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'Massive uplift' in healthy living pharmacies since cuts

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Deborah Evans: Becoming a healthy living pharmacy is not just a tick-box exercise to receive funding

Contractors are rushing to become healthy living pharmacy (HLP) accredited, to clawback funding under the government’s quality payments scheme, C+D has learned.

The HLP model, which was first piloted in Portsmouth in 2009, aims to help reduce health inequalities among local populations, by offering services such as weight management, smoking cessation and sexual health

Pharmacies can now claim up to £1,280 under the government’s quality payments scheme if they can prove they are level one HLP-accredited by either the April 2017 or November 2017 review points.

Mike Holden, principal associate at consultancy Pharmacy Complete, which helps pharmacies to become HLPs, said the “massive uplift” in the number of pharmacies looking to become HLP accredited is “undoubtedly” because of the qualifying criteria under the quality payments scheme.

“We were already working with a number of contractors across England,” he told C+D last Wednesday (February 15). “But by the summer we will have trained around 3,000 people this year.”

According to PHE figures, there were over 2,100 accredited – or on their way to being accredited – HLPs in January 2016, with 3,500 health champions.

 

HLP is “more than just a quality mark”

 

Deborah Evans, managing director of Pharmacy Complete, who led the national HLP pathfinder work programme, said she is “positive that NHS England has recognised that HLPs are an important part of pharmacy’s future, by putting the quality payments against the achievement”.

“I’m also positive about the fact that pharmacies get reimbursed for the investment they put into staff development (see below),” she added.

Ms Evans said that becoming a HLP is a good way to demonstrate “[pharmacies'] improved offerings to the community [they] serve”. It is also “a really good opportunity to become relevant to local commissioners”, she added.

However, she stressed that becoming a HLP must not be a “tick-box exercise”.

“If you sign up to become a HLP, you're signing up to an ethos where you put the community's health and wellbeing at the centre of what you do.

“It is not something you do on two days a year to achieve your quality payments. It’s something you maintain as a way of operating,” she added.

 

From local schemes to national criteria

 

The Royal Society of Public Health (RSPH) has been commissioned to pilot the new “profession-led self-assessment process” for HLPs outlined by PHE in 2016.

However, Mr Holden said this pilot of “only 500” pharmacies does not take into account the "thousands" of pharmacies already registered as HLPs.

“You may have been HLP accredited from a local scheme, but if that can’t be mapped to the national criteria then you either have to start again or build on what you’ve done already before you self-declare,” he said.

Pharmacy Complete is working with PHE and RSPH to help simplify the process for pharmacies and commissioners, he added.

 

To meet the Public Health England criteria published in 2016, HLPs must:

  • show evidence of workforce development
  • operate in premises that are fit for purpose
  • and prove it has engagement with the local community, other health professionals, social care and public health professionals and local authorities.

Source: Public Health England: Healthy living pharmacy: Level 1 quality criteria

 


Have you considered entering your healthy living pharmacy into the 2017 C+D Awards? This year, the Health Initiative of the Year combines the Public Health Initiative and Clinical Service of the Year awards. Check out the requirements and enter today.

 

30 Comments
Question: 
Have you become an HLP since the funding cuts were announced?

Valentine Trodd, Community pharmacist

It just strikes me as more than a bit sad that the profession has had to sink to the level of ticking boxes for getting an email account, one access of the SCR (don't care what it's for), becoming Dementia Friends (whatever that means), etc. all for monetary gain. Is this the great clinical future we all had in mind? Who in the NHS is coming up with this madness?

Clive Hodgson, Community pharmacist

"Who in the NHS is coming up with this madness?"

Perhaps of more interest is why someone is accepting this madness on our behalf.

Surely those negotiating for us should just say NO.

Valentine Trodd, Community pharmacist

Absolutely. Someone needs to step up and say enough is enough.

Dave Downham, Manager

Who? When you can get £320 for clicking on a website, who's going to say, nah, I'd rather not.

Lucky Ex-Locum, Superintendent Pharmacist

The thing is, we're all carping on about the HLP concept which is a bit of a pain in the rump, but we can make a few bob at least (or get back a few bob of what the NHS is stealing from us) by a few dead easy exercises. I actually found the Dementia friend meeting (I went to an event - what a goody two shoes!) really eye opening and I genuinely learned something. All of the other bits except the HLP are a doddle to do.

Valentine Trodd, Community pharmacist

I'll go back to my original question then... "Who in the NHS is coming up with this madness?"

Lucky Ex-Locum, Superintendent Pharmacist

The same one who came up with MUR, NMS and all the other dozy things we have to do. He lives in a padded cell at NHS Ivory Towers and just gets let out to inflict more misery on us....

Ebers Papyrus, Pharmaceutical Adviser

With local monies being tied up funding hospitals it's difficult to see easy avenues for services being commisioned currently. Building a display and engaging your community which we already do won't pay the wages.

On a positive note though I'm convinced pharmacy will forge new services which add value and can be profitable. The issue currently in most localities is that the services are only being piloted, it may take some time for them to be commisioned locally or even better nationally.

 

N O, Pharmaceutical Adviser

£1,280 !!! For all the hastle and no actual benefit to anyone except the big fat cats at the Public Health and other organisations making money out of this so called HLP scheme. The HLP concept itself beats the basic concept of Community Pharmacy and all the professionals working here.

