The negotiator is "starting a phase of discussions with the Department of Health (DH) and NHS England to present [its] ideas", director of NHS services Alastair Buxton told delegates at a pharmacy seminar in London yesterday (January 16).

PSNC confirmed to C+D today that negotiations have not started yet, but the contractual framework it will be submitting has been decided upon.*

The negotiator is looking to “develop a derivation of the current community contractual framework” which will “meld bits of advanced services like the new medicine service (NMS) and medicines use reviews (MURs)” into it, Mr Buxton said.

This would require a "fundamental change" to funding models, ensuring that they "support local commissioning of services", he stressed.

Requires a new "funding structure"

Mr Buxton told the Westminster Forum that the current contractual framework does not [clearly] "tick the boxes for what patients and the NHS needs".

The current contract risks dissuading local commissioners, who may think, "do I want to commission these people, because they're still getting paid for every item they dispense?", he added.

"[The payment] is the driver to dispense prescriptions, so we need to sort that out, because that is a fundamental problem for us."

However, he stressed a new contract would "require a new funding structure". "Hopefully [we] will be discussing some of these draft ideas with the rest of you very shortly," he told delegates.

Using the 'Murray' review

The proposed contract is a step towards achieving the “excellent proposals” of the 'Murray' review, Mr Buxton said. The review – published in December 2016 – made a number of recommendations, including that “MURs should evolve into full clinical medication reviews”.

Mr Buxton said PSNC does not want the review's "ideas and concepts to be lost", even if NHS England has slightly "brushed it under the carpet".

NHS England announced in October last year that it would not publish its long-awaited response to the review, as it felt the findings had "by and large" been taken into account.

*PSNC has since clarified that its proposals for initial discussions with the DH and NHS England were discussed in its committee meeting last week.