In July this year, besieged by controversy, Boris Johnson took up the reigns with the monumental task of reaching a consensus that his predecessor could not in a Parliament that was fundamentally divided on Brexit. Two months on, and (at the time of writing) a prorogued Parliament and we’re perilously close to the 31 October deadline. The outlook could not be bleaker as the nation begins to plan for what seemed to be the unimaginable – a no-deal exit.
July was not only a big month for politics but also for pharmacy with the publication of the new Community Pharmacy Contractual Framework (CPCF); despite Simon Dukes and his PSNC teams’ best efforts, the funding agreement remains flat for the next five years.
The real challenge is that community pharmacy’s cost base is rising; inflation, wage increases, locum rates to name but a few. Therefore, in real terms, flat funding of £13bn over the next five years represents a reduction in funding each year.
We are sympathetic to the frustrations contractors will experience as a result of the new contractual framework. That said, we strongly believe that there are significant opportunities for community pharmacy to be famous for improving the health outcomes of patients within their local communities. Whilst the funding model is moving away from a dispensing and supply role to a service-driven model, for me, it is important that we are optimistic and embrace the service-driven agenda to maximise income opportunities wherever possible.
We are being asked to do more for less, however, there are some key considerations that will allow us to free up time as part of the dispensing process and utilise our pharmacy team more effectively to delivery against the new CPFC.
This month we see the introduction of a new NHS Community Pharmacist Consultation Service (CPCS) as an advanced service. A sum of £4million has been allocated for delivery of this service and contractors can expect to receive £14 per consultation. We strongly support this service as it better meets the skills of community pharmacists and firmly places pharmacy at the hub of managing minor ailments and urgent medication supply.
In turn, the service will relieve pressure from other healthcare providers. It also supports the push for community pharmacy to be the first choice for patients with acute or chronic health conditions, only escalating to local GP practices should it be necessary.
It will become increasingly important to begin to consider how community pharmacists will transition and meet costs associated with the integration into Primary Care Networks. Whilst funding will be made available within the next 18 months or so, it remains unclear as to the specific role pharmacy teams will play.
However, what is abundantly clear is the need to be at the party when the transition takes place. Primary Care Networks are here to stay and as MURs are gradually phased out, clinical pharmacists will have an integral role within these PCNs. Collaboration is key. It will be important to start developing relationships with other healthcare professionals within local communities.
For many Numark members, the freeze in funding over the next five years has done little to boost morale. In fact, that could somewhat be viewed as an understatement. However, what is important is for community pharmacy to take a step back and look at how they are now being remunerated and proportionately invest time in areas where funding opportunities exist. This may be delivering advanced services such as the CPCS or maximising opportunities through private services such as travel or flu vaccination, clinical aesthetics, care homes or any number of services via the private PGD route.
The penny increase on the single activity fee speaks volumes about what the Government considers important investment both in time and resource. It wants us to use technology to drive efficiencies in the dispensing process to help free time to support patient health first and foremost.
We also can’t ignore the rise of digital integration, however challenging the change may be. Patients increasingly have an expectation of digital capability and are more in control of their health using apps and smartphones than ever before. We must harness the power of digital to further engage our customers and patients in the community pharmacy setting. Whether that’s having a website, an online repeat prescription service through an app or in-store digital health screening that interfaces with a patient’s health metrics. Sounds like science fiction but very soon customer expectations are going to put pressure on community pharmacy to go digital by default.
Jeremy Meader is Managing Director of Numark.
This article also appears in the October issue of Pharmacy Business.