the Department of Business, Innovation and Skills  said in the document.

They highlighted the need to "facilitate online, delivery-to-door and click-and-collect pharmacy services”.

"The proportion of adults using the internet to make a purchase increased to 74% in 2014. Despite this, less than 10% of adults ordered their medicine online," they said.

"The government wants to ensure hardworking families leading busy lives and an increasingly elderly population with complex needs can receive a home delivery service," they added.

Saving NHS England money

The Department of Health (DH) told C+D it is looking into the proposals as one of the ways to achieve NHS England's search for £22 billion in efficiency savings.

“This is one of those efficiencies it is likely will be made... watch this space,” a DH spokesperson told C+D yesterday (December 1).

In its response to the document, which sets out a range of ways the government will look to increase competition across Britain’s economy and “bring down bills” for families, government competition watchdog the Competition Market Authority (CMA) criticised regulations that restrict the "number and location of pharmacies".

"These restrictions deny customers the convenience they take for granted when buying other products," said CMA chief executive Alex Chisholm. Removing them would save patients “time and money”, he added.

 

What do you think of the government's plans?

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30 Comments

Isabel Carroll, Pharmacy owner/ Proprietor

It is really a brilliant idea and in this modern time it becomes popular. Day by day it increases the attention to the people. It is the right option to get medicines by online, because it reduces the wastage of time. I don't want to say that it is perfect in all cases, because we must go to doctor if somebody is more serious. It is perfect for those whose start treatment for long time and they need regular medicines. By online pharmacy they can get their desire medicines at their door steps without any types of hassles. For more info visit here: theindependentpharmacy.co.uk

Dodo pharmacist, Community pharmacist

How much are the government going to pay us to do home deliveries then?

London Locum, Locum pharmacist

Nothing. You doormats have been doing it for free for years so why change now because you've finally grown a pair.

Dave Downham, Manager

We'd wondered where you'd been...

Mr CAUSTIC, Community pharmacist

you are joking. psnc was starting to negotiate on broken bulk for dressings when i qualified in 1972, they recently agreed to abolishing broken bulk on most other things instead of getting an agreement on dressings. one has to ask who are they working for? it does not appear to be for our benefit. perhaps their salaries should be tied in with the benefits they obtain for us. i.e. payment on results. the increase to be voted on by contractors.

Nat Mitchell, Community pharmacist

I consider myself quite forward thinking, but on days like today when all we've seemed to do is solve problems not of our making, I can't even contemplate how online pharmacies can operate.

Simon MEDLEY, Community pharmacist

my mother was very computer savvy at 60, was orering everything online at 70, but now shes 80 , actually on medication and cant even open her own emails easily. Why is policy always decided by idiots who don't actually look at how these services are used, I think they beleive eveything is used by t he 20 to 50 age group .

Marc Brooks, Community pharmacist

It just shows how little polticians know about pharmacy. Majority of pharmacies already offer free delivery services. And whats the point of delivering to hard working families, which will be hard at work, so not in to accept and sign for the delivery. We have to move with the times, but the Government needs to remember what a cheap service comminity pharmacy provides and is freely available to the public for many health services and advice. The more online pharmacies there are, the fewer pharmacies there will be for the public to visit. This will just open the door to even more spurious applications for these online pharmacies, that miraculously do 400 MUR's without actually having a door open to the public!!

Stephen Walsh, Community pharmacist

From the PJ 22/04/2015..... “Contrary to popular opinion, patients are allowed to access the distance selling pharmacy but only for non-essential services — for example, medicines use reviews (MURs)” explains Conor Daly, a pharmacist and barrister, and a partner at consulting firm Rushport Advisory. Please forgive the cut and paste but I think you get the jist.

Marc Borson, Community pharmacist

In August P2U did around 78k items, lets imagine that they send on average 4 item per shipment. Assuming £4 per shipment thats £936,000.00pa in shipping not including human resource cost in delivering logistics. Lets say 16k item pm costs in rent £20k, £15k delivery driver multiply these values by 5 we get £100k rent £75k driver logistics, total £175k £175k/£936K = 18%. The current delivery model is 18% the cost of a centralised model such as P2U Yes people buy poor quality high margin goods online, but the goods are produced to allow for the high volume distant selling. For example clothes, stationary, toys, even electronics. Pharmacy is different and the margins do not allow for centralised distribution. Centralised is only profitable for home care as there is VAT savings. P2U accounts are public domain and they show significant losses even though they have a good retail offering. PSNC must use evidence that now exists to show the current model works. However i think pharmacists must be prepared for the prospect of losing the establishment payment. it could save circa £250m per year, and the govt know this, due to previous cost of service studies. Further savings could be found by eliminating expensive and unnecessary dispensing doctors, that prescribe high value medicines with the intention of reclaiming generous manufacturer rebates - purposeful waste. The Flu vaccination services has shown how effective CP can be at delivering national service, and at significantly lower cost. If the NHS wanted to really save money, they should expand the levy to over 60s. We need patient to be as frugle with medicine as they are with money and food. People use left overs, swap unwanted food and use out of date food. People go without to save money. I am not advocating this and this can not be recommended officially but when people have to pay for medicine they do these things. I have experienced this in many different places across the UK and world. I remember a patient saying he buys ventolins from car boots sales to save the levy fee and i have seen patient prescribed nutritional supplements on eBay. The general public are highly adaptable and resourceful when they need to be the govt must use this strength to their advantage. Personally I would prefer to see this than mail order pharmacy.

