1. psnc.org.uk/campaign #lovemypharmacy campaign@psnc.org.uk Community Pharmacy in 2016/17 and beyond The Community Pharmacy Review 2016/17

2. psnc.org.uk/campaign #lovemypharmacy campaign@psnc.org.uk Overview What DH and NHS England have proposed PSNC’s response PSNC’s service development proposals The ongoing negotiations

3. psnc.org.uk/campaign #lovemypharmacy campaign@psnc.org.uk Context The NHS has a massive financial crisis – hospital trusts overspent – GP recruitment and retention crisis – wage pressures and workforce unrest (e.g. junior doctors) Demands on the service and resource are seen as unmanageable Need to save £22bn per annum by 2020

4. psnc.org.uk/campaign #lovemypharmacy campaign@psnc.org.uk Timeline 17th December 2015 – open letter to PSNC 27th January 2016 – DH publish slide pack and foreword from Keith Ridge Response requested to first phase of consultation by 12th February 2016 Further stakeholder meetings in March 2016 Consultation period closes 24th May 2016 Implementation of proposed changes in October 2016

5. psnc.org.uk/campaign #lovemypharmacy campaign@psnc.org.uk 17th December 2015 letter Open letter to PSNC Announces funding for community pharmacy in 2016/17 will be cut by £170m (from £2.8bn to no higher than £2.63bn) A reduction of more than 6% in cash terms Planned to take effect from October 2016 The decision to publish the letter is unprecedented

6. psnc.org.uk/campaign #lovemypharmacy campaign@psnc.org.uk Greater efficiency Government believes efficiencies can be made within community pharmacy without comprising the quality of services or public access – more pharmacies than are necessary to maintain good access – 40% of pharmacies are in a cluster where there are three or more pharmacies within 10 mins walk – large-scale automated dispensing provide opportunities for efficiencies

7. psnc.org.uk/campaign #lovemypharmacy campaign@psnc.org.uk Funding changes Simplify the remuneration payment system – the Establishment payment received by pharmacies dispensing 2,500 or more prescriptions a month incentivises pharmacy business to open more NHS funded pharmacies – propose the Establishment payment is phased out over a number of years

8. psnc.org.uk/campaign #lovemypharmacy campaign@psnc.org.uk Pharmacy Access Scheme (PhAS) Aim to maintain patient and public access to pharmacies Propose introduction of a Pharmacy Access Scheme – would provide more NHS funds to certain pharmacies – considering factors such as location and the health needs of the local population – a ‘robust and sophisticated national formula’ to be used to identify pharmacies that are the most geographically important for patient access

9. psnc.org.uk/campaign #lovemypharmacy campaign@psnc.org.uk Modern services Online journey for patients ‘slow and awkward’ Patients should be offered more choice about how they access their medicines and advice – ensure patients are offered the choice of home delivery or collection when ordering their prescription – introduce a new terms of service for distance-selling pharmacies and differentiated payment

10. psnc.org.uk/campaign #lovemypharmacy campaign@psnc.org.uk Period of treatment Encourage the optimisation of prescription duration – balancing clinical need – patient safety – avoidance of medicine waste – greater convenience for patients 28 days to 90 days supply…

11. psnc.org.uk/campaign #lovemypharmacy campaign@psnc.org.uk Hub and spoke dispensing Consultation on change to the Human Medicines Regulations 2012 to allow all pharmacies access to ‘hub and spoke’ dispensing Legislative change by October 2016

12. psnc.org.uk/campaign #lovemypharmacy campaign@psnc.org.uk Pharmacy at the heart of the NHS There is real potential for far greater use of community pharmacy and pharmacists: – in prevention of ill health – support for healthy living – support for self-care for minor ailments and long term conditions – medication reviews in care homes – as part of more integrated local care models Aim - a clinically focussed community pharmacy service that is better integrated with primary care

13. psnc.org.uk/campaign #lovemypharmacy campaign@psnc.org.uk Pharmacy Integration Fund (PhIF) To help transform how pharmacists and community pharmacy will operate in the NHS £20m in 2016/17, increasing to £100m by 2020/21 Year one proposal - focused on key enablers to achieve integration of community pharmacy – supporting the deployment of clinical pharmacists in a range of primary care settings, including GP practices, multi-speciality community providers, urgent care hubs, care homes and NHS 111

14. psnc.org.uk/campaign #lovemypharmacy campaign@psnc.org.uk PSNC’s initial response The proposals will deliver a destructive blow to the support community pharmacies can offer to patients and the public The letter lacks detail in critical areas Fear that DH was aiming for a larger funding cut in 2017/18 alongside – reductions in pharmacy numbers – a drive towards a commoditised supply service Proposals entirely silent on how a clinically focussed community pharmacy service would be achieved

15. psnc.org.uk/campaign #lovemypharmacy campaign@psnc.org.uk Points made in discussions with DH The £170m funding reduction – committed to protecting a strong, diverse and accessible service – reject any proposals that would reduce the support pharmacies offer their patients Pharmacy closures – do not accept that there are too many community pharmacies – agree that there is some clustering of pharmacies and will work with the NHS and Government to facilitate voluntary mergers – reject proposals to use blunt instruments based on volume as a crude measure of the care provided by pharmacies

16. psnc.org.uk/campaign #lovemypharmacy campaign@psnc.org.uk Points made in discussions with DH Online pharmacy services and hub and spoke models – committed to the further adoption of online services – don’t accept the development of large warehouse supply operations – will not oppose amendment to legislation to support hub and spoke – would oppose models for hubs without community pharmacy spokes – any revised regulations must prevent misuse of collection point arrangements intended for rural locations

17. psnc.org.uk/campaign #lovemypharmacy campaign@psnc.org.uk Points made in discussions with DH Periods of treatment – will commit to developing changes to pharmacy funding delivery that will drive prescribing periods appropriate to patients’ clinical needs by repeat dispensing and clinical interventions – must have effective protection against GP direction of prescriptions

18. psnc.org.uk/campaign #lovemypharmacy campaign@psnc.org.uk PSNC’s proposed service developments PSNC’s proposals set out how the CPCF could develop in order to meet DH and NHS England’s stated aims They have been presented to DH and NHS England as outline proposals to prompt further discussions with PSNC Set out in three phases

19. psnc.org.uk/campaign #lovemypharmacy campaign@psnc.org.uk Negotiations ongoing… Negotiations with DH and NHS England are ongoing PSNC has submitted counter proposals which are being discussed More news on this when we are able to share it Working with Pharmacy Voice to develop a narrative on future community pharmacy services Contractors and pharmacy teams – keep up the hard work on the campaign!