In recognition of the extreme financial and operational pressures facing community pharmacy contractors, PSNC consistently campaigned throughout the year for additional financial support for the sector.
4.1 | COVID-19 costs
A key focus for PSNC during 2021/22 was ensuring that contractors were fairly reimbursed for the costs incurred as a result of the COVID-19 pandemic. After rejecting an offer to allow contractors to claim for only three months’ worth of costs at a maximum of £120 million for the sector, PSNC campaigned for the Government to write off the £370 million of COVID-19 loans in full. A huge amount of work was undertaken with the support of LPCs and the other pharmacy bodies to drum up support from key stakeholders; meet with MPs, secure national media coverage; and raise public awareness.
After one MP engagement event, over 30 parliamentarians from across the political spectrum wrote to the Secretary of State for Health, the Chancellor of the Exchequer and the Chief Secretary to the Treasury, urging them to provide additional financial support for community pharmacies.
Tireless campaigning on this issue helped to turn the dial in our favour and, after several months of intensive discussions with the Department of Health and Social Care (DHSC) and NHS England, it was agreed that pharmacies would be able to claim for full reimbursement of their COVID-19 costs, with the first payment coming in October 2021. As well as producing a range of resources, we also ran two workshops to help make the claims process as simple as possible for pharmacy owners.
4.2 | Funding bids
Given the immense pressures that community pharmacy businesses were under, PSNC submitted a comprehensive bid for an uplift to the Community Pharmacy Contractual Framework (CPCF) funding ahead of the Autumn Budget. The bid was timed to coincide with early cross-Government discussions on the Spending Review and included detailed analysis of pharmacies’ increasing costs and of the efficiencies that pharmacy businesses had been forced to make as a result of the real terms decrease in funding for the sector since the cuts imposed by the Government in 2016.
Unfortunately, despite the weight of evidence submitted, neither the Autumn Budget nor the Spending Review brought any immediate financial relief for pharmacies. Later in the year we submitted further evidence supporting our request for an increase in funding, but by the end of 2021/22 we were still awaiting a formal response from the Government.
4.3 | Reviewing progress
As part of the five-year deal, PSNC, DHSC and NHS England agreed to carry out joint annual reviews of the CPCF. In part due to the pandemic, the first annual review was not carried out until Autumn 2021. From the outset, PSNC’s aim was to have an honest and open discussion about what had worked well, but more importantly, what was not working. We raised serious concerns around the capacity available in community pharmacies given the absence of planned efficiency gains, and about the unsustainable efficiencies that the past couple of years had required of the sector.
In all conversations, we made clear that without additional funding, the capacity of community pharmacies was unlikely to grow and would likely shrink. We presented a significant amount of high-quality data as part of the review process, but unfortunately the Government stood firm once again, rejecting our call for the introduction of urgent measures to address pharmacies’ capacity and cost issues.
4.4 | Protecting pharmacy payments
PSNC’s ongoing mission to protect contractors from fluctuating medicines prices continued. As part of work to monitor Drug Tariff pricing, we successfully negotiated more than 700 concessionary prices as well as obtaining special container status for 10 products and Discount Not Deducted status for nearly 200. We also secured retrospective price adjustments for products such as Isocarboxazid tablets and Metformin oral solutions. The worsening situation has now led PSNC to call for an overhaul of the concessions system to better serve contractors. A series of improvements to paper prescription sorting and submission requirements were introduced in October 2021 to ease the administrative burden. The last paper FP34C submission documents were posted in February 2022 as monthly declarations moved to the Manage Your Service (MYS) portal.
The arrangements for Year 3 on the CPCF also brought a commitment to progress discussions on implementing reforms to community pharmacy drug reimbursement that had been delayed in part by the pandemic. The first of many expected changes was the launch of a new section of the Drug Tariff, Part VIIID, from March 2022. This sets out payment arrangements for specials and imported unlicensed medicines (mainly tablets and capsules) to be paid relative to an identified pack size.