1. Simon Dukes Pharmaceutical Services Negotiating Committee
The Future of Community Pharmacy: How pharmacies fit into the NHS Long Term Plan
Simon Dukes
Pharmaceutical Services Negotiating Committee

2. The Future of Community Pharmacy
Pharmacies in England
A five-year deal for pharmacy
New services: CPCS and Hepatitis C
Supporting our NHS colleagues
Working within Primary Care Networks

3. Community Pharmacy: Key statistics
11,600 pharmacies in England
- Independents (1-5 pharmacies) 38%
- Multiples (6+ pharmacies) 62%
89% of the population can reach their local community pharmacy within a 20 minute walk
An estimated 1.6 million visits to pharmacies take place daily

4. Community Pharmacy: Key statistics
Over 90% of pharmacies now have a private consultation room
Community pharmacies are accessed by people who may not access other NHS services, helping to reduce health inequalities
NHS income for a typical community pharmacy accounts for 85% of their total turnover

5. The five-year CPCF agreement
PSNC negotiates with DHSC and NHS E&I
Deal fixes funding at £2.592bn per year from 2019/20 through to 2023/24
Sets out the expansion of clinical service delivery through pharmacies, in line with the aims of the NHS Long Term Plan

6. Ambitions of the five-year agreement
Pharmacies will adapt to provide new services
The settlement will:
“Expand and transform the role of community pharmacies and embed them as the first port of call for minor illness and health advice in England.”
Matt Hancock, Secretary of State

7. Negotiations: Political Context
This was not the deal pharmacy wanted
We argued for further investment
Highlighted rising costs, threats to viability and the impact of cost-saving tactics
The deal secures future funding for as long as possible from Treasury, who are seeking efficiencies in dispensing
We believe it was the best deal available
This was not the deal that PSNC wanted – we pushed hard for further investment in the sector.
But we were unable to extract more money from Treasury, who see us as an expensive way for them to get medicines to patients.
We outlined how rising costs were already threatening the viability of many community pharmacies warning that cost-saving tactics would reduce capacity to deliver the new services.
The Government is not interested in covering pharmacy contractors’ costs; it wants to commission cost-effective services, including a significantly more efficient dispensing service.
We believe Government no longer wants to pay for 11,600 community pharmacies: they believe there are too many pharmacies not utilising technology to the full.

8. What does this mean for pharmacies?
The deal guarantees a future for those pharmacies who are up for change
Specific challenges will be around:
dispensing efficiencies 
freeing up pharmacists’ time
wider use of clinical workforce
branch viability and consolidations
coming together locally in PCNs
working closer with GPs
The deal guarantees the sector a future – not one that will be easy to attain, but one that does present opportunities for those who are willing to engage with it and to change.
What that change might look like is something that all businesses will need to think about.
It will mean looking at the dispensing process and seeing how this can be made more efficient to free up pharmacists’ time to focus on clinical services.
For large businesses it will mean some difficult decisions about the viability of some branches.
For independent contractors, particularly those in clusters of pharmacies, it will mean some incredibly difficult conversations with other local pharmacy businesses to work through how you can deliver what the Government wants either working in partnership, or even through consolidating your businesses.
For everyone it will mean looking at your businesses and stopping doing the things you are not paid for.
And no matter the size of your business, it will mean coming together with other pharmacy businesses locally to ensure that you are all a part of the emerging PCNs.

9. Two new national services in 2019/20
The Community Pharmacist Consultation Service (CPCS)
Hepatitis C testing service
Capacity being released through the decommissioning of MURs (replaced by structured clinical medication reviews)
Hepatitis C testing will be available to people using pharmacy needle and syringe programmes.
This service supports the Government’s new national Hepatitis C elimination programme

10. Supporting NHS Colleagues: The Community Pharmacist Consultation Service (CPCS)
Helping people with minor illnesses and those needing urgent supplies of medicine
Pharmacist will provide healthcare advice or assess whether an emergency supply of medicine is appropriate
Onward referrals will be made if needed
GPs to be notified electronically

11. Supporting NHS Colleagues: The CPCS
Referrals initially to come from NHS 111
Pilots to test expansion with referrals from
GP practices (reception teams)
Increasing patient awareness of pharmacy as the ‘first port of call’ for minor illness
Reducing pressure on practices and urgent care providers
Supporting patients to self-manage their health

12. Driving pharmacy clinical service development
Through the five-year deal, a range of pharmacy services will be piloted
If successful, these may be commissioned nationally in future years
The Pharmacy Integration Fund and the PCN Testbed programme are NHS development initiatives that will be used to provide the necessary funding for pilots

13. Reimbursement Changes and Consultation
PSNC, BMA and DDA worked on shared principles
Our response is principle-based:
- Base prices on suppliers we purchase from
- Remove dispensing at a loss
- Fair distribution of margin
- Certainty of reimbursement prior to dispensing
- Smooth transition to new systems
- Preventing any patient safety risks
Time to revisit generic substitution

14. Conclusions
Pharmacy’s new deal does much to integrate us with general practice
Supporting medicines safety, optimisation and prevention
CPCS: a new chance for us to help
Collaboration will be key – both at PCN and individual practice level

15. Contact Information
psnc.org.uk