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RPS board member slams DH's 'cynical reversal' on 100-hour pharmacies

Evidence for the review was submitted in confidence to the DH by 100-hour providers
Evidence for the review was submitted in confidence to the DH by 100-hour providers

A proposal to allow 100-hour pharmacies to reduce their opening hours is a “cynical reversal” by the government, a Royal Pharmaceutical Society (RPS) board member has said.

During a consultation on the statutory review into NHS market entry regulations, “some business stakeholders raised a concern about the commercial viability of 100-hour-per-week pharmacies”, the Department of Health and Social Care (DH) said.

“Evidence was supplied indicating a very low use of early- and late-hour pharmaceutical services from this type of pharmacy, as well as data on the associated staffing costs,” the DH added in the review, published last month (March 29).

The DH recommended a “review of 100-hours-a-week pharmacies that analyses who uses these services” and consider “remov[ing] or reduc[ing] the requirements” for these businesses to open for 100 hours.

Hampshire contractor and RPS English board member Sid Dajani tweeted to C+D that the sector “must move heaven and earth in opposing” the proposals.

100-hour pharmacies were introduced “to increase out-of-hours access to those needing medicines and avoid using emergency services for common ailments”, Mr Dajani claimed.

“[The DH’s] reversal is cynical, [and] only burdens A&E [and] NHS 111 [services], costs taxpayers more [and] is bad for self-care and patients,” he added.

He urged the RPS, the Pharmaceutical Services Negotiating Committee (PSNC) and the National Pharmacy Association (NPA) to work together to fight the proposals.

Impact on independents

In contrast, Raza Ali, owner and superintendent at Riverside Pharmacy in Nottingham said: “As an independent contractor operating [a] 100-hour [pharmacy and] pitted against several multiples, [changing the regulations] would level the playing field.”

Mr Ali claimed “a lot of multiples did abuse the system”, but argued that not all 100-hour pharmacies “should be put in the same box”.

Nat Mitchell, pharmacist and director of JWW Allison & Sons Ltd in Cockermouth, Cumbria, stressed: “One of the things that makes [100-hour pharmacies] great are the extended hours they offer.”

However, Mr Mitchell said his own pharmacy and two others nearby “became either unviable or not far off unviable” when a 100-hour pharmacy opened in the town.

100-hour pharmacies represent 10% of market

According to the DH’s analysis, “as of February 2018, there were 1,153 100-hour-per-week pharmacies” in England, “representing 9.8% of all community pharmacies”. Of the nine regions the DH split England into, the north-west has the highest number – comprising 19% of the total.

The DH repeated its claim that “clustering remains, and in some areas there are more pharmacies than required to ensure access to NHS pharmaceutical services” – an allegation it has repeatedly used in the past to justify cuts to pharmacy funding in England.

According to available data on 1,135 of the 100-hour pharmacies, “636 (56%) were identified as being clustered”, the DH added, with more 100-hour pharmacies situated in areas with increased levels of deprivation and poor health.

Currently “the only option…to reduce the costs associated with this extended-hours provision is to close these pharmacies”, which “could negatively impact upon access and equalities”, the DH stressed.

Evidence from 100-hour providers

The DH told C+D this morning (April 20) that evidence for the review was submitted in confidence by current 100-hour providers and so it could not disclose the data used as a basis for its proposals.

The DH will hold a public consultation before any changes are made to the pharmacy regulations, but there is currently no timescale for this to happen, it told C+D.

According to a snapshot poll of 103 respondents on the C+D website, 85% do not think the government should "remove or reduce" the requirement for 100-hour pharmacies to open for 100 hours.

Result

Do you think the government should "remove or reduce" the requirement for 100-hour pharmacies to open for 100 hours?
Yes
15%
No
85%
Total votes: 103

Earlier this week, Xrayser expressed his anger at the DH’s proposals. Read his reaction in full here.

18 Comments
Question: 
What do you make of the DH's proposals?

b t, Manager

Why have control of entry anyway ? Surely competition drives up standards ?

Brian Austen, Senior Management

I've finally sussed what this is all about as far as the DOH are concerned. NHS England will reduce the 100 hour pharmacy hours and then use the substantial reduction in the pharmacies costs to reduce the overall pool of funding. It will be a double whammy. The ex 100 hour pharmacies will become more cost effective and the standard hour independent contractors will pay for it!

A.S. Singh, Community pharmacist

A brainless monkey could figure out that reducing 100 hour pharmacies contract to, for example 80 hours, will save nothing for the DH so when you mention cost effectivness there isn't any

Graham Morris, Design

I have always believed that allowing 100 hour pharmacies was a government ploy to encourage pharmacies into supermarkets. Yes, others jumped on the bandwagon, but supermarkets are an essential requirement in a long-term plan to establish successful hub and spoke dispensing. 

