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Opinion: Pharmacy contract still plagued by problems


Opinion: Pharmacy contract still plagued by problems

By Alexander Humphries

Community pharmacy in England urgently needs an injection of fresh thinking and new ideas from its leadership because the current approach is getting us precisely nowhere...

The announcement regarding the arrangements for year three of the Community Pharmacy Contractual Framework in England was bitterly disappointing.

I thought the annual review mechanism was meant as a safety valve to protect against exactly the sort of exceptional circumstances we have faced during the last 18 months. Yet not an extra bean could be found to support pharmacies, who have been incredibly dedicated and resilient in the face of such adversity that it has cost the lives of some members of the community pharmacy family.

While the rest of the NHS gets enraged by admittedly tiny pay uplifts from the Government, pharmacy contractors in England have suffered a further real terms pay cut. If the DHSC was ever going to agree a funding increase for pharmacy, surely now was the time. Since this hasn’t happened, I have to conclude that the review mechanism isn’t worth the paper it is written on.

We now face the stark certainty that in 24 months the situation will undoubtedly be worse as there will be no extra funding. So this is either a breach of good faith (as the other side clearly had no intention of reviewing funding) or PSNC’s interpretation was jarringly out of alignment with that of the Government. A problem either way.

Moreover, the way in which the Treasury has flatly refused to consider any increase in baseline funding leaves me with huge concern over the outcome of the sector’s Covid costs claim.

While PSNC has received assurances that this will get the ‘light touch’ approach, I can see big problems over the next 12 months. I fully expect a retrospective cap on claims to be introduced and for every claim to get stripped back to the bone by a ‘computer says no’ attitude, which will probably see contractors massively out of pocket. I sincerely hope I am wrong.

If there is a large disparity between what is claimed and what is actually paid, contractors will ask some serious questions about the whole negotiation process, and whether PSNC can even continue to negotiate in good faith with its current interlocutors.

We all welcome at face value the expansion of the NMS, the new smoking cessation service and even hypertension case finding. However, depression has yet again been left out of the NMS despite a clear and important need to improve adherence in that particular group And while the smoking cessation service sounds great, the detail reveals it to be a push model – meaning that patients can only access it if they have been referred by their hospital at discharge. And who’s really got time to find customers with high blood pressure as we gear up for the busiest winter season ever?

We’ve been here before with CPCS, for which I am receiving more referrals than ever. Sadly they have all been informal referrals from practices too busy to see patients, let alone make referrals.

No further forward

I welcomed the five-year deal at the time because it gave us the opportunity to plan for the future and explore innovations that might help to free capacity to deliver more services. Yet here we are more than half-way through the cycle and seemingly no further forward.

Inflation is biting, pharmacists are becoming increasingly difficult to recruit and retain, the multiples are temporarily shutting branches with mounting regularity – and we’ve had a once-in-a- generation public health disaster that has failed to garner any recognition for the sector’s exemplary response beyond the usual warm words.

Let me turn this around. We cannot rely on the same old faces that got us into this mess to get us out of it – so what are you going to do about it?

*Alexander Humphries is the pen name of a practising community pharmacist. The views in this article are not necessarily those of Pharmacy Magazine. Would you ever consider assuming a pharmacy leadership role? Email

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