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PSNC calls on contractors to stop providing unfunded services for free

Simon Dukes: "Simply not possible" for many pharmacies to offer services for free
Simon Dukes: "Simply not possible" for many pharmacies to offer services for free

Community pharmacies should stop offering services that “fall clearly outside” their contractual obligations for free, the PSNC has said.

The Pharmaceutical Services Negotiating Committee (PSNC) advised contractors to “reconsider” providing services that are not part of the community pharmacy contractual framework (CPCF) for free in a statement today (August 21).

This comes after reports from contractors that they are “increasingly being asked to pick up primary care work which would normally fall outside of pharmacies’ funded services,” the negotiator said.

PSNC chief executive Simon Dukes said the “very treacherous financial situation” that many pharmacies are in means it is “simply not possible for many to continue to offer extra services free of charge”.

This statement comes following the COVID-19 pandemic, during which pharmacies have told PSNC of “significant increases to their workload” and new ways they have stepped into supporting patients through the crisis.

The negotiator said a large proportion of the unfunded work contractors have been carrying out “has been prompted by the COVID-19 pandemic”.

It includes services such as “taking blood pressure measurements for patients; helping patients to use other health monitoring equipment; helping patients with reordering repeat prescriptions and liaising with practices; and delivering medicines to vulnerable or housebound patients (outside of the government’s scheme for shielded patients)”, the PSNC added.

As this work is not funded as part of the contract, contractors are entitled to “charge people for some of these services”, the negotiator said. They can also “choose to say that they are unable to provide this help”, it added.

“While some of this work is a core part of community pharmacy’s remit as a key local healthcare resource for local communities, other tasks now being asked of pharmacies fall outside the scope for which they are remunerated,” Mr Dukes said.

Additional funding under negotiation

The PSNC has “put a comprehensive business case” to the government regarding the increased costs faced by contractors as a result of COVID-19, which is currently under negotiation, it said

However, as there is no extra funding available at this time, the PSNC has advised that contractors stop providing services for free – advice Mr Dukes said is “not given lightly”.

“As a sector we have for many years offered services free of charge or at a tariff that does not even cover our costs, and this simply is not sustainable in the current funding environment,” he continued.

“Without action to balance costs, the core professional services of pharmacies may all be at risk, and this would have a significant and detrimental impact on patients which must be avoided,” Mr Dukes added.

37 Comments
Question: 
What do you make of the PSNC's statement?

John Schofield, Locum pharmacist

Re  this topic: I wonder how many PSNC reps either as proprietors or company reps aggressively offered these services  ten to twenty years ago They have only themselves to blame!Thankful to have completely retired but still read C&D on iphone 

 

Watto 59, Community pharmacist

I have always thought that offering a free delivery service for NHS prescriptions created an invidious distinction.  This is where the GPhC could act if they dare take on the vested interests.  For online pharmacies they should at least be made to charge a delivery fee at cost as a minumum

.

C A, Community pharmacist

That would require the Drug Tariff to change as it currently say's they can't charge for deliveries.

Mark Ashmore, Superintendent Pharmacist

Great suggestion but if we were all to start charging for deliveries then there would be even more script direction to Internet pharmacies by GPs

 

A.S. Singh, Community pharmacist

my local surgery have shut their doors for months now. They have also expected my pharmacy to request all patients medication (they will not handle paper) and also expect us to monitor when patients are not due despite requesting.

Total joke

*This comment has been edited to comply with C+D's community principles*

Mark Boland, Pharmaceutical Adviser

The employers are not providing services for free - the employees are. The services bring in prescriptions and so profit. Employees are ordered to carry out the services in addition to their normal workload without extra pay or additional help - they absorb any cost.

After a while the employees burn out and quit. They are quickly replaced by the endless supply of workers who feel lucky to have job. The cycle restarts.

Axed Locum, Locum pharmacist

Indirectly the Employees and Locums earnings which have remained subdued or gone down in real terms, supports the free delivery and collection service!!.

 

 

Adewale Samuel ANIGILAJE, Community pharmacist

I have been wondering why Pharmacists in the UK likes to sell themselves so cheap. No one offers a services not paid for. In the past, some pharmacies buys delivery van, employ driver or pays a driver to deliver. If I were in Government shoes, I will execute all the funding cuts we are now witnessing . Such behavioural pattern of free services only shows you are paid too much. Offering services not paid for should not even have anything to do with Funding, it should only be about a contractual framework.

Freelance Chemist, Pre-reg Pharmacist

Isn't this cartel behaviour??!
 

So it's ok for the shoe shop, cream company, owl, opposite to ill. Night (opposite to this) Lewis to act like a cartel?

Adam Hall, Community pharmacist

Not at all - it is just a suggestion. If you wish to continue to fund free, non-contractual services from your ever-dwindling income, fill your "shoe shop"! The challenge has been that, historically, every provided free services in order to compete but now, script income has been eroded such that it's better to let someone else (you?) provide that service at a loss than bear that loss yourself. 

Freelance Chemist, Pre-reg Pharmacist

I don't own a pharmacy so it doesn't bother me. 

but to me it sounds like an instruction/direction. As the old saying goes "If it looks like a duck, swims like a duck, and quacks like a duck, then it probably is a duck!"