Shamir Patel, Community pharmacist

Marc, I think you really need to look at revising your figures. I operate an Internet pharmacy and it's actually cheaper to post a prescription, rather than employ a driver and vehicle etc. Remember that the minimum wage will be £18k by 2020 and drivers will earn that wage as well. The likes of Amazon have introduce massive competition within the postal sector and postage prices are sub £2 for next day delivery and approaching £1. Hence we can post prescriptions next day tracked to patients, with text message alerts, which retail pharmacies have failed to grasp the efficiencies. With regards to services, why not have FaceTime or Skype MURs/NMSs. 5 mins in a consultation is wasted in getting a patient in and out of a consultation room. This already exists in doctor land with web consultations. This is message the government is trying to get across. Look at your process, evaluate and is there a better way of delivering prescriptions and services???

Barry Pharmacist, Community pharmacist

The Department of Health (DH) told C+D it is looking into the proposals as one of the ways to achieve NHS England's search for £22 billion in efficiency savings. That's what this is all about. Reducing the global sum because KR et al say hubs can do 67% of all Rx and the rationale behind this when asked on the Today programme? To get everything delivered to save the trouble for hard working families! *ollocks. The DH budget has just been cut by 25% and they are thinking let's do the same to the global sum - just for the hell of it! There's nothing wrong with what we have now but the want to change it anyway.

David Kent, Community pharmacist

Another nail in the coffin of independent pharmacy.

Mr CAUSTIC, Community pharmacist

david is that a pun on me writing about deaths of patients

Mr CAUSTIC, Community pharmacist

what a good idea. drugs sent by post. postman puts card in door to collect from sorting office or to request a new delivery. elderly person too frail to run to front door and postman leaves another card. patients runs out of meds during this pantomime and collapses and is admitted to hospital. this costs the nhs a fortune and blocks beds. Another well thought out plan. Actually there is another explanation. if the elderly patient passes away through lack of meds the government saves on pension / disability payments and gets death duties earlier. what a BRILLIANT devious plot.

Ian Strachan, Community pharmacist

Community pharmacy is defined by its diversity,its efficiencies, and it's innovation particularly from the independents. The sector is driven by competition as it strives to improve the patient experience because that's how we compete and that's how we survive. Efficiency Savings year on year are a well documented 4% but I suspect it's actually much more than that. Procurement by inentivised purchasing of CAT M generics has saved the NHS a staggering 10 billion pounds in less than ten years. These evidenced based facts illustrate how community pharmacy has been the most efficient element of the NHS. The models being proposed of automation, click and collect and scaled solutions ,are questionable and largely un evidenced. Our patient base is primarily the elderly who survey after survey will reveal prefer face to face contact. Deliveries and repeat ordering are well established principles already in community pharmacy so nothing new there. The real solution is to liberate the power of our network by investing in pharmacy to save. Treat community pharmacy as the gateway to the NHS to tackle waste, to manage repeat dispensing, to manage extended hours and unnecessary demands to A and E .These are the real conversations we need to have that champion the power of the network and it's social capital. That's when Community pharmacy is defined by its diversity,its efficiencies, and it's innovation particularly from independents.The sector is driven by competition as it strives to improve the patient experience because that's how we compete and that's how we survive. Efficiency Savings year on year are a well documented 4% but I suspect it's actually much more than that.These. evidenced based stats illustrate how community pharmacy is the most efficient element of the NHS.e models being proposed are already in existance and practiced.The real solution is to liberate the network by investing to save.Treat community pharmacy as the gateway to the NHS and it's solutiowe really understand the networks unexplored value and potential.

Ian Strachan, Community pharmacist

Community pharmacy is defined by its diversity,its efficiencies, and it's innovation particularly from the independents. The sector is driven by competition as it strives to improve the patient experience because that's how we compete and that's how we survive. Efficiency Savings year on year are a well documented 4% but I suspect it's actually much more than that. Procurement by inentivised purchasing of CAT M generics has saved the NHS a staggering 10 billion pounds in less than ten years. These evidenced based facts illustrate how community pharmacy has been the most efficient element of the NHS. The models being proposed of automation, click and collect and scaled solutions ,are questionable and largely un evidenced. Our patient base is primarily the elderly who survey after survey will reveal prefer face to face contact. Deliveries and repeat ordering are well established principles already in community pharmacy so nothing new there. The real solution is to liberate the power of our network by investing in pharmacy to save. Treat community pharmacy as the gateway to the NHS to tackle waste, to manage repeat dispensing, to manage extended hours and unnecessary demands to A and E .These are the real conversations we need to have that champion the power of the network and it's social capital. That's when Community pharmacy is defined by its diversity,its efficiencies, and it's innovation particularly from independents.The sector is driven by competition as it strives to improve the patient experience because that's how we compete and that's how we survive. Efficiency Savings year on year are a well documented 4% but I suspect it's actually much more than that.These. evidenced based stats illustrate how community pharmacy is the most efficient element of the NHS.e models being proposed are already in existance and practiced.The real solution is to liberate the network by investing to save.Treat community pharmacy as the gateway to the NHS and it's solutiowe really understand the networks unexplored value and potential.

