A look back on a challenging year for independents – and what the NPA has done to support members

23 Dec 2019

Implementing the new contractual framework in England

Implementing even the most basic elements of the new Community Pharmacy Contractual Framework (CPCF) in England is complex and takes time. To help our members get a handle on it, the NPA has already produced nearly 30 resources relating to the Pharmacy Quality Scheme (PQS) and the Community Pharmacist Consultation Service (CPCS) alone – everything from Standard Operating Procedures to GP referral forms and red flag factsheets. This is an indicator both of the hard work the NPA is putting in to support members and of the sheer scale of the task that pharmacy teams face.

Our CPCF calendars and checklists will help ensure you don’t overlook vital deadlines, including deadlines for claiming payments. We know from the volume of calls coming into our advice and support helpline that members are hungry for support with the implementation of new services, in particular the CPCS. Our popular webinar on this topic can still be viewed on the NPA website. The live event gave members the chance to put questions to two pharmacists who developed and delivered the original NHS 111 referral service in the north-east of England. Then there are risk reviews, patient safety reports, digital enablers, and many other things to be done, big and small.
NPA resources for all of these can be found on our website www.npa.co.uk/CPCF.

Helping independents get to grips with changes to local NHS structures in England

There’s a hugely significant engagement agenda at a local level. Pharmacies are well placed to support delivery of a range of services for which billions of new funding has been made available to primary care contractors. Therefore the NPA has invested in new capacity to support independent pharmacies to cooperate with one another on service delivery and to engage with Primary Care Networks (PCNs) effectively. This includes the part time appointment of Michael Lennox – chief officer of Somerset LPC – to advise and educate members.

Please click here for a reminder of some of the business and practice resources we provided to members in England in 2019.

Supporting members in Scotland

The Supporting Excellence resource for Scottish NPA members has been a hit, with many members asking for copies. Scottish NPA member forums in Glasgow 2019 were well attended and the NPA board also convened in Glasgow. The forums will rotate around Scotland next year with the first one in March in Edinburgh. Recognising the significance of workforce pressures, we’re working collaboratively with other Scottish pharmacy organisations to develop a toolkit to promote community pharmacy as a career choice.

Please click here for a reminder of some of the business and practice resources we provided to members in Scotland  in 2019.

Representing independents in Northern Ireland

We launched the Supporting Members in Northern Ireland resource, which helps members to operate efficiently and to support their teams through challenge and change. Other bespoke resources provided in 2019 included support for Continuity Planning, Patient Incident Reporting, SOPs on Pharmacy First and the Living Well campaign. We responded to consultations from PSNI on amended guidance for Patient Consent and Maintaining Sexual Boundaries and provided detailed comments to GPhC’s Joint Assessment for Pre-registration. We also worked with members to formulate responses to Department of Health’s proposals for new Drug and Alcohol strategy and Reshaping Stroke Services in NI.

Please click here for a reminder of some of the business and practice resources we provided to members in Northern Ireland in 2019.

A time of change in Wales

The last year has been a year of significant change for our members in Wales as they have continued the journey to a more clinical service. The financial pressure is however building up on the network as overall funding has again been frozen and the change in distribution of the Wales Global Sum is not providing the funding to the network that was anticipated. The NPA has been actively involved in ensuring that the needs and desires of our members are understood by both Community Pharmacy Wales (CPW) and the Welsh Government.

By April 2020, CPW and Welsh Government will be close to agreeing Heads of Terms for a new contractual framework which we hope will address some of the current perverse incentives and leave members less vulnerable to local changes in prescribing habits. We will need to continue to influence the agenda on behalf of our members and to help members understand the implications of any planned changes.

Please click here for a reminder of some of the business and practice resources we provided to members in Wales in 2019.

Shaping policy

The NPA took part in dozens of consultations from Government, the NHS and regulators, representing the voice of independent community pharmacy.

We began the year by continuing our influencing of the NHS Plan in England and the immediate aftermath of its publication in January 2019. The plan clearly signals that the NHS wants pharmacists to support the prevention agenda and urgent care, and provide part of the workforce solution in primary care.

We were the only pharmacy organisation to help develop the first ever Quality Framework for Public Health, which provides everyone who works in, runs, commissions or makes decisions about public health services with core information such as roles and responsibilities in the public health system.

Having briefed the policy team preparing the Prevention Green Paper (July), we were pleased to see the proposal in the document to “commission more services from community pharmacies and support them to become further integrated into local NHS provider networks.” A number of further steps will need to be taken to turn this into firm actions by commissioners.

Political and stakeholder engagement

We maintained contact with leading politicians throughout the year, to ensure the voice of NPA members was heard in Westminster and beyond. The Pharmacy Minister attended our conference in Manchester and the NPA was present at the three main UK-wide party conferences flying the flag for our members. We also held roundtable discussions at the Labour and Conservative conferences, working with colleagues from other national pharmacy bodies.
Alongside the other pharmacy bodies, we launched a joint manifesto for community pharmacy for the December 2019 General Election, and created an online ‘General Election Hub’ hosting a range of resources to help pharmacy teams to actively engage with their local parliamentary candidates in the run up to the general election.

For the first time, Ask Your Pharmacist Week was officially backed by NHS England, a small but perhaps significant precedent for further joint work in the future. The context for this year’s campaign in England was the NHS Long Term Plan – which states an aim to make greater use of community pharmacists’ skills and opportunities to engage patients. The clinical context resonates in Scotland, Wales and Northern Ireland too, as all parts of the UK are on a service development journey.