Supermarkets with their already extended hours, established logistics for swift delivery of stock, huge regular footfall and massive car parks make an ideal location for patients to collect their scripts. 

In addition, supermarkets are used to working on relatively low profit margins have welcomed pharmacies into their premises not only because of increased footfall but better margins than selling baked beans.

I am against reducing the hours for 100-hour pharmacies. If they are unprofitable, they should be allowed to fail. Reduced remuneration will have its effect, more on the independent than the large chains, due to their advantageous buying power. However, as far as I’m concerned, the horse has bolted and an important piece of the hub and spoke jigsaw is in place for future NHS plans.

Sultan Dajani, Community pharmacist

100hr pharmacies gained market entry to provide 100hrs of services. Not 20, 30, 40 or 50 otherwise they weren’t allowed to open. They took advantage of relaxed rules to provide out of hours services. If their long-term plan was to reduce hours in the first place then they should never have gained market entry in the first place. It also means we will have less out of hours pharmaceutical care and more minor ailments burdening A&Es. It is especially galling considering there’s already an existing mechanism for reducing contractual hours (around patient need) for the rest of us but not these pharmacies. 100hrs pharmacies gained entry through the backdoor and now want to bypass existing agreements and systems. How can this not be cynical on a national scale at every level?

John Steelw, Community pharmacist

"The creation of 100-hour pharmacies is having an impact on recruitment in the community sector, with some companies this year describing the situation at challenging and tough."

<a href="https://www.pharmaceutical-journal.com/news-and-analysis/opening-of-100-hour-pharmacies-has-upsides-and-downsides-for-recruitment/10008191.article">https://www.pharmaceutical-journal.com/news-and-analysis/opening-of-100-hour-pharmacies-has-upsides-and-downsides-for-recruitment/10008191.article</a>

Z Rafiq, Community pharmacist

If core hours are reduced for 100 hour pharmacies then I see no issue. If these pharmacies reduce their hours then I would still like them to have an extended hours status. Those who opened the 100 hour pharmacies did so because they could at the time as the rules allowed them. If the rules change again I see no issue. I note many are arguing against the reduction of core hours however it’s a little bit like a retail shop bemoaning internet outlets for their loss of business. 

A.S. Singh, Community pharmacist

you sound like a typical 100 hour contractor. I've worked out you need to be doing 12000 items a month or more or work 60-70 hour weeks as the contractor pharmacist to make 100 hour pharmacies viable. 

Rehan Nawaz, Pharmacy owner/ Proprietor

Did you carry out these workings without a calculator? It seems so

Reeyah H, Community pharmacist

There’s not a proper comparison at all. 

Tony Schofield, Community pharmacist

in my view

The creation of 100 hour pharmacies was in response to the OFT report that claimed that the control of entry regulations were anti competitive. It was directly responsible for the increase in pharmacy numbers that led to the letter in December 2015 stating pharmacy funding would be cut and the announcements at the time indicating DOH wanted large numbers of pharmacy closures. In my view those that qualify for inclusion in the PhAS should be able to agree their hours with the local commissioners which may or may not result in a reduction in their hours. The rest got their contracts by way of a specially created category that should continue. If they go under so be it. There are thousands of contractors currently at great risk. It’s perverse to accept that those responsible for the over provision of services should be allowed dispensations at a time when DHSE has launched an aggressive assault on the entire sector .

Reeyah H, Community pharmacist

Spot on. The first ones to close should be the 100 hours who set up on the doorsteps of long existing pharmacies and took the business with dirty deeds. That’s the truth whether anyone likes it or not. They bribed receptionists and knocked on people’s doors with ‘incentives’ to build up trade. 

A.S. Singh, Community pharmacist

Yes 100 hours should be the first to close. I know of a previously existing pharmacy (LLoyds) based in a London suburb close to 8k items. The lease of the neighbouring newsagent expired and someone opened a 100 hour right next door with those two pharmacies being the only commercial premises on the spot. Now both pharmacies are struggling (actually Lloyds sold up to Iman) sharing 4k items each...what's the point in that? 

Farhat Ahmed, Locum pharmacist

Does anybody know what the cost saving is to the DH of these pharmacies reducing their hours?

Reeyah H, Community pharmacist

None. Once the establishment payment goes that is. 

N O, Pharmaceutical Adviser

Establish payments at the moment are not based on opening hours but the number of items dispensed. So, practically they don't save anything. Only thing I can foresee is the amount being paid under the table to powers may be, to get this legislation in place to benefit the owners of these 100hr Pharmacies. No one else, including public will benefit.

Tom Kennedy, Pharmacy Area manager/ Operations Manager

It's above your paygrade, get back to signing boxes.

Francis Andrews, Non Pharmacist Branch Manager

@Tom Kennedy, you may be suprised to learn some 'box-tickers' may earn considerably more than you 

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