PSNC secured the first ever multi-year funding commitment to NHS community pharmacies. The deal guarantees funding levels until 2023/24 and outlines a clear vision for the expansion of clinical service delivery.
The NHS Long Term Plan and GP Contract published in early 2019 gave the first indications of what the Department of Health and Social Care (DHSC) and NHS England and NHS Improvement (NHSE&I) would be looking for from community pharmacy in the 2019/20 round of negotiations. Several months of difficult negotiations followed in which PSNC made the case for a long-term investment in the sector rather than more funding cuts, demonstrated the value of community pharmacy services to the NHS, insisted that pharmacies’ costs and workload must be reviewed on an ongoing basis and argued that pharmacies would need help in releasing capacity.
£2.592bn per year from 19/20 to 23/24 and monthly transitional payments
New service embedding pharmacy in NHS patient referral pathways
Updates to Quality Scheme each year and incorporation into Terms of Service
A range of new services to be piloted and introduced over the five year contract
Annual reviews each Autumn and consideration of reimbursement reform
Funding and payments
A key PSNC aim was to secure a multi-year finding settlement, and the five-year Community Pharmacy Contractual Framework (CPCF) agreement secured £2.592bn per year for community pharmacies in England. As well as providing pharmacy owners with a greater degree of certainty about the future this was a significant increase on the Government’s planned funding levels. PSNC also safeguarded the pharmacy network by ensuring changes to funding distribution were made in a phased manner.
The deal plotted a route towards a more clinically focussed future for the sector and, to help contractors meet the costs associated with these changes, a series of monthly ‘Transitional’ payments were put in place. In exchange, we agreed to consider a range of reforms to reimbursement arrangements: these will not impact the agreed funding envelope and should help to smooth delivery of retained margin, but they need to be carefully considered. This began with a public consultation in summer 2019 with detailed discussions to follow.
New consultation service
The launch of the NHS Community Pharmacist Consultation Service (CPCS) on 29th October 2019 was a significant milestone. This newly agreed Advanced service saw patients referred into community pharmacy by the NHS 111 phone service with plans to expand to include referrals from NHS 111 Online and from GP practices. The CPCS aims to help relieve pressure on the wider NHS and speed up patient access to treatment by making use of pharmacists’ core knowledge and skills. It further embeds pharmacies in NHS pathways.
Providing CPCS: A pharmacist’s perspective
‘The introduction of the new NHS CPCS should be an exciting development for community pharmacies across England: it is a positive development in our journey towards becoming providers of more clinical services.
Over time the service will enable us to take the lead role in managing people with minor conditions on behalf of the NHS. This will have a positive impact in reducing pressure on urgent care services and, crucially, it will give us a core clinical role at the heart of primary care, with GPs and other services relying on pharmacies and sending their patients directly to us. PSNC will be using our success to make a business case for further investment in the service and the sector in future years.’
Gary Warner, Chair of PSNC’s Service Development Subcommittee and independent community pharmacy contractor, July 2019
CPCS Early Data: The first ten weeks of the service
patients were referred from NHS 111 to CPCS
Quality scheme update
The Quality Payments Scheme became the Pharmacy Quality Scheme (PQS); a minor change but one that set a better tone for discussions with wider stakeholders. To help drive progress and improvement, PSNC agreed that the gateway and quality criteria for PQS will change on an annual basis, with some, such as obtaining Healthy Living Pharmacy status, becoming CPCF Terms of Service requirements during 2020/21. Aspiration payments were introduced to ease the financial burden whilst pharmacy teams worked towards the criteria.
The sector has long been making the case for the range of services that pharmacies are funded to offer to be expanded and, as part of the CPCF deal, we were able to draw up a timeline for a range of new services to be piloted and introduced over the course of the five years. These services should help to further embed the sector within the NHS as well as offering improved care to patients and the public.
Year two: 20/21
In late February 2020, PSNC finalised the arrangements for the second year of the deal with DHSC and NHSE&I. Key arrangements included: confirming new post-discharge medicines and Hepatitis C testing services, setting timelines for the next PQS review point and changes to the Terms of Service, and announcing the piloting of additional public health services. COVID-19 then led to some changes to this plan, as PSNC argued that coping with the pandemic needed to become the top priority.