The NPA, alongside other pharmacy bodies, worked with the Department of Health and Social Care as they reviewed legislation to enable pharmacists to support the wider NHS in the event of serious shortages of medicines. We successfully advocated for Serious Shortage Protocols (SSP) which allow pharmacists to substitute medicines that are in short supply with suitable alternatives, without the need for referral back to a GP.

Financial pressures

We continue to make representations about the financial pressures on independent pharmacies. A survey of nearly 250 NPA members UK wide carried out in the first half of the year showed that cash flow is having a “critically negative effect” on their ability to operate & sustain a successful pharmacy business. Nine in 10 said the current financial situation is making it more difficult for pharmacies to maintain a safe service to patients. Many reported a drop in staff morale. The data was shared with the Department of Health and Social Care in England – to help inform decisions about future investment in the sector, and make the case for improvements to the concessionary pricing system.

We have also made representations to PSNC, warning of the danger of irreparable damage to the pharmacy network, if the current funding settlement is accepted as a ceiling rather than a floor. We are very clear that funding is not keeping pace with the increasing costs and workload, and the situation is exacerbated by turbulent and escalating medicines prices, in all parts of the UK.

Business, practice and professional advice

We have continued to provide best in class advice to members, handling tens of thousands of telephone calls and emails and producing guidance documents. Find out more about this core area of NPA support here.

Members attending our conferences and events learned from experts and from each other about developments in business, practice and policy. Our live webinar programme covered topics as diverse as pharmacy funding, business finances, employment law, social media, Brexit and the NHS Community Pharmacist Consultation Service.

Community pharmacies began implementing the Falsified Medicines Directive (FMD), showing their commitment to patient safety, even in the light of Brexit and funding uncertainties. The NPA provided detailed advice, through the UK FMD Working Group, and continues to engage regulators.

From April 2020, companies employing more than 50 people will become responsible for assigning the tax status of locums contracted through their own limited company, to reflect the correct employment status position. The NPA advised members on these ‘IR35’ changes, as well as formally highlighting concerns to HMRC about the potential impact on the sector.

Keep an eye on our Brexit resource hub, which we have been keeping up to date throughout the year.

New & popular business resources

Usage of Pro Delivery Manager (PDM) picked up significantly this year. Over 25,000 deliveries are made a day using the PDM app and on average 40 deliveries are made per day, per driver. Users report that PDM is improving the efficiency of deliveries and enhancing customer relations.

We have worked with our partners Lyreco to introduce new solutions to help NPA members save money on confidential waste services, work wear, Managed Print, hygiene solutions and more.

We also changed the way we provide access to pharmacy essentials by enhancing our arrangement with EMT Healthcare. This has ensured members benefit from better pricing on stationery and can order everything they need on one order.

The NPA now has more than 30 recommended business partners who provide specially negotiated deals for members, and can help your pharmacy business with everything from increasing your footfall, claiming tax relief and saving on your utilities. A full list of current services can be found at https://www.npa.co.uk/services-and-support/business-support/business-partners.

We are also finalising arrangements with several patient app providers and financial planning services, to add to our portfolio of support early in the New Year.

Medicines supply chain

NPA research confirmed that many independents are paying out more in bills to wholesalers than they are being reimbursed by the NHS. Pharmacy teams have displayed great professionalism and have put patients first by continuing to supply medicines to patients promptly, in good faith, despite knowing that they may be doing so at a loss.

There is no easy fix to what is a complex problem. However, NPA members in England and Wales have a new tool at their disposal, to help them monitor their Part VIIIA medicines procurement costs vs Drug Tariff indicative reimbursement prices. It allows pharmacies to monitor the indicative difference in costs between the prices they pay when buying Part VIIIA listed medicines and the reimbursement for dispensing those medicines, including the indicative difference following price concessions, if granted.

NPA members had their say on wholesaler service standards in a survey covering fairness, responsiveness and courtesy, timely communication, efficient service and transparency. Independent community pharmacies are unhappy with key aspects of the service they receive from wholesalers, but see improvements in some areas, alongside continuing challenges with quotas, communication and surcharges. We have discussed the results with the Healthcare Distribution Association who have responded constructively. We will be working with the wholesaler sector to tackle the issues that matter most to our members.

Workforce development

We have been busy behind the scenes to place courses on the NPA’s new eLearning platform – Learning Academy. There are currently three courses on this platform and by the end of 2019 another three courses will be added including the popular Medicines Counter Assistant (Interact) and Dispensing Assistant course (ADAC).

Currently we are focused on writing content for a new Level 3 Diploma and combined Medicines Counter Assistant and Dispensing Assistant course to be launched early in 2020.

We’ve also enhanced our Health Living Pharmacy Leadership training for members in England and Wales and will be running face-to-face interactive workshops early in 2020 to support members who need to be accredited as a Healthy Living Pharmacy by April 2020.

The NPA was successful in its application to be appointed to the Register of Apprenticeship Training Providers (RoATP) in August 2019, which means we are now able to deliver an apprenticeship programme in England the future, should this be a viable option for the NPA and its membership.

Indemnity insurance

As NPA members would expect, the NPA Insurance team has continued to provide high levels of support and assistance for claims involving allegations of breach of professional duty and in other legal matters involving pharmacy business. As the world of pharmacy changes and the role of the pharmacist becomes more clinical, our members can rest assured that we are behind them in providing indemnity cover for new service developments.

And finally…

All of the above is just a selection of the support the NPA has given to members in 2019.

Please make sure to make the most of your NPA membership in 2020! Take a look at our membership brochure to ensure you’re not missing out on any part of what we offer: https://www.npa.co.uk/wp-content/uploads/2019/10/NPA-Membership-insert-19.web_.pdf