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NHS should pay pharmacies on wholesalers’ payment terms, inquiry says

Matt Barclay: Existing system for advance payments add "complexity to cashflow"

The NHS in Scotland should reimburse community pharmacies on the “same payment terms” established by the wholesalers, according to a Health and Sport Committee’s report.

The recommendation came after the committee heard of the financial risk pharmacies face when procuring high-cost medicines.

Community Pharmacy Scotland (CPS) had told the committee that “wholesalers' payment terms [are] 30 days, but the NHS [does not] reimburse for two-three months”, the MSPs wrote in the report on the supply and demand for medicines.

Existing systems to apply for advance funding were described by CPS director of operations Matt Barclay as “clunky”, according to the report, which was published earlier this week (June 30).  

Mr Barclay told C+D yesterday (July 2) that Scottish pharmacies can apply to individual health boards for advanced funding “for extraordinary costs related to NHS service provision”, including the purchasing of high-cost medicines.

However, this system is “bureaucratic for the contractor and the health board and adds complexity to cashflow”, he said.

“We need a robust solution that suits all parties and will continue to work with our stakeholder partners to make supply of these medicines seamless and less complex than is currently the case,” Mr Barclay added.

"Full redevelopment"

A spokesperson for NHS National Services Scotland (NSS) told C+D today (July 3) that NSS is currently “undertaking a full redevelopment of the data capture validation and pricing system used to calculate the payments to community pharmacies”.

This includes making "better use of electronic prescribing and dispensing claims”, they said.

In time, this could allow for “the elimination of paper prescriptions from the payment processes which could facilitate a shortening of the…re-imbursement…of payments to contractors”, they said.

The NSS “cannot endorse any recommendation at present but may do so as work develops in response to this report”, the spokesperson added.

The recommendation to bring NHS Scotland reimbursement for community pharmacy in line with wholesaler payment terms was one of 129 recommendations put forward by the committee in the report.

Sharing information

The MSPs also heard about the time pharmacists spend sourcing medicines and suggested that this role should be shifted to pharmacy technicians. This would “improve efficiency” and free up pharmacists’ time to share “clinical expertise with patients”, they said.

“We recommend the procurement of medicines become part of the formalised training for pharmacy technicians, including how to manage other staff to assist,” they said in the report.

The Scottish government should, “as a matter of urgency, formalise the systems for sharing information between prescribers and dispensers”, the MSPs said.

This suggestion was put forward as the committee heard from the chair of the Royal Pharmaceutical Society’s Scottish pharmacy board, Jonathan Burton, that the “recording of discussions [with patients is] down to the professional judgement of the pharmacist”.

MSPs explained that they were asking the Scottish government to inform them “what aspects of data collection are covered in the new pharmacy contract”.

They also recommended that the government “formalise the systems for sharing information between prescribers and dispensers”. This should be done “as a matter of urgency” and in “collaboration with GPs and pharmacists”, they added.

A Scottish parliament press release accompanying the release of the report referred to “the dismal failure of NHS Scotland” to “collect and share data”.

4 Comments
Question: 
Do you think the reimbursement system should be changed?

Career Miss Take, Locum pharmacist

It should apply everywhere and ' right to buy' should be scrapped 

C A, Community pharmacist

Yes

Leon The Apothecary, Student

The methodology currently used for payment reimbursement is bizarre and outdated.

Gordon Brown, Superintendent Pharmacist

As a contractor that battled with both the Health Board and Payment services when an "administration" error re advance payments for multiple high cost Hep C scripts left a whole in our accounts of over £100,000 for months. I firmly believe and have been arguing for a transparent and fully traceable payment mechanism. The high cost payments were not even linked to the scripts so were almost impossible to trace. It has improved but should be far more transparent and faster. Would be far better to be paid in full with in 30 days rather than paid advance which then comes back off up to six months later. 

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