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GPs threaten contractors with 100-hour pharmacies

Control of entry Some GPs are threatening to exploit the 100-hour exemption rule to open pharmacies unless they are given financial incentives from pharmacy contractors, the Independent Pharmacy Federation has warned.

Some GPs are threatening to exploit the 100-hour exemption rule to open pharmacies unless they are given financial incentives from pharmacy contractors, the Independent Pharmacy Federation (IPF) has warned.

In a letter to the government, the IPF said that members were "reporting approaches" from GPs wanting to open 100-hour pharmacies within their own facilities. The group highlighted one case where a GP surgery told a contractor that unless they were prepared to offer some "financial arrangement", it would open a 100-hour pharmacy.

100-hour threat: GPs accused of threatening to open in competition to their local pharmacies

IPF calls for moratorium on 100-hour rule

Control of entry - could it be more of a mess

The quirks of control of entry

IPF chief executive Claire Ward said the opening would "decimate the contractor's business" and called on the government to look again at imposing a moratorium on the 100-hour exemption.

"Some of our members are reporting approaches by GP surgeries, with whom they have worked closely for many years that are being tempted into external commercial deals to open pharmacies within their facilities," Ms Ward wrote in a letter to pharmacy minister Earl Howe.

The government is consulting on removing the 100-hour exemption later in the year, instead making pharmaceutical needs assessments (PNAs) the basis for decisions on new openings.

However, the proposals have also come in for criticism, with Pharmacy Voice recently expressing "serious concerns" about the quality and accuracy of existing PNAs.

The organisation has called on the Department of Health to address the matter, saying that while it is sensible to judge applications against identified need, the system still needs to allow for competition and innovation.

"Robust pharmaceutical needs assessment are an appropriate basis for market entry - robust being the operative word," said Pharmacy Voice chief executive Rob Darracott. "Unfortunately, PNAs published by primary care trusts in the past 18 months have been, in many cases, substandard and defensive."

Are you aware of a local surgery opening a 100-hour pharmacy?

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20 Comments

Jatin Morjaria, Community pharmacist

There is nothing new about this article, the GPs are greedy, have always been greedy and will stay the same unless there is change in the way the health service is delivered in this country. If the law of the land allowed you to grab a larger slice of the pie legally wouldn't you do it? Ethical and moral considerations go by the window.
But then why are the pharmacy contractors crying "wolf", when their contracts are threatened. Have they not being doing the same by holding restrictive contracts which by default have prevented the younger generation of pharmacists ever having a hope of owing their own business???
Sorry but I feel that everyone is on the greed band wagon-no one is patriotic enough to say enough is enough- The future of our health service is at stake and it is time to get togather.

Aneesa Halima Ishaque, Locum pharmacist

In the end who suffers? Always the independents!!

Rashid Mahmood, Superintendent

Its all about the money . Money Money Money.

Budgets are being squeezed, cost of running the business increases every year. Hence, people will look out for more oppurtunities with in the legal boundaries to make more Money.

London Locum, Locum pharmacist

Hhhh

Nick Purser, Pharmacy technician

PNAs can only be as robust as the information provided by the individual Pharmacies which, in many cases isn't!

mari williams, Community pharmacist

more to the point the accuracy with which the information provided by the pharmacy is transcribed by the PCT comissioner/ manager/ comissioning assistant/ secretary into the PNA document

Naresh Chauhan, Community pharmacist

Fact of the matter is that GPs have always known that unless they write a prescription - the pharmacist cannot dispense (or make a living). Some of them have now decided to take their power of prescribing to its ultimate unethical conclusion. The way forward as I see is that either all the pharmacy bodies lobby the DoH to stamp on the misuse of
prescribing power or reclassify more medicines from POM to P so that Pharmacists may use their expertise more.

Z ZZzzzz, Information Technology

GPs have always over the years found ways of “punishing” contractors in different ways with respect to how they issue scripts. They will suddenly start writing 3 months worth on a script (sometimes 6 months), and when contractors moan about this they throw them the lifeline of issuing 2 months worth. Everyone from PCTs, PSNC, RPS, DH etc etc etc are powerless to stop this manipulation. In areas where dispensing GPs are in competition – as they see things - with a community pharmacy this is commonplace, especially when gradualisation comes to an end. GP excuse for this is that it will help patients during the transition from being their dispensing to prescribing patients – never mind the GP, as well as patients, have had usually around 6 months to cope with the transition. I always find it odd that patients that remain dispensing GP patients will never be issued with more than one month’s supply whilst prescribing patients can ask for and obtain more (see exceptions below) – again there is currently nothing any official body can do about that. I also think you will find that any pharmacy owned by a GP will never have to supply any more than one month’s supply on a script issued from that GP. I also think you will find any pharmacy owned by a GP supplying medicines through MDS will never have to negotiate to have anything other than 7 day scripts for those patients. Don’t you also find it incongruous these days that patients that live more than 1.6km from a community pharmacy that could be next door or even in the same building as a dispensing GP can still remain dispensing patients at that practice, when that does not happen elsewhere, just because some seriously out-dated legislation classifies that someone lives in a “rural” area. PSNC have always taken the view that the Clothier agreements should remain in place as a good thing for pharmacy because there would be a free-for-all if they were ripped up. Come on PSNC, wake up and look at what has been happening whilst you cling to the mistaken belief that GPs play fair. They really don’t when it suits them!

Kevin Hope, Pharmacist Director

Naresh you forgot to mention the disparity in payment for prescription dispensing between GP's and Pharmacists.

