Plans for community pharmacy in 2020/21 include the rollout of new national services and proof of concept piloting, and of course the impact of COVID-19 in the UK is expected to be significant.
A year of transition
2020/21 was set to be the first full year of the five-year deal for community pharmacies. This would have been a transition period, bringing a number of new clinical services (e.g. the Discharges Medicine Service) on stream over the course of the year whilst preparing the way for others (e.g. piloting additional public health services).
From a funding perspective, the Transitional Payments – introduced to recognise work engaging with local Primary Care Networks (PCNs), implementing new working practices and staff training to support new services – were set to increase for 2020/21, with the intention for it to steadily be re-allocated to new services.
PSNC also hoped to work with NHS England and NHS Improvement (NHSE&I) and the Department of Health and Social Care (DHSC) to progress changes that would help contractors to release capacity.
Planned CPCF developments for 20/21
Discharge Medicines Service when patients leave hospital
New Pharmacy Quality Scheme supporting high quality care
Hepatitis C Testing Service to support eradication ambitions
Pharmacies offering advice to patients
CPCS referrals (urgent supply) from NHS 111 online
GP practice referrals to CPCS
Pilots for blood pressure testing, stop smoking referrals for patients discharged from hospital and sore throat test for Step A
The COVID-19 pandemic
At the very end of 2019/20, what began as a novel coronavirus across the other side of the world became a global pandemic with community pharmacy teams in England diverting significant resources to help respond to this healthcare crisis. PSNC in turn focused all its attention on helping contractors to get through the crisis – negotiating emergency advance funding and Bank Holiday funding, and seeking measures to help pharmacy to protect their teams and core services.
A number of changes to the CPCF were made in March 2020 to ease the workload pressure on pharmacies, and these were revisited later in the year with further announcements made in December 2020.
PSNC has been concerned throughout the pandemic about the considerable operational and financial challenges that pharmacies have been facing. We began an exercise to capture contractors’ costs which has been ongoing throughout the pandemic, and this survey has been used in two funding bids – one on COVID-19 costs, and one seeking an uplift to core CPFC funding – put to Ministers. We still await the outcomes of these bids.
CPCF year two: PSNC negotiating team views
‘The coming financial year will see a number of really positive service developments for community pharmacies, not least the launch of a new national service focused on helping people to understand and use their medicines post-discharge.
But for pharmacies, none of this will be easy.
The challenges in delivering all that Government wants from us within a flat funding envelope are already evident.’
Bharat Patel, PSNC Vice-chair and independent community pharmacy contractor
‘Year two will be another crucial year for the sector.
We need to build on the platform that we have built and continue to show Government that we are serious about helping them to meet their objectives.
The new Discharge Medicines Service (DMS) and the extension of referrals to the CPCS will give us some key opportunities to do that, while also continuing to build an important evidence base giving us leverage for the future.’
Clare Kerr, Head of healthcare policy and strategy at McKesson UK
Laying groundwork for investment
An annual review process was agreed as part of the five-year Community Pharmacy Contractual Framework (CPCF) deal, and as well as our finding bids PSNC has begun work to prepare for the first of these, which we expect to feed into negotiations about Year 3 (2021/22). This will be our opportunity to demonstrate the costs and capacity challenges that pharmacy is facing to make the case for further investment in the sector.
Systemic underfunding of the sector combined with the efficiency squeeze being placed on community pharmacies is reaching a critical point, and PSNC will continue to make the case for further investment in the sector, using data to back up its bids, and working with the other national pharmacy organisations to strengthen our case. Contractors can expect ongoing requests for help gathering evidence and data to support this work, and thank you to the very many contractors who have already helped us with these.
It is clear that the COVID pandemic will be with us for some time, and at PSNC our focus is going to remain on supporting contractors through that: battling for the funding and support that you need, while also making sure that you can take advantage of all the opportunities it presents.
The pandemic has highlighted more than ever the important role that NHS community pharmacies play at the heart of the NHS: patients need and value your advice and open-door policy; GPs and other health services want you to keep patients from their doors; the public want you to have a role in vaccinations. We will be fighting for recognition of all of this, and more.