For the record we should only do the bare minimum as set out in a contract, they will then need to pay more.  
 

I don't wanna hear the [email protected] about slave drivers having no money!!

 

C A, Community pharmacist

"If it looks like a duck, swims like a duck, and quacks like a duck, then"

It's probably a Grebe... wait what

Sanjay Patel, Community pharmacist

There is no coherence amongst all of us -you just have to look around with the increased marketing from the big boys (B... ,L...,W...,Co... P2U..etc) offering "Free delivery service".

 

 

Adam Hall, Community pharmacist

The free deliveries are associated with online ordering where the scripts are dispensed through central hubs (internet pharmacy by any other name) and as such, the cost per item to dispense is that much lower. I would not be surprised if many of them use dispesing robots, so you can really "sweat the asset" by running it 24/7

C A, Community pharmacist

It will be interesting to see P2U 2020/21 financials... I'll tell you that much.

 

Gerry Diamond, Primary care pharmacist

I remember free collection and delivery of prescriptions just starting, free care home systems and wondered how long this would be sustainable. Seems the gas has run out on them with charges on these items, and rightly so the customer should pay if not funded.

Leon The Apothecary, Student

PSNC once again is showing it has a complete disconnect from the actual machinations of community pharmacy. If everyone was to stop delivery service tomorrow, there would be a massive outcry.

Other things to consider is the timescales in which we get prescriptions prepared. If a patient comes in early, start telling them they may only turn up after five working days.

Ironically, both would take off so much pressure from pharmacy businesses, apart from the mass hysteria they'd have to endure. 

Getting Shorter, Community pharmacist

Our delivery service is very smooth as we tell them when we will deliver so there's always a day or two built in.

 

On the other hand, since the surgery shut down morning surgery, they have been telling all the patients spoken to remotely, etc, that their script "will be ready after 1:30" - which is, of course, the time we're allowed to pick up the pile as well. I know this is not a new thing, but it's jumped an order of magnitude since lockdown and the surgery closing doors. We're now facing a stream of grumbling and abuse as we're trying to build in a couple of ~hours~ to let us get sorted (and reduce waiting-in-the-rain times, number of visits etc)... and that's after the surgery have had a couple of ~days~ to produce the repeats, of course...

Ebers Papyrus, Pharmaceutical Adviser

Dukes has tried his best to be collaborative but has finally come round the inevitable conclusion that you can't negotiate with incompetent bullies and blaggards. I say finally because it's been painful watching both NHSE and DH offer only lip service but maintain their multi directional attrition on the sector. PSNC need to maintain this approach and step it up as morally the treatment of the sector has been abhorrent. We must address the issue of the advance payments and ongoing funding and support urgently. We have heard for months that a strong business case was put to DH regarding advance payments and COVID costs but they have just ignored it. The bully (DH, NHSE) continues to ignore and only negotiates on their terms offering token lip service, enough is enough.

sunil maini, Community pharmacist

Look.For the first time in living memory (or my 25 years as a contractor) PSNC has grown a pair,and stood up for us properly.Is it ant coincidence that the PSNC's future remit is under review?I guess not.However if this has given them a boot up the backside,well all lets give thanks for that.However Mr Jukes,the proof is in the pudding.Get us reimbursed properly for all we did during lock-down;because unless you do,I am not sure I will be able to convince and motivate my staff to put themselves at risk again when the next inevitable lock-down occurs.

Adam Hall, Community pharmacist

If you do stuff for free, the assumptions made are 1) you must be making money hand over fist & 2) why should we pay you for providing a service when you are clearly prepared to do stuff for free

Adam Hall, Community pharmacist

A few years ago I took over a pharmacy and the first job was to stop the delivery service. The number of people who came in to the pharmacy to ask how they would get their medicines was not insignificant (the irony was lost on them) but they all stayed with me. Sometimes, you just need to manage peoples expectations.

Getting Shorter, Community pharmacist

"I'm sorry, we won't be able to deliver that until Monday."

"Oh, I'll pop down and get it, then."

Leon The Apothecary, Student

So many times I've heard that same conversation. 

K.J P, Locum pharmacist

HOORAY...., 

 

Mr Anon, Community pharmacist

Nice thoughts from PSNC (never thought I'd say that). Now just need to implement them. As others have said, a profession where your fellow competitor is ready to steal the patients you throw away, can't see this happening anytime soon.  

N patel , Non Pharmacist Branch Manager

at last..the penny drops......unfortunately not going to happen in a divided profession when some are willing to nick business from others at any cost

S Morein, Pharmacy Area manager/ Operations Manager

What a great idea.

Suggest that contractors act as a complex monopoly to the NHSE. Do PSNC want to end contract limitation because such an idea is contrary to competition and anti-trust legislation both European and British because that would be the obvious conclusion that would be reached.

Dave Downham, Manager

As the DHSC is a de facto monopolistic customer as far as most community pharmacy is concerned, sounds reasonable that the suppliers' representative is right to suggest that doing stuff for free ain't a great negotiating tactic.

Richard Judge, Manager

It's 10 years since the Cost of Service Inquiry. 

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