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Rural pharmacies facing closure remain in dark over funding

Contractor Graham Phillips says his NHS England area team has been "very negative" about extending funding for his pharmacy

Businesses designated as Essential Small Pharmacies – such as one owned by Graham Phillips, pictured – are still waiting to find out if NHS England will continue to support them financially, two months before funding is due to end

EXCLUSIVE


Rural pharmacies facing closure have still not been informed whether they will receive funding from NHS England beyond March, C+D has learned.
 
The Essential Small Pharmacies Local Pharmaceutical Services (ESPLPS) scheme, which pays a variable top-up fee to around 100 contractors dispensing between 6,000 and 26,400 items a year, will finish at the end of March, putting some pharmacies at risk of closure. NHS England has told C+D that it has no legal powers to continue the ESPLPS scheme nationally, but its area teams are “considering where support would be needed”.

Contractors on the scheme told C+D last week that they had applied to their area teams for funding, but many were still waiting for a decision.
 
Roger Kirkbride, owner of Wymeswold Pharmacy in Leicestershire, said his area team had been “very closed” about whether they would provide further funding. The team had told him that if funding was agreed it would be less than under the ESPLPS scheme – forcing the pharmacy to do “more for less” – and may not be in place before existing funding ran out, he told C+D.
 

‘Completely reliant on funding’

 
Faisel Baig, owner of St Mawes Pharmacy in Cornwall, told C+D that it was “completely reliant” on ESPLPS funding. If the pharmacy closed then elderly patients would struggle to obtain medicines from the nearest pharmacies - either 15 miles by road or a ferry journey away, he said.
 
Despite “positive” conversations with his area team and almost 500 signatures of support from patients, Mr Baig said he would remain anxious about the pharmacy’s future until he had confirmation of alternative funding in “black and white”.
 
Graham Phillips, owner of Manor Pharmacy Group (Wheathampstead) Ltd in Hertfordshire – which includes one pharmacy on the ESPLPS scheme – told C+D that his application for continued funding had been backed by a local GP. However, the area team had been “very negative” and he was unsure whether the pharmacy would remain open beyond March.
 
PSNC head of regulation Steve Lutener said the negotiating body had worked with NHS England to try and find a national funding solution, but this had "not been possible". It hoped area teams would reach their funding decisions quickly, he said.

According to PSNC, a maximum of 99 pharmacies in England were operating under the scheme last August and Mr Lutener said the organisation had issued guidance to help these pharmacies in their applications for continued funding.
 
Rekha Shah, chief executive of Kensington, Chelsea and Westminster LPC and secretary of Pharmacy London, told C+D last Thursday (January 29) that area teams would write to all ESPLPS pharmacies within the "next two weeks” to set out the next steps in the decision-making process.
 
Hertfordshire LPC chief officer Helen Musson said all ESPLPS pharmacies in the county were in conversations with the area team and the LPC was supporting them through the process.

The scheme initially ran from 2006 to 2011, before NHS England extended if for a further four years
 

Will your pharmacy be affected by ESPLPS funding decisions?

 

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8 Comments
Question: 
What do you make of this story?

Malcolm Guillemette-Smith, Community pharmacist

Several years ago, I opened a Pharmacy in a village location. I qualified for ESPS payments. The village had a surgery with Dispensary. The only reason for the need for the ESPS payments was because the number of prescriptions was determined by the one-mile, which imposed an artificial limitation to dispensing. Without this rule there would be no need for the Surgery Dispensary, only a few hundred yards away, and the Pharmacy would be viable without any supplement. If ESPS funding is being scrapped, should the need for Dispensing Doctors be reviewed, as they appear to be inextricably linked?

Malcolm, my recent experience is that many dispensing GP surgeries actually dispense to patients living within the one-mile radius of a pharmacy - there are many reasons for this (e.g., dispensing patients previously eligible moving to within 1m of the pharmacy and the surgery not removing them from the dispensing list, or practice staff making incorrect assessments of patient's eligibility to receive GP dispensing when they register, etc). If as in your case (and I know of at least one other) the NHS England Area Team responsible actually did its duty and removed those ineligible patients from the dispensing list, it would make all the difference between viability and non-viability for the pharmacy. I advise you to put in a request under the Freedom of Information Act, to find out where those patients are, how many there are of them, then do the maths and present the Area Team (and your MP) with your findings.

Pharmacy HLP, Manager

I think genuine ESP Pharmacies are an absolute bonus to the patients they treat, the pharmacists can care and look after their population without having to worry about the commercial cost of running an otherwise unviable business. In the grand scheme of things this is very small beer. The good far outweighs the potential cost in my opinion. I am just a regular contractor.

Although LPS pharmacies have a right of entry to the Pharmaceutical List (and become subject to the same contractual framework as normal NHS community pharmacies), most will not be able to survive financially as such. The resulting closures will mean (I estimate) about a third of the 152 Pharmaceutical Needs Assessments the Health and Wellbeing Boards have laboriously been drafting for the past 18 months will need immediate revision and the NHS England Area Teams in those areas can look forward to a surge in new Market Entry applications and an eye-watering hike in GP dispensing fees. Patients will suffer, too - though they might not understand - because that often vital safety check in meds management, will have been removed. With less than 2 months to go before even knowing what continued NHS funding - if any - will be available locally, it's no way to run a National Health Service.

Brian Austen, Senior Management

Lets hope that NHS England do not treat this in the same way as they did the Minimum Practice Income Guarantee (MPIG) for certain GP Practices. They seemed willing to watch practices go out of business in certain areas of the country.

Jacques Gholam, Community pharmacist

I run an essential small pharmacy and like my fellow contractors in a similar situation am deeply concerned about the future funding. PSNC guidance indicated that the monies are there in the global sum and applications cannot be refused on the grounds of saving money nor can they be considerably less than previously available. The reason for being unable to run the scheme nationally , I am given to understand is because the overall size of the fund, in excess of £5 million pounds, under EU rules have to held out to tender Europe wide , which means that a pharmacy in Slovakia , can apply for the fund! I have been in contact with my local team and am hopeful that good sense will prevail (at least what I would consider to be good sense in my own case). I apologise to those contractors who'd feel aggrieved that we are perhaps robbing Peter to pay Paul from the the global sum, but as the title strongly suggest, we are Essential Small pharmacies playing a vital role in our communities. My only quibble has been that I was initially misdirected in my application and the delay is causing me serious consternation in my ability to plan for the longer term and as a Pre-Reg tutor, whether or not I can take on a new trainee in the summer...... Watch this space

Frederick David Roberts, Other healthcare professional

Patients need not worry. The dispensing doctor service is ready to take over.

Paul Dishman, Pharmaceutical Adviser

Handy that. They can sign the death certificates in house as well

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