It would be unfair to say we weren’t warned. Pharmaceutical Services Negotiating Committee (PSNC) CEO Simon Dukes and director of funding Mike Dent were both keen to stress to contractors last month that the sector “owes a lot of money” to the government from the overpayment of margins – an admirable attempt at expectation-setting.
PSNC’s previous plan had been to enter negotiations with an outline for a service-focused contract – a sensible move for both pharmacies and an over-burdened NHS. But what we are left with is a continuation of the funding cuts for at least another five months.
The negotiator seems to be playing the long game – accepting the frozen funding level with good grace, in the hope the government will, in the words of Mr Dukes, “see this agreement as a signal of our willingness to work with them in the future”. It’s not a bad strategy for a player with little bargaining power. The question is: is this a game the Department of Health and Social Care (DH) even wants to play?
When the funding cuts were introduced in December 2016, the government could plead ignorance as to how it would impact pharmacies, which chancellor Philip Hammond insisted to Theresa May were “over-subsidised” in any case. Two years later, with the annual rate of pharmacy closures having ballooned from a pre-2016 average of 40 to an estimated 165 between October 2016 and July 2018 alone, it’s hard to argue the cuts haven’t done real damage.
In recent months, the government’s attitude has outwardly softened, with health minister Matt Hancock praising pharmacy services to GPs, and pharmacy minister Steve Brine critiquing the current contract as “sluggish” and telling C+D he wants to see “fair and sustainable” funding. But these good intentions didn’t seem to make it into the negotiation room.
As the NHS braces for another season of unsustainable winter pressures across secondary care, the government would have done well to heed the words of High Court judge Justice Collins when he summarised the potential effects of the funding cuts last year: “The concern that there will be pressures on GPs in deprived areas – where they are scarcer – and on A&E units in hospitals is a real one.”
Instead of funding pharmacies to divert patients away from hospitals at this critical time, the DH will burden them with a “cashflow dip” in January, courtesy of an upcoming 3p drop in the single activity fee. If either Mr Hancock or Mr Brine are serious about making use of pharmacy’s potential – now is the time to act.
Have funding cuts affected your pharmacy in the last 12 months? Is the picture different in Scotland, Northern Ireland and Wales? Take the C+D Salary Survey and tell us how community pharmacy across the UK is faring – complete the survey here.