The pharmacy funding contract needed a shake-up. I think you’d be hard-pressed to find a pharmacist who has been happy with the situation in recent years. And if you think pharmacists are lamenting the loss of medicines use reviews (MURs), you’d be very much mistaken. That being said, where pharmacists are relieved, contractors are left considering their options for recouping £11,200 per year.
From the initial information, new pilots in the pipeline for pharmacists to get involved with – such as identifying undiagnosed cardiovascular disease and point-of-care testing – seem quite exciting. For years our skills have been untapped and we’ve settled for the hand we’ve been dealt. Perhaps in its desperation, the NHS is finally recognising the capability that has been under its nose all this time.
Funding remains at its reduced level and the payments from MURs will be lost in the abyss from 2021, along with the hopes of pharmacists who were anticipating better from the Department of Health and Social Care (DH). Services appear to be a significant focus of the new contract, but with NHS 111 referral payments at a measly £14 per consultation and no funding increases, where does this leave us? And are we expected to be grateful, since the Pharmaceutical Services Negotiating Committee (PSNC) claims we have more funding than was originally intended? PSNC’s ‘success’ in maintaining the same level is a poorly disguised, progressive decline in funding.
It’s a five-year funding settlement for pharmacy. Five years in which we will see the transformation of community pharmacy as we know it, with services galore and a drought of funding required to sustain them. Pharmacists have called for more services; we’ve shouted for the opportunity to put our roles to use in keeping the NHS afloat. But if NHS England thinks it can ask us to provide services without adequate financial backing, it’s an insult to pharmacists everywhere. It would be prudent to forecast a five-year migration of pharmacists into other sectors, as they become increasingly short-changed and short of patience.
Pharmacists are adaptable and amenable folk. We've accepted change and worked through a considerable number of challenges set by the government over the years. An influx of new services means our teams will need further training, our pharmacies might need more hardware and our patients will expect more of their pharmacists. Without the funding, who is going to pay for the time and resources for it all? Certainly, multiples might find the changes suited to their needs, but independents will suffer. It is also likely that pharmacists will feel the pinch, as their salaries could be squeezed.
Health secretary Matt Hancock claims the ‘French model’ is the way forward; he wants to ensure we are reducing the burden on healthcare professionals so they have more time to care for the community. And what of the pharmacy contract? They are giving us more to do and less to do it with. Money made from dispensing will drop as salaries increase and the single activity fee payments remain the same. These so-called 'savings' will be ploughed back into 'value added service delivery'.
Pharmacies can provide a solution to an NHS that can’t cope with its demand. But pharmacist services aren’t just the cheap option to save the NHS. And yet the government continues to exploit us, taking advantage of our determination to provide for our patients. It knowingly gives us services and opportunities with one hand, while using the other to pull money from our back pockets. The contract is disappointing, not because the services look like they’ll make a difference to our patients, but because we'll struggle to provide them.
Laura Buckley is a community pharmacist based in north England