“Promoting the interests of Dispensing Doctors and the excellence of doctor dispensing for the benefit of patients” 1

2017 Conference Reimbursement Pharmaceutical needs assessments (PNA) Dispensing fee EPS FMD Pharmacy Shortages Rural practice challenging times Securing the future 2

Reimbursement Unfinished business Seen NHS Employers Want a system where right prescription for the patient is the right one for the NHS and the practice Remove perverse incentives 3

Pharmaceutical Needs Assessments (PNAs) These are very important. Health and Wellbeing Boards are writing the new ones due in April 2018 You need to check yours Need to make sure your LMC is involved with them. Your dispensing might be at risk! Used to cut pharmacy contracts 4

Dispensing fee 2017 Still on the same formulae No inflationary uplift Staff numbers defined Pay cap removed Fall in October Should increase in April 5

EPS It is continuing to be rolled out Pharmacies will be signing up patients Dispensing module for practice systems is being developed Cost is an issue DDA working with NHS Digital/NHS England. Looking to pilot EPS4 6

EPS Workload, should decrease if properly implemented, but if not will increase Risk re loss of scripts

FMD To be implemented by 2019 Plans as yet vague Could have large workload implicactions

Pharmacy Contract Cut in dispensing fee DH appears to want less contracts but more pharmacists Move towards clinical services and away from dispensing ? Changes to reimbursements Threats and opportunities

Working with pharmacy Workload, the need to help with GP workload not create it Need to make sure resources are made available so general practice is not destabilised Clinically safe Will be work for us from secondary care Clinical pharmacists

Shortages Ongoing No solution Prices very fluid this month Keppra/ Levetiracetam Cat M price £2.76 buying price about £27.50 11

Rural practice Challenging times GP shortage Workload increase Solutions urban centric Poor IT Less cross subsidy from dispensing as profits falling Wales LHB 33% more expensive Suffolk GMS contract plus 50%

Challenges Smaller practices due to Geography Branch surgeries to support

Securing the future Need NHS and politicians to understand Look after what you have New systems will be more expensive Once lost very difficult to replace Dispensing is a key to survival Need rural as well as urban solutions

“Promoting the interests of Dispensing Doctors and the excellence of doctor dispensing for the benefit of patients” 15