Chris ., Community pharmacist

Come on London Locum where are you?! Come on, come say 'death of pharmacy'......

John Alan James Robinson, Superintendent Pharmacist

The contract/global sum has no provision for costs of delivery. They didn't honour COSI. Its difficult to see how money will be saved. The logistics could be a nightmare. Imagine the poor patient who is not at home or doesn't receive their meds. Tracking , Customer services, 20 mins at least to get through to a call centre. Complaints to GPhC. Complaints to the GP and Pharmacist. This sounds like some muddy blue sky thinking coming from NHS England. KR ,Chief Pharmacist wants hub and spoke and technicians manning the dispensaries leaving Pharmacists to deal with clinical matters. KR and others have said that there are too many pharmacies so now the competition merchants want more. that will lead to dilution of funding. The global sum wii stay as is ! All this with Tories in charge. Yes Minister.

Stephen Fishwick, Marketing

NPA, through Pharmacy Voice, will be communicating our concerns to Govnt about these short-sighted proposals. Agree with Mark C that the document totally misses the point and betrays a lack of understanding of the pharmacy sector by the BIS officials concerned. Agree also with Steve J that community pharmacy network is already running some of the models outlined in the ‘better deal for families’ proposals (e.g. home delivery). PV press release expresses "concerns about any moves to create a crude Amazonisation of medicines supply and pharmacy services", and points out that CP is already one of the most cost-efficient parts of the health service. NPA Head of Comms

kalpesh patel, Superintendent Pharmacist

Has the government learnt nothing from Leap frogging, and 100 hour Pharmacies to talk about opening up competition? When will they learn?????

Susan M Shepherd, Community pharmacist

And how is moving things on-line likely to help the elderly obtain their medicines? Plus the approximately 10% of the population that do not have access to high speed broadband? The most ominous part of this article was the DoH quote "This is one of those efficiencies it is likely will be made... watch this space,” Is this just an excuse to cut our funding further?

Bal Singh, Locum pharmacist

THIS IS BRILLIANT!!! I've never heard such amazing short sightedness by the government in pharmacy! Yes! by all means, open up the barrier to entry, conveniently forgetting about practice payments (that cost money) and delivery of services (which THEIR OWN health minster wants!!) What right do Treasury and the Department of Business, Innovation and Skills have in making pharmacy comments? And here is the final Coup D'etat......Boots and Lloyds would lobby so hard against this with their "influences" that it will be a dead duck.

Steve Jeffers, Community pharmacist

Can someone (hopefully the PSNC) point out to the government (all depts.!) that most pharmacies already provide a home delivery service and many offer the ability to order their prescription via a website. They also of course collect prescriptions (or obtain via EPS) for the patient to collect from the pharmacy. There are the thousands of bricks and mortar pharmacies that already exist plus of course we have the exclusively online pharmacies of which there are now hundreds. Perhaps Mr Osborne and Mr Javid can be invited to suitable pharmacy and given a demonstration of all of the above?

Alchemist 1948, Locum pharmacist

I agree totally, I feel this paper has totally missed the point. The community pharmacy service is incredibly efficient already and offers a multitude of systems allowing patients to choose how they interact with us, walk in, online, phone etc. To me the rate limiting step is the Rx ordering process for patients via the GP surgery - seriously have you tried to use some of the online ordering systems? And, of course, that is assuming what the patient requests is actually what ends up written on the Rx. The fact that patients can use community pharmacies to facilitate the ordering of Rx might explain the "low" usage, let’s face it we are just better at it !! Proper NHS Repeat Dispensing for patients with long term conditions managed by community pharmacy is the way forward. It’s there! It’s available! but it is poorly used - certainly in Lancashire. So if there is going to be a review lets really look at the value we deliver in Community Pharmacy - the patients seem to know it why doesn't the government?

N O, Pharmaceutical Adviser

""""“bring down bills” for families""""" ........ First abolish the prescription charge and close down the anti-fraud team (worth billions) at DoH. Next get rid of the fat cats who make these nonsensical suggestions/ comments. You don't need to go anywhere else, the target will be achieved.

Dave Downham, Manager

Would love to see amount saved v cost of the anti-fraud team. The old audit commission had to save £7 for every £1 spent - would be fantastic if the prescription detectives achieved the same result.

Kevin Western, Community pharmacist

I look forward to overseeing the postman completing their MUR and NMS training!

Paul Miyagi, Information Technology

The thing is Kevin, most MUR's and NMS's are a waste of time and most pharmacists would rather not do them !! - Have you ever met one that honestly does like doing them ??. So looks like they'll be going.

Ianto Jones, Community pharmacist

especially with pharmacists in the GP surgeries....why can't they do the MUR's....why double up the costs

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