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Over three quarters of small pharmacies in dark about funding

Jane Ellison MP: This is not a large-scale problem

Only 16 out of 73 'essential' low volume pharmacies know whether their top-up funding will continue beyond next month, says health minister Jane Ellison MP

Less than a quarter of pharmacies with low dispensing volumes have been told whether their top-up funding will continue beyond this month, the government has revealed.

Only 16 of the 73 pharmacies who receive the additional NHS England funding – designed to support 'essential' small businesses at least 1km from another pharmacy – have been assured they will continue to be financially supported once a national scheme ends on March 31, health minister Jane Ellison MP said yesterday (March 3).

In response to concerns raised by MPs about potential pharmacy closures if this funding ended, Ms Ellison stressed that this was a "localised" issue and not a “not a large-scale problem”.

Forty-seven pharmacies were waiting to hear whether their local NHS England area team had accepted their proposal for continued funding and 10 were still “working closely” with area teams, she said at a parliamentary debate on the issue.

Pharmacies on the current scheme – the Essential Small Pharmacies Local Pharmaceutical Services (ESPLPS) scheme – told C+D last month that they were “completely reliant” on the extra funding, and would have to close without it.

Spurring teams into action

The minster recognised that the situation was difficult for contractors, she said, who may not have had the time for “protracted contractual negotiations” with area teams about their funding. She hoped the debate would “spur” area teams to urgently look at outstanding funding proposals.

Ms Ellison insisted that an end to national funding did not mean these pharmacies had to close. It was “obviously up to the individual contractor” whether they wished to apply for an extension of their support funding or return to the normal pharmaceutical list, she said.

If these pharmacies closed, their patients would still have access to pharmaceutical services from internet businesses and delivery services, she added.

But shadow pharmacy minister Jamie Reed MP said some contractors would be left with “no option” but to close without the funding, which would have a “devastating impact” on communities.

“Isolated health economies are already struggling and frequently achieving sub-optimal outcomes. Reducing access will only worsen those outcomes and increase acute service pressures,” he said.

Romsey and Southampton North MP Caroline Nokes, who called for the debate, said few pharmacists had confidence that funding would be agreed before the end of the month.

“The reality is that March 31 is exactly four weeks away and for many pharmacists there is still no certainty. I am acutely aware of how many are simply in a state of limbo, having no idea whether their business will be viable 28 days from now,” she said.

Last month, ESPLPS contractors told C+D that NHS England’s area teams were not prepared to fund their pharmacies indefinitely – instead expecting the businesses to make themselves more profitable. 


Do you know of any small pharmacies still waiting for a funding decision?


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The NHS England Wessex Area Team has stated that "there is no legal mechanism simply to continue top up payments", but quite forgot to mention that there is legal provision within the pharmacy regulations for NHS England's Area Teams to provide financial assistance to essential small pharmacy contractors in the form of development grants pending the finalisation of the new LPS proposals they are now required to make if they do not wish to "return" to the pharmaceutical list. To my certain knowledge, other Area Teams (such as North West and Devon, Cornwall & Scilly) have supported their small pharmacy contractors in this way. Whether or not these development grants approximate to the former top-up payments I cannot say, but it would seem extremely likely. It seems a pity that other Area Teams (such as Wessex) are in effect telling their contractors that no financial assistance will be forthcoming until the new contract proposals have been consulted on and found acceptable (a process likely to take another six months). To some small businesses that have for decades been reliant on financial support from the NHS, this is the equivalent of a death sentence, yet continuing the equivalent of top-up payments in the form of an LPS development grant, would cost no extra since it all comes from the same source (i.e., the pharmacy global sum). Personally I find it most regrettable that NHS England seems to have shrugged its corporate shoulders and devolved all decision-making to the Area Teams - I know there are legal reasons for this (EU tendering directives) - but without issuing any detailed national policy guidance (which could have been pre-agreed with the professional representative bodies at national level), it has led to major inconsistencies from area to area and thus the avoidable mess we are now contemplating.

London Locum, Locum pharmacist

Survival of the fittest. If you're not financially viable why must you be subsidised when pharmacies are pretty much everywhere?

N O, Pharmaceutical Adviser

The DH wanted people to open pharmacies in areas where no one would go and then Cash Rich Govt. funded this. The scheme would have been gone long ago .. but for some resistance from some influential people. Now that there are so many Pharmacies in and around these LPS pharmacies and the NHS is bankrupt they dont want to feed these pharmacies for the kind of benefit they provide (£79k !!!!!) There is a logic !!!!

SydBashford Sold&Retired&DeRegistered, Community pharmacist

Disagree with you on some of your points. Some of these ESPLPS are in rural locations with a source of prescriptions (ie GP surgery) and would require an 8 mile round trip to access the next rearest pharmacy. ie they were deemed essential. The funding (top-up) to reach the target fee (regardless of number of Rx's) comes from the pharmacy global sum, and therefore does not cost the NHS amything cannot be removed and cannot be used for other purposes.

N O, Pharmaceutical Adviser

If the global sum can be increased without actually increasing the actual sum, then why not ?? That is what they are doing. They will take all these payments off and during next negotiations say that the sum is either enough or more than required and either claw-back or let the sum remain same for all other Pharmacies. There are people trying to open new normal hour contracts in these rural areas ""WITHOUT SUBSIDY" and are always stopped due to the existence of these ESLPS contracts. So, I don't think the patients will be left on their own !! May be even the doctors take up as dispensing doctors !!! Either provide the service or let others, who are queing, to provide it.

SydBashford Sold&Retired&DeRegistered, Community pharmacist

When the area teams or the health minister says we have the option to return to the pharmacritical list, I do not think they realise the impact on the funding. Esplps target fees top up to £79k Viable Normal contract > 2450 Rx/month approx £66k in fees Viable...ish Normal contract < 2450 Rx/month approx £24k in fees Non-Viable !!! Even those nearing 2200/mnth top end of current esplps cap would also become instantly unviable too. So the option of return to the pharmaceutical list is not really an option, we would be forced to close. What we need an LPS that raises the low cap to approximately 2900/month that would then be Equal in fees of £79k as a normal contract would achieve at this level. This would secure essential pharmacies.

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