I doubt you would have many Dispensing GP's if they were paid the same rate as us.

Another thing if these ideas do go ahead this will place an extra economic burden on an already stretched NHS budget..

It's time the people in the Ivory Towers realised what good value Community Pharmacy is to the NHS.

Medicine Master, Primary care pharmacist

Hurray for the GPs or is it their wives at last we will see their true colours and instinct for not for profit. Commissioning will become easier as no monies will leave the family.
And of course the opposition fella pharmacist goes out of business. Leaving the ultimate capitalist dream and government nightmare a monopoly. Pharmacy can truely advance their clinical calling without having to resort to generating a profit. bring it on

Frederick David Roberts, Other healthcare professional

As Corporal Jones would say "They don't like it up 'em, sir". This takes me back several years to pharmacists who had no compunction at all about pouring through the "loophole" in the old Clothier Regulations like, well, I'd better not say. Hundreds of pharmacists exploited this loophole in the regs for their own personal profit heedless of the havoc they were causing to rural dispensing practices. And no, it didn't do pharmacy's reputation any good especially as they were incited to do so by their representative bodies.
And don't come back at me with all that rubbish about each to our own profession. What about the prescribing pharmacist and the diagnosing pharmacist and all the rest?
A little less hypocrisy wouldn't go amiss, methinks.

Another Pharmacist, Hospital pharmacist

The future viability of traditional contracts is dubious with some multiples proposing mergers (essentially closures) and the future likelihood of 100 hour pharmacies to make a profit is doubtful with past articles in C&D reporting a need to dispense 20k items PCM to break even. We simply cannot allow more pharmacies to open with the current funding model that exists, we aren't like every other retailer we are professional people required to provide a service that meets all legal and ethical requirements that exist in our sector and cannot be compared to clothes shops and wine merchants which incidently are closing at unprecedented rates because of oversupply in their sectors. PNAs were conducted by PCTs but even in the absence of a need being identified in an area contracts were still granted. Our funding model is wrong, further dilution of this reduces income which ultimately leads to further erosion of locum rates. I think it is naive to think locum rates are reducing simply because of opportunism by the big companies, this may play a role but Cat M clawback, further dilution of global sum, falling counter/shop sales and a potential fall in dispensing fee have made it increasingly difficult to pay for head office support function and still end up with a profit to distribute to shareholders/owners. The future isn't great but entering into ill conceived partnerships with GPs with the inevitable consequence of forcing established contractors to shut is not the answer to the situation we currently find ourselves. The PSNC needs to be more effective at negotiating with the DoH so that we get a fairer deal, the government needs to understand that pharmacy already provides great VFM working within its current finances and can ill afford additional cuts and clawbacks and pharmacists need to prepare themselves for a difficult future - the good times are unfortunately over.

S S Locum, Locum pharmacist

welcome to the real world.newsagents, wine merchants , shoe sellers, clothes shop etc are able to open anywhere then why not Pharmacies (what ever any one says retail pharmacy is a business just like others) These greedy supermarkets and multiples (who freeze or even cut locum pay) need to have competition.This is fair play and NOT crazy at all !!!

Kevin Hope, Pharmacist Director

How long as SS been a locum or for that matter a Pharmacist, can't he/she remember pre 1986 days?? When in the larger cities Pharmacies were found in the back room of most corner shops. None of these were viable, it actually cost the Government of the day money to keep them on the register!! That is why there were financial incentives at the time to close.
100 hour Pharmacies will go down the same route, how many are actually manned by a Pharmacist for 100 hours?
In relation to Locum pay the Independent will always pay that extra for quality Locums if their business is run like clockwork in their absence.
As for GP's trying to open within their surgeries let them try, I think they'll find there's not the money in Pharmacy that they think, there was a time when dispensing a Rx returned 33% profit lucky to see 10% nowadays, besides the GP's have probably the most enviable contract in the NHS at the moment!!

A P, Community pharmacist

i don't think i put my point across correctly. the crazy part is that it seemed like blackmail - 'if you don't give me money, i'll open a shop'?!?!??!?!?

A P, Community pharmacist

This seems a bit crazy. It is not showing Gp's in a good light at all. Maybe they should give us a financial incentive?!?!?!? they might be better employers, i don't think it can get any worse than it is at the moment. i have always gotten on well with the local gp's, but what this article is saying is totally dodgy.
do we know why they think they deserve a financial arrangement? can you elaborate more on these 'external commercial deals'? who is this external source??

, Superintendent Pharmacist

Locums and employees should support the doctors and offer to work for the doctors.
They should offer to go in to partnership with doctors.

Existing contractors treat locums poorly.. No rate increases etc.
Surely a locum would be no worse off with a doctor employing him, and proably better off.
The may treat the pharmacist as a professional and pay a fair rate.

I welcome this. It is the only defence employees and locums have to combat exploitation.

Adina Brown, Community pharmacist

i agree absolutely

Stephen Eggleston, Community pharmacist

This looks like you would happily sell your soul in some sort of faustian pact - with what could be untold damage to pharmacy in the medium & long term; GPs owning pharmacies is a bad idea - they will recommend to their patients that they use the GPs pharmacy (I am careful to avoid accusations of direction) to the detriment of all contractors. Yes - life is tough in pharmacy but you don't see GPs squabbling amongst themselves. If you actually believe GP will be better than a contractor as an employer, I think you are being a little short-sighted

Clive Hodgson, Community pharmacist

Giving in to and working for a blackmailer does not seem to be a great idea to me.

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