PSNC worked hard to support community pharmacy teams in 2018/19, including securing funding levels and producing numerous guidance materials. A core function of PSNC is to help community pharmacies to fulfill their healthcare role for the NHS; here are some ways we did that this year.
Negotiating fair funding for all the work that community pharmacies do as part of their NHS contract, and ensuring that funding is delivered in full and fairly to contractors, is a crucial part of PSNC’s role. Contractor costs and the manageability of the services they have to offer are central to all our funding discussions and we use financial modelling and analysis to show the rising pressures on the sector and to support our case to Government.
The settlement we reached with the Department of Health and Social Care (DHSC) and NHS England in October 2018 maintained funding levels at £2.592 billion, thereby stopping a planned cut of £33 million and protecting contractor funding as much as possible. Reaching an agreement also allowed us to start rebuilding constructive working relationships with HM Government.
Prior to October 2018, we also protected pharmacy funding distribution by keeping the Single Activity Fee (SAF), Establishment Payments and Pharmacy Access Scheme (PhAS) payments the same as the previous year. Then with mounting pressure on pharmacies’ cashflow, PSNC’s representations to DHSC secured a reduction in the level of margin recovery through a £15 million increase in Category M prices over the summer.
KEY DEVELOPMENT: FLU VACCINATION
The Community Pharmacy Flu Vaccination Advanced Service was once again commissioned for the 2018/19 flu season. PSNC negotiated an uplift in fees for the service, with pharmacies receiving £9.48 per flu vaccination administered. We also streamlined some of the processes for pharmacies, for example by securing the removal of the requirement for pharmacies to register with the NHS Business Services Authority (NHSBSA) before providing the service and making provision for patients to be vaccinated at home. Other improvements related to payment processes and training requirements.
Recognising the immense pressure on pharmacies, PSNC is continually working to ensure that healthcare developments are as practical as possible for busy community pharmacy teams. This year we pressed for improvements to be made to NHSmail and helped NHS England and Primary Care Support England (PCSE) – managed by Capita – to address issues relating to market entry and the delivery of NHS stationery for the community pharmacy sector.
We also made sure that lessons were learnt from pharmacies’ experiences of the Electronic Prescription Service (EPS), and secured a route for pharmacies to appeal against overpayment decisions as part of the new post-payment verification process.
KEY DEVELOPMENT: QUALITY PAYMENTS SCHEME
We worked with DHSC and NHS England on improving the Quality Payments Scheme and, for the second scheme of 2018/19, a correction period was agreed for any pharmacies found not to be meeting the gateway criteria in the first instance. This gave pharmacies another chance to meet the gateway criteria, rather than simply losing out on all their Quality Payments.
Representation on key topical issues
Recommendations for the 2018/19 Flu Vaccination Advanced Service included a new product for those aged 65 and over: the adjuvanted trivalent influenza vaccines (aTIV). Once it became clear that the sole manufacturer, Seqirus, would struggle to meet demand, PSNC was keen to secure an equitable distribution of aTIV between GP practices and pharmacies. We met with DHSC and NHS England throughout the flu season to monitor the situation and make representations to them on how the phased delivery system was impacting on pharmacies’ ability to provide the service.
The second half of 2018/19 saw a surge in Brexit related work, particularly contingency planning for a possible no-deal scenario. PSNC formed the Community Pharmacy Brexit Forum to bring together all the relevant parties, including DHSC, to discuss the issues affecting pharmacy. The Forum shared messaging from Ministers and gave details of actions to take where possible.
KEY DEVELOPMENT: INFORMATION GOVERNANCE TOOLKIT
As part of an overhaul of the NHS Information Governance (IG) requirements, we worked closely with NHS Digital to develop a new Toolkit for pharmacies’ 2018/19 IG return. We secured auto-completion of around half of the questions for those who had completed PSNC’s Workbook on General Data Protection Regulation (GDPR) earlier in the year, and we initiated plans for PMR suppliers to provide answers for 12 technical questions – all making it easier for contractors to make their IG returns.
Giving pharmacy a voice
In 2018/19 we responded to more than 10 major consultations on contractors’ behalf. Our responses addressed the types of items prescribed on NHS prescription, regulation of registered pharmacies, safe custody of controlled drugs (CDs), decriminalisation of inadvertent dispensing errors, and the rural economy. In particular, our representations led to the exemption of pregabalin and gabapentin from the safe custody regulations when they become Schedule 3 CDs so that pharmacies were not required to keep these commonly dispensed drugs in the CD cabinet.
As NHS England worked on its Long Term Plan, we collaborated with the other national pharmacy organisations to feed into the various working groups. We provided detailed briefings on how community pharmacies could be better enabled to help the NHS, highlighting innovations already taking place across the country.