Community Pharmacy in 2016-17 and Beyond — House of Lords, 2016-10-20
Topic: Health
Caroline Chisholm (Conservative, Centre-right): My Lords, with permission, I will repeat a Statement made by my honourable friend the Parliamentary Under-Secretary of State in the other place on community pharmacy in 2016-17 and beyond. The Statement is as follows: "In December 2015 the Government set out a range of proposals for reforming the sector. Our intent was to promote movement towards a clinically focused community pharmacy service that is better integrated with primary care and makes better use of pharmacists’ skills. I now wish to update the House on the outcome of this consultation and the measures we intend to take forward Let me be clear at the outset. The Government fully appreciate the value of the community pharmacy sector. There are now over 11,500 pharmacies, up by over 18% over the last decade. Indeed, the overall pharmacy spend has increased by 40% over the last decade and now stands at £2.8 billion per annum. However, we do not believe that the current funding system does enough to promote either efficiency or quality; nor does it promote the integration with the rest of the NHS that we, and pharmacists themselves, would like to see The average pharmacy receives nearly £1 million per annum for the NHS goods and services it provides, of which around £220,000 is direct income. This income includes a fixed-sum payment—called the establishment fee—of £25,000 per annum for most pharmacies, regardless of size or quality. This is an inefficient allocation of NHS funds when 40% of pharmacies are now in clusters of three or more, which means that two-fifths are within 10 minutes’ walk of two or more other pharmacies. Instances exist of clusters of up to 15 pharmacies within 10 minutes’ walk At a time when the overall NHS budget is under pressure and we need to make £22 billion in efficiency savings, it is right that we examine all areas of spend and look for improvements. The measures we are bringing forward today have at their heart our desire to be more efficient and spend precious NHS resources properly. Community pharmacy must play its part as the NHS rises to this challenge I am today announcing a two-year funding settlement. In summary, contractors providing NHS pharmaceutical services under the community pharmacy framework will receive £2.687 billion funding in 2016-17 and £2.592 billion in 2017-18. This represents a 4% reduction in 2016-17 and a further 3.4% in 2017-18. Every penny saved by this reset will be reinvested and reallocated back into our NHS to ensure the very best patient care. Furthermore, separately commissioned services by NHS England, clinical commissioning groups and local authorities will not be affected by this change. I want this commissioning of services to continue to grow From December 1 2016, we will also simplify the outdated payments structure and introduce payment for quality so that, for the first time, we will be paying pharmacies for the service they provide, not just the volume of prescriptions they dispense. We will also relieve pressure on other parts of the NHS by properly embedding pharmacy in the urgent care pathway As we continue the path of reform, we will be informed both by the review of community pharmacy services being carried out by Richard Murray of the King’s Fund and stakeholders such as the Royal Pharmaceutical Society. NHS England is investing £42 million in a pharmacy integration fund for 2016-17 and 2017-18. This will facilitate the faster movement of the sector into value-added services As an example, last week, I announced two additional initiatives to improve our offer to patients. First, those who need urgent repeat medicines will be referred by NHS 111 directly to pharmacies, not out-of-hours GPs, as at present. Secondly, NHS England will encourage national roll-out of minor ailment schemes already commissioned by some CCGs. This is expected to be complete by April 2018 We are confident that these measures can be made without jeopardising the quality of services. In fact, we believe that the changes will improve them. To safeguard patient access, we will be introducing a pharmacy access scheme in areas with fewer pharmacies and higher health needs. We are today publishing the list of pharmacies which will be eligible for funding from this scheme. Copies are available on gov.uk and from the Vote Office. This list includes all pharmacies which are more than one mile from another pharmacy. These pharmacies will be protected from the full impact of the reductions In addition, we will have a review process to deal with any unforeseen circumstances affecting access, such as a road closure. We will also review cases where there may be a high level of deprivation but where pharmacies are less than a mile from another pharmacy, if that pharmacy is critical for access. This will cover pharmacies that are located in the 20% most deprived areas in England, are located 0.8 miles or more from another pharmacy and are critical for access. Additional funding over and above the base settlement will be made available as needed We have already announced NHS England’s proposal significantly to increase the number of pharmacists working directly in general practice, with a budget of £112 million to deliver a further 1,500 pharmacists in general practices by 2020 Colleagues will be aware that the Government consulted the Pharmaceutical Services Negotiating Committee and other stakeholders, including patient and public groups. I am grateful for the responses received, which reinforced the value of community pharmacy and confirmed its front-line role at the heart of the NHS. The consultation also confirmed that there is potential for the sector to add even more value. However, we are disappointed by the final response from the PSNC. We endeavoured to collaborate and listened to its many suggestions over many months. Sadly, we were unable to reach agreement. Its role is, in the end, to represent the business interests of its members, and I respect that. My role is to do the right thing for the taxpayer, the patient and the NHS. I close by setting out my firm belief that the future for community pharmacy is bright. These vital reforms will protect access for patients, properly reward the quality of services delivered by pharmacists for the first time, and far better integrate care with GP and other services. That is what the NHS needs, what patients expect and, I believe, what the vast majority of community pharmacists are keen to deliver. I commend this Statement to the House".