Simon Dukes, CEO, PSNC

Simon Dukes says PSNC will not accept any offer from the Department of Health and Social Care that undervalues community pharmacy’s critical work.

Speaking at a virtually-held Pharmacy Business Conference on Nov 24, the chief executive of the Pharmaceutical Services Negotiating Committee told delegates that it’s simply not acceptable that community pharmacy should be “invisible or at best an afterthought to the powers that be”.

“Keep battling away,” he told community pharmacy teams, reassuring them that his negotiating team will be “fighting hard” to support the sector. “We will continue to stand our ground in negotiations and will not accept offers that simply undervalue the critical work that pharmacies are doing.”

Dukes urged community pharmacy owners to think about the “possible light at the end of the tunnel” and keep their focus on their “ambitions for the future”.

Science fiction

He said whilst the positive preliminary results of the first Covid-19 vaccinations were “undoubtedly good news” for everyone, the vaccine candidate from Pfizer “will have limited impact on our sector”.

“The logistics read like something from a science fiction film,” he said, referring to vaccine’s requirement of maintaining storage temperatures of approximately negative 70 degrees Celsius for up to 10 days.

“And there is simply no way that most pharmacies will be able to turn their retail areas into a vaccination clinic that sees 200 people per day everyday for five days and also allows them to stay safely socially-distancing.”

“Instead we must look to primary care networks. We must see how we can contribute to any local plans through them. We must do whatever we can to help. But crucially we must be ready to jump in with a proposal the moment that we have a vaccine that looks easier to manage.”

Without naming the Oxford-AstraZeneca vaccine candidate, he said community pharmacy would have a huge role to play in a national roll out of Covid-19 vaccines with less complex storage requirements and are simpler to administer.

He added that the sector could take heart from the success so far with this winter’s annual flu vaccination programme.

“We have evidence of the impact we can make from our fantastic flu season. At this point we have already vaccinated more people in community pharmacy than ever before, that’s 1.9 million people – a fantastic effort. We must use that to make our case.”

In the New Year, Covid-19 Testing II could be an area in which Dukes sees a potential key role for community pharmacies in the future, particularly if the prime minister’s vision for same day testing via ‘Test and Trace’ were to come to fruition.

“A pilot is already underway, and we must continue to position the sector to be able to do this. Our accessibility to the public is second to none,” he said.

Beyond pandemic

And what about our ambitions for the sector beyond the pandemic?

Dukes said that if he were to pick a positive from the legacy of this pandemic, it would be that “the days of competition within the health service were left behind us. We must play our part in trying to attain that vision.”

He said the vast majority of the new cohort of patients aged 50-64 could receive their flu vaccination in a community pharmacy and added that supply of additional shots from central government would soon start to flow more quickly.

“That’s not just an ambition about jabbing as many people as we can although clearly I’d urge all contractors to do that, but it is also about progressing our relationships with GPs, especially, and primary care networks, and trying to seek a truly collaborative approach to this and all vaccination programmes.

“As a sector we also have a lot to play for in the roll-out of new Contractual Framework services as set out in the five-year deal last summer. Yes, some of those have been delayed but the pandemic has not halted progress in time. It’s my hope that by this time next year we will be starting to see the results of that ambitious service development programme.

Expressing his hope that the GP referrals to Community Pharmacist Consultation Service would prove to be a success, he said the advanced service could lead the sector to a care pathway that’s well-walked by the patients. “Alongside that, we also want to see pharmacies paid for all the advice they give on a walk-in basis,” he stressed.

“The discharge medicine service will also roll out in 2021 and of course we want to see positive results from that. We may also get positive results from the other contractual framework service pilots that we agreed with possible national commissioning of a wider-range of clinical services.”

Regulatory dispensation 

“In every negotiation we have impressed upon officials the immense pressures facing the pharmacies we represent,” he said, before outlining a number of regulatory dispensations which PSNC has been seeking to give pharmacy teams the freedom to prioritise patient facing services and make it easier for contractors to maintain sufficient staffing levels.

A key dispensation sought relates to the Pharmacy Quality Scheme (PQS). PSNC is requesting that contractors are given more time to complete Part 2 PQS, but that this does not delay delivery of the associated funding.

“We know many contractors have already made good progress on meeting the quality criteria but those in areas of a higher Covid-19 prevalence have struggled. The valuable work associated with the scheme should still be completed in due course, as long as access to that vital funding is retained in the agreed timeframe.” the PSNC said in a statement on Nov 26.

Dukes announced at the conference that PSNC was asking for national announcements that would allow pharmacy teams to work behind closed doors when needed so they can focus exclusively on vaccinations for parts of the day. “The regional announcements on (pharmacy) opening hours are helpful but they are not enough,” Dukes said.

“We want regular testing of community pharmacy staff and we want national guidance to help tackle NHS Test and Trace issues.

“We want the Pharmacy Audit and the Community Pharmacy Patient Questionnaire waived. NHS England has said already its Clinical Audit will be waived this year, but this needs to be confirmed.

“And finally, we want contractors to be given the freedom to prioritise patient-facing services so they do not have to comply with for example routine data requests until further notice. And they have clarity on Christmas and New Year pharmacy provision as a matter of urgency.”

Grand scale penny pinching

Giving an update to contractors, Dukes said that although funding negotiations we still ongoing, his negotiating team will not accept an offer from the DH that was any less than full reimbursement for pharmacies of all their Covid-related costs.

“At a national level decision making remains very slow. We see penny-pinching on a grand scale and officials are simply not doing enough to support the sector on which they and the network of GPs rely on day in day out.

“Don’t just take my word for it,” he said, before reading out excerpts from an open letter to community pharmacy that Jo Churchill, the parliamentary undersecretary of state for health, had sent out, praising the sector for it’s effort during the pandemic.

“The DH and NHS England must understand that when we say pharmacies are falling over, we mean just that,” Dukes added.

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