NPA statement: What independents need from the pharmacy contract in England
11 Jun 2019
The NPA is urging everyone involved in negotiating the community pharmacy contractual arrangements for England to:
Be ambitious and don’t accept that decline is inevitable
This is a significant moment in the long history of community pharmacy and we hope all parties to the negotiation will be ambitious about the future. Decline is not inevitable. Instead, we want to see tech-enabled community pharmacies, better integrated with other health services, operating efficiently as neighbourhood health and wellbeing centres, providing excellent patient care and recognised as the front door to the NHS. The contract negotiations now underway are a chance to make a decisive shift, incentivising clinical services, integrated with safe access to medicines.
Be fair to independent pharmacies
The current system does not deliver the margin element of funding equitably across the sector. Most independents are disadvantaged by averaging, because smaller businesses cannot easily spread risk or hope to have losses averaged out. That means they are at the mercy of factors beyond their control, such as hikes in medicines prices and branded generic prescribing. A model in which a smaller proportion of funding is derived from margin should be explored.
Provide clarity and certainty
A successful outcome to the negotiations would include a clear direction on clinical service development, as well as a multi-year funding settlement, to give pharmacy owners the confidence to invest in services that will meet the priorities described in the NHS Long Term Plan.
Provide sufficient and sustained funding for change and improvement
Funding has been declining for several years, despite the increasing cost of doing business, which has led many pharmacies to reduce service levels and cut staff. The current, dire financial situation is a powerful disincentive to pharmacy owners to invest in NHS services. More funds should be made available to community pharmacy where we can demonstrate that the sector is delivering on NHS priorities. To make the necessary investments in staff, services and tech, pharmacy owners need to know there is a realistic prospect of a return.
Act with urgency
Day by day, the gap is growing between what pharmacies have the capacity and impetus to achieve and what NHS England wants them to deliver. An urgent response is required to stop irreparable damage to the network. One change that could make a difference relatively quickly is reform of the concessionary pricing system, to ensure accurate and prompt payments and give pharmacies more forward visibility plus assurances that they will not be working at a loss.
The NPA has written to PSNC with a more detailed description of how we view the contractual framework and the future position of independent community pharmacy in England. It can be viewed here. PSNC performs its very difficult functions diligently, seeking to balance the needs of all contractors, so we are confident they will take our views into account as they continue negotiations with NHS England and the Department of Health & Social Care.
We’ve taken the decision to publish this letter so that everyone can see where the NPA is coming from. It’s important to be transparent with NPA members about what we’re saying on their behalf.