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PSNC chief: Of four priorities for pharmacy, one ‘keeps me awake’

Delivery of CPCS "vital" to the survival of community pharmacy, Mr Dukes said
Delivery of CPCS "vital" to the survival of community pharmacy, Mr Dukes said

There are four key areas the sector must focus on to deliver the funding deal, including one that “keeps me awake at night”, PSNC chief executive Simon Dukes has said.

The five-year funding contract sets out a “clear vision” for community pharmacy services in England, but poses “significant challenges”, Pharmaceutical Services Negotiating Committee’s (PSNC) Mr Dukes said at a Westminster Health Forum event in London on Wednesday (November 20).

Although there are “many” priorities for the sector, Mr Dukes highlighted four that pharmacies should “focus on for delivery”: the Community Pharmacist Consultation Service (CPCS); capacity; collaboration; and quality of pharmacy services.

Delivery of the CPCS “vital”

More than 10,000 pharmacies have signed up to deliver the CPCS – which sees pharmacies receive £14 for each consultation resulting from a referral from NHS 111 for minor illnesses and urgent medicines supply – Mr Dukes said.

This is “fantastic stuff”, as it “allows us as community pharmacy to demonstrate our clinical ability to deliver” and provides PSNC with “leverage” for future negotiations, he added.

Successful delivery of this service is “vital” to ensure it is extended to include referrals from GPs, NHS 111 online, urgent care centres and more, Mr Dukes said.

Capacity issues “keep me awake at night”

The second priority for the sector – capacity – “keeps me awake at night”, Mr Dukes said.

Pharmacy can only deliver the new contract “if we have the capacity within business to do so”. But, “we are still at the mercy of a volume-driven funding model”, which “has got to change”, he stressed.

Technology, automation and hub-and-spoke dispensing, as well as utilising the “wider workforce”, will “help build” the capacity required to deliver services, he suggested.

It is also important that technology is “available fairly” for the entirety of the sector, Mr Dukes added.

“We have four years for it to change.”

PCN meetings “pretty awkward”

“Collaboration” is another important priority for the sector, Mr Dukes said, but he recognised that pharmacies are “competitive businesses”.

Although it is “bloody difficult” for community pharmacies to work together with primary care networks (PCNs), “rivalries” and “disputes” must be put aside, because the survival of the sector “depends on it”, he stressed.

“Those first community pharmacy PCN meetings are pretty awkward and there's a lot of suspicion,” he admitted.

However, Mr Dukes is optimistic that pharmacies will “succeed”, due to their “entrepreneurial abilities” as businesses.

Discussions that take place at these meetings will “lead to business decisions” that “benefit patients, community pharmacy and the NHS”, he added.

“Demands will continue”

The final priority for pharmacies is ensuring “quality” is maintained and Mr Dukes acknowledged that making all the changes required to deliver the funding contract against “the backdrop of the pharmacy quality scheme (PQS)” is “particularly difficult”.

However, the PQS is an “opportunity to raise the bar”, by rewarding quality and “pharmacies have made an “amazing start”, Mr Dukes said. “Next year will be easier,” he predicted.

Do you agree with the four priority areas for pharmacy that Mr Dukes has highlighted?

Locum Pharmacist, Locum pharmacist

Try voting labour.We will get nothing out of the greedy grasping tories.

PoPeYe- Popeys Car Wash, Community pharmacist

The PSNC will not have "leverage" for future negotiations. Pharmacy will be told what it has to do for its shrinking global sum- and the cutting each others throats in the scramble for pennies will continue.

Reeyah H, Community pharmacist

The new Caramel Nytol may help? 

Ebers Papyrus, Pharmaceutical Adviser

Dukes needs to realise and quick that sacrificing a volume based model on a promise would be suicide. Pilots and poorly established services are not a panacea. Evidence, audit and funding is crucial then migrate. 

Bricks and mortar pharmacies, especially those dispensing less than ~7500 items per month are not part of the NHS long term plan. The new funding plan clearly demonstrates this, there is little value put on the supply service which they believe can be done at central locations for pennies.

Dukes knows this, which is why they keep banging on about "services" and "collaboration" being the future. Which they clearly won't be for most pharmacies, unless there is some sort of radical shift where income from services can match the income from prescriptions. 

C A, Community pharmacist

Whilst hubs may be able to dispense for pennies, getting it to patients can prove expensive, just ask P2U. Plus even if they don't realise it patients want a "fast" service as well as a convenient one. The amount of amoxicillin, flucloxacillin, metoclopramide or promethazine I do for irregular patients tells me that. Where does hub dispensing leave patients then? 

Leon The Apothecary, Student

Aye, the modern pharmacy has nothing to do with medicine, it is just a logistical challenge, rather than a clinical one. There are plenty of solutions and ideas out there for irregular dispensing, dispensing from GP, a local hub, next-day-delivery are just a few off the top of my head.

Point being CA, you'd need to consider more than just anecdotal antibiotics to justify your pharmacy's existence.

Watto 59, Community pharmacist

Early days for CPCS but almost a month in and only received one referral and  nothing I can do to mprove that.   Collaborating with PCNs about what exactly ? Ever increasing administration and box ticking.  Ever increasing costs and ever decreasing remuneration

PSNC should stop trying to polish  a turd and  coordinate a collective protest against this abomination. 

C A, Community pharmacist

You could always tell them to phone 111 when they turn up asking for a loan... 

Leon The Apothecary, Student

NHS 111 are merging with the Ambulance Service, so you'd be giving Paramedics a reason for increasing their job role as prescribers and management of long-term conditions.

Something Pharmacists should have been pushing for and utilising years ago, in my opinion.

N patel , Non Pharmacist Branch Manager

The only thing that keeps executives awake at night is the loss of their privileges bonuses and pension pots

N patel , Non Pharmacist Branch Manager

Can anyone smell the bs in the air

Dodo pharmacist, Community pharmacist

How can pharmacy owners invest anything in their businesses against the background of a 30% real terms funding cut over 7 years? 

Leon The Apothecary, Student

Certainly a very valid point. If the government wants the pharmacy to become a pharmaceutical clinical hub, then it would be reasonable for them to financially aid pharmacies to make this change.

As it stands, there's no incentive to do so, and promises of the future unfortunately do not pay the bills of today.

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