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10 things you should know about the English pharmacy contract update

PSNC is still working on the details of each new service
PSNC is still working on the details of each new service

While the overall funding for community pharmacy is fixed at £2.592bn per year until 2024, the number of services offered by the sector will grow in 2020-21.

An update on the English community pharmacy contractual framework (CPCF) for 2019-20 to 2023-24, shared with contractors last week (February 23), offers more detail about some of the services first announced in the contract last year.

Changes include the introduction of the NHS Discharge Medicines Service, which community pharmacies will be expected to provide a new essential service from July. As part of this, hospitals will be able to digitally refer patients to their pharmacy for guidance on newly prescribed medicines or updated prescriptions.

Pharmacies will continue to deliver the Community Pharmacist Consultation Service (CPCS), which will be expanded to include referrals from NHS 111 online in June, and from GP practices later this year.

The Pharmaceutical Services Negotiating Committee (PSNC) is still finalising the details of each service, in collaboration with NHS England and the Department of Health and Social Care (DH) and working towards an agreement on the payment contractors will receive in 2020-21.

Here is our pick of the 10 key updates contractors need to get ready for:

  • Hepatitis C testing service: This service will be nationally commissioned from April, and will ask pharmacies to refer patients found to have positive antibodies to a local treatment service. Although all pharmacies can offer this service, it will “generally only be of interest to those pharmacies offering a locally commissioned needle and syringe programme”, PSNC said in a Frequently Asked Questions document, published last week (February 23). Reimbursement fees and service specifications are still being defined.
     
  • CPCS referrals from NHS 111 online: From June, pharmacies could receive referrals for urgent medicines supply from NHS 111 online.
     
  • NHS Discharge Medicines Services: This new essential service is expected to be introduced from July. It will allow pharmacists to use their skills as medicines experts to offer guidance on newly prescribed medicines to patients recently discharged from hospital. Under the service, PSNC expects pharmacies to receive a fee for each referral they complete, but the amount is still being decided.
     
  • CPCS referrals from GP practices: This extension of the CPCS could be introduced as early as October, subject to the success of current pilots, and will see GP practices refer patients to pharmacies when appropriate.
     
  • Clinical pilots: A number of clinical services will be piloted over the coming financial year. These include a blood pressure testing service; a smoking cessation referral service; and a point of care testing for Streptococcus A in community pharmacy.
     
  • NHS travel vaccinations service: Subject to negotiations with NHS England and the DH, pharmacies could soon be offering four NHS travel vaccines: against polio, typhoid, hepatitis A and cholera. PSNC believes these vaccines, already provided by some GP practices, could be introduced by March 2021.
     
  • Transitional payments: These will increase from April and will be linked to each pharmacy’s dispensing volume. However, payments will reduce over the course of this financial year, as new services are introduced and funding is transferred to them. PSNC was unable to share details on the revised payment bands for 2020-21 at this stage, as these are currently being finalised with the DH.
     
  • Establishment payments: Contractors can expect to receive reduced establishment payments. These will be phased out by the end of 2020-21, as announced as part of the CPCF last year.
     
  • Reduced Medicines Use Reviews (MUR) budget: In 2020-21, NHS England will commission a maximum of 100 MURs per pharmacy and from July, when the new NHS Discharge Medicines Services is introduced, “70% of MURs will be targeted solely at high risk medicines”, the commissioning bodies, the DH and PSNC said in a letter to contractors. MURs will be decommissioned by April 2021.
     
  • Pharmacy Quality Scheme (PQS): Funding for this has been maintained at £75m but payments will be made to pharmacies depending on their 2019 prescription volume – a new aspect of the scheme. More details on this will be announced in “due course”, according to a PSNC briefing published last week (February 23).
5 Comments
Question: 
What do you make of the contract update?

D Change, Community pharmacist

There was words of strikes in the last meeting. What happens if pharmacists in community begin striking like doctors have done

N patel , Non Pharmacist Branch Manager

wow
thank you for your precise dissection of the new contract
looks like we are sha...ed again. but don't expect a revolt against the psnc.....like meek lambs our proffesion will accept all this in the name is integrating into the NHS and 'proving our worth'

SP Ph, Community pharmacist

The new contract (5 year stuck) is an absolute disgrace. It is not uniform, has no fixed plans and depends completely on Pilots (which take a lot of money away)

How? Read below the reasons point by point as mentioned in this article:

1. Hepatitis C testing service: As you can read from this article ""generally only be of interest to those pharmacies offering a locally commissioned needle and syringe programme""" -- So what about other Pharmacies??

2. CPCS referrals from NHS 111 online: Again a disaster. Just like point 1 above, this is not uniform to all pharmacies and cannot be planned hence does not form part of your financial planning. Doomed is the right word.

3. NHS Discharge Medicines Services: First of all, this is now termed as Essential service, meaning the funding will be from existing pot NO new money. Second, this kind of service is already happening in many pharmacies without being paid. The patient is discharged, the representative (never the patient as they are very ill to get out of the houe) of the patient visits pharmacy with the Pharmacy copy of the discharge summary and demand we speak to the surgery to get all medicines dispensed in blister packs in next 4 days. Again, how many patients will each Pharmacy receive in a month/ year? Disillusioned!!

4. CPCS referrals from GP practices: Same as point no. 2, but don't keep any hopes high as the GPs would simply refer the patient to the Pharmacy verbally instead of the designed referral pathway. Hence designed to fail.

5. Clinical pilots: Just an eye wash. As mentioned before, none of the services will benefit any Pharmacy in the current scenario, but the pilots will take a fare amount of funding from the main pot benefiting may a few pharmacies during the pilot.

6. NHS travel vaccinations service: Are you kidding me? Is this something that the NHS will spend money on which the GPs are already paid for? And do you expect this service to boost your NHS income lost in MURs and Establishment Payments? 

7. Transitional payments: With new proposals from PSNC that these will be linked to the Rx volume, smaller Pharmacies stand to lose a lot.

8 & 9 : Hahaha what a shame.

10. Pharmacy Quality Scheme (PQS): Again, the PSNC is trying to tie up the payments to Rx numbers meaning the most velnerable small ruarl lonely Pharmacies would lose BIG TIME.

Its time we boycott the PSNC and take the funding matters in our own hands. Just like our neighbouring Scots and Irish colleagues.

P M, Community pharmacist

fact all monies are be transferred to high volume dispening pharmacies.. ie web based .. 

the subsequent closure of small pharmacies is going to be a real shame for the public, who will soon have to visit larger pharmacies..similar to what happened to post offices.. longer waits etc

the general public dont know whats going on .. as there has been no coverage in media and hence no outcry.

 

Leon The Apothecary, Student

But it has been covered in the media. I believe the term "Pretend Doctor" was thrown around on mainstream television. I believe that should be an indication of the public perception of pharmacy.

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