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Small pharmacies: Funding threshold increases threaten survival

Contractor Hassan Khan says the threshold rise shows PSNC and NHS England are "favouring the big boys"

Low volume pharmacies awaiting NHS England top-up funding say the new 2,500 item threshold to receive establishment and item-based practice payments will make their struggle even tougher


The raised thresholds for establishment and item-based practice payments has put low volume pharmacies' survival “further out of reach”, contractors have said.

Small pharmacy contractors still waiting to hear whether they will continue to receive NHS England top-up funding once a national scheme ends tomorrow (March 31) said last week's PSNC funding announcement would make it even harder for them to qualify for normal contract payments.

The threshold to receive the establishment payment and item-based practice payments will rise from 2,430 to 2,500 items a month on Wednesday (April 1).

NHS England area teams can choose to extend top-up funding for pharmacies in their area dispensing between 6,000 and 26,400 items a year (between 500 and 2,200 a month). But the government revealed earlier this month that less than a quarter of the 73 pharmacies on the scheme had already agreed extensions.

Contractor Hassan Khan of Cullimore Chemist in Edgware, London, said the threshold rise showed PSNC and NHS England “don’t care about small pharmacies”.

“If they’re going to get rid of [the national top-up scheme], I thought they were going to lower [the establishment payment threshold]. In my head I created a vision that I could climb there. It’s 2,500 now, that’s put another eight months to a year on my plans,” he told C+D.

"My heart sank"

Roger Kirkbride, owner of Wymeswold Pharmacy in Loughborough, said his “heart sank” when he heard that the establishment payment threshold was increasing.

“My area team has issued a letter saying they’ll work with [low-volume] contractors to try to get them to return to the pharmaceutical list. But that's nonsensical if you can’t get to the [establishment payment] threshold,” he told C+D.

Makinder Suri, owner of Worsley Pharmacy in Nottinghamshire, said the rise would make survival harder. Her area team was willing to extend the funding initially but would reduce payments over two years until the pharmacy was “standing on its own two feet.”

“As they lift the bar, it’s going to be really challenging if you don’t get that extra help,” she told C+D.

Last week, contractors and a finance expert said the rise in the establishment payment threshold was an "attack on the weakest".



What impact will the threshold changes have for your pharmacy?


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James Spiral, Community pharmacist

The minimum thresholds were introduced in 2006 to stop 100 hour pharmacies opening and claiming these payments. Now the 100 hour option is closed there is no other reason to have these thresholds other than a blatant attempt to close smaller independent pharmacies. A mandate must be for forced on PSNC to renegotiate the thresholds to, at the very least, make them a more gradually stepped process as even the government doesn't in general support 'cliff edge' thresholds. The C&D should support this campaign and integrate it with the their ESPLPS campaign, as minimum thresholds are the only reasons these pharmacies are now in serious trouble. If you think you are safe, bear in mind 100+ pharmacies will become nonviable every year, if this isn't acted upon now the the minimum threshold will reach 3000+ in a few short years!

Freelance Chemist, Pre-reg Pharmacist


SP Ph, Community pharmacist

As I had pointed elsewhere, the sector doesn't seem to be working for the small fishes in the pond. It is easy to make statements but actions never follow. It is time all the small pharmacies come together and fight. All the best.

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