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

2. 2 Challenges and Opportunities in the New Dispensing Enviroment New models of care New models of care Federations Federations Super practices Super practices Medicines optimization Medicines optimization Pharmacists in General Practice Pharmacists in General Practice Strengths Strengths Weakness Weakness Reimbursement Reimbursement Dispensing Fee Dispensing Fee

3. New models of Care Five year forward plan Traditional General Practice Vertical integration Horizontal integration 3

4. Working at scale Why? 30000 patients Seven day working Cost savings Skill mix 4

5. Cost savings? Less building costs Less money spent on staff including GPs Less paperwork for NHS, contracts and CQC visits etc Does it work in rural areas 5

6. Federations West Suffolk Nothing happened CCG coping Practice income falling East Suffolk New services for practices 7 day working All having similar processes Removal of variation CCG in special measures Practice income falling Looking at a super practice 6

7. Super practices One list Merger Increased skill mix Sharing functions Board to give direction More power with CCG Seven day working New Contract ?? 7

8. Rural perspective Same income for all partners so less for some more for others Danger of losing dispensing list Headquarters to pay for need to make savings Close premises Pay all staff less including partners Easier for NHS to control Goodwill? 8

9. Medicines Optimisation Discussing with DH Better care not about savings Along the lines of NMS in pharmacy 9

10. Pharmacists in General Practice Dispensing practices well placed Take work off GPs Part of the skill mix Think about the development of practice nurses No on going money 10

11. Strengths Integration of GMS and pharmacy services Skills in the dispensary Well run CQC says better than average 11

12. Weakness Small Need dispensing income to survive Not understood Large distances between practices 12

13. Questions What do rural areas do about the new models of care? Can practices work together without loosing their own contract? Do you merge? 13

14. 14 Reimbursement Unfinished business Election should not hinder progress! Discussions with NHS England, including GPC & Department of Health Any agreement unlikely to be implemented before 2016. 14

15. 15 Dispensing fee 2015 Decrease in fee last October was unexpected Small increase in April.

16. 16 Cat M Price Rise Price rose last October Price rose last October Dispensing reimbursement linked to Cat M Dispensing reimbursement linked to Cat M But no discussions with DDA or GPC But no discussions with DDA or GPC Little understanding of issues within NHS England Little understanding of issues within NHS England

17. 17 “Promoting the interests of Dispensing Doctors and the excellence of doctor dispensing for the benefit of patients”