Do we not give all the health advices as routine already ???? If not then the contract of the pharmacy should be revoked !! What about all the Public Health campaigns (which are mandatory every year) ??? What services are you expecting from the NHS or DoH, just because you are a HLP 1?? What services were commissioned through the existing HLPs before the funding cuts ?? Were they sufficiently remunerated?? 

£1,280/ year = about £106/ month. This will neither help the contractor nor the Responsible Pharmacist (and the staff), when the process involves so much of beurocracy, paperwork, training, audit etc. etc.

What if the next step of this process is to achieve a minimum HLP 2, 3, 4, so on and so forth with no real increase in the actual funding. One word somes it all CRAP.

L H, Community pharmacist

So after checking out the website and reading the promotional info at  www.healthylivingpharmacies.org , plus a Google search, I still can't find any actual evidence in the past year that becoming a HLP is benificial to patients.  Does any such evidence exist?  Appreciate a point in the right direction should anyone know of any.  Regards.

Steve Jeffers, Community pharmacist

Type in "Portsmouth HLP evaluation study" into google and you will find the evidence

A Hussain, Senior Management

Is this not diluting the HLP model if pharmacies inevitibly do it just for the quality payment.  Pharmacies will be advertising the fact that they aren't HLP's next as a selling point.  Especially if it is exposed to the public why it is being done!

Leon The Apothecary, Student

A pharmacy business would be silly not to pick up the funds. Every penny counts this day and age.

Andy Burrells, Community pharmacist

What does it say about our opinion of these services and their impact on our working lives if they have to bribe / force us to use them.
If we felt them genuinely beneficial, we would be already!

Shaun Steren, Pharmaceutical Adviser

Quite correct, but as you might be aware from your pre-reg experience, talking sense and thinking intelligently will not get you very far in community pharmacy. Just get the box ticked or you will be performance managed. 

Dave Downham, Manager

Will the £1,280 be repeated in 2017/8? If not, a one -off £1,280 seems not a lot to recoup the time, hassle, administrivia to achieve an accreditation that most of the public will not have heard of.

Nat Mitchell, Community pharmacist

We are not a HLP and as much as we need the funding accreditation would bring, I can't see a way in which we could honestly satisfy the requirements of being a HLP at this time.  If HLP status came with a guarantee of services then that would be a different matter.

Ben Merriman, Community pharmacist

Before Mowat decided that the most accessible and convenient part of the NHS was obviously too accessible and convenient, some areas would give priority to HLP accredited pharmacies when commissioning new enhanced services as they had shown commitment to provision of services.  Unfortunately, a significant minority of pharmacies agree to provide services and then fail to deliver the services which reflects badly on the whole sector, not just the poor performers.

Lucky Ex-Locum, Superintendent Pharmacist

It seems a lot of work for not enough gain. This whole thing smacks of the government attaching a little bit of money to making us do the things they wanted us to do all along (HLP, Summary care records etc) that we were slow to take up.

Beta Blocker, Primary care pharmacist

Glad I got out of community pharmacy when I did. Agree with Clive, we do too many free services that then lose value and then we stop getting paid for them. Community pharmacy is very undervalued and looked down upon in my opinion, having worked within community for a while I wouldn't ever go back.

Stephen Eggleston, Community pharmacist

When HLP was launched, we had to pay for the training and there was no payments recieved for being an HLP - the hope was that those with HLP status would be offered more services first. As it has turned out, HLP accreditation is now available free and services have all be cut! Ironic, or is that just me?

Clive Hodgson, Community pharmacist

I think the lesson we should all have learnt by now is never to perform services for free or at a loss in the expectation of realistic funding for future services. Disappointment is inevitable and HLP is a good example.

Lucky Ex-Locum, Superintendent Pharmacist

Ummm....is this supposed to be surprising? The surprise would be if it hadn't happened (and there wasn't a rush to become dementia friends, get a generic NHS mail account, take up summary care records access etc etc). 

Clive Hodgson, Community pharmacist

It is not suprising regarding the uptake of Dementia Friends, NHS mail and SCR access as the costs involved are minimal. With HLP however, I doubt the £1,280 payment will come close to covering the training and provision costs.

Lucky Ex-Locum, Superintendent Pharmacist

Our LPC are running free training for this. I'm enrolled on a free leadership training course (dreading it) and the Healthcare champion training is also free for one person at least.

Clive Hodgson, Community pharmacist

But is your time (and your Champions's) given up for free? Also HLP "training" is an perpetual commitment.

Lucky Ex-Locum, Superintendent Pharmacist

We get paid as normal (plus O/T for attending training days) because my little company is a good one, hence the user name!

Lucky Ex-Locum, Superintendent Pharmacist

And also, if the big boys are getting involved which they seem to be doing, there must be money to be made somewhere. If the multiples are good for anything, they act as a bellweather of what is profitable and what isn't.

Chemical Mistry, Information Technology

I understand multiples are making all their pharmacies HLP to get the money that's all.

There is no evidence to show that HLP pharmacy is any better or provides a better service than a non HLP.Making pharmacy jump through hoops for the scraps from the NHS table.

 

Lucky Ex-Locum, Superintendent Pharmacist

This is quite true and when all pharmacies are HLP (if ever) what cockeyed scheme will they come up with then? I'm a sort of if-it-ain't-broke-don't-fix-it sort of person and although community pharmacy has always had it's issues as long as I've been in the game, it's never been broken so these fixes are a bit brain dead. I'm far from being an apologist for the dopey schemes we get foisted upon us but unless we ALL get together and say enough is enough they will keep on happening so we might as well go with the flow.

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