Community pharmacy reforms

Latest updates (October 2016)

Launch of a Pharmacy Urgent Care pilot programme

Community Health and Care Minister David Mowat has announced the launch of a Pharmacy Urgent Care pilot programme which is due to start in December 2016.

The move means that patients who contact NHS 111 for their urgent repeat medicines will be directed straight to community pharmacies instead of out of hours GP surgeries.

The minister also announced a new approach for referring patients with urgent minor ailments to community pharmacy to ensure people can get high-quality, timely care. NHS 111 will develop a new approach to allow them to refer patients with urgent minor ailments, such as earaches, sore throats and bites, to community pharmacy for advice and medication from skilled professionals. This scheme will be rolled out across England between December 2016 and April 2018.

What does the RPS think about these proposals?

The intention for the implementation of a new national NHS Urgent Care emergency medicines supply scheme through pharmacy is good news for patients. However, the existing locally commissioned NHS emergency medicines supply service is already tried and tested, with fantastic results that have both improved patient care and freed up time for GPs. There is absolutely no need for further piloting of a service that is badly needed as we head towards winter. NHS Emergency supply service needs to be implemented across England without further delay.We also need assurance that the Government is serious about a national NHS funded minor ailments scheme through pharmacy. Any NHS minor ailments scheme needs to be true to the founding principles of the NHS and be free at the point of use. Patients and the public need a fully integrated NHS service, which enables them to access NHS care for minor ailments from their local pharmacy, only then will we see people change behaviour, and pressure be taken off GP out of hours and A&E.

PSNC rejection of DH funding proposals

PSNC has rejected the Department of Health’s (DH) proposed funding package for 2016/17. The proposed package includes substantial cuts to pharmacy funding.

This will reduce funding from December 2016 to March 2017 by 12% on current levels, to £2.687bn and reduce funding for 2017-18 by 7.4% on current levels, to setting funding at £2.592bn for that year.

This is £113m less than expected from December 2016 to March 2017 and £208m less the following year.

What does RPS think about the funding proposals?

We are deeply disappointed that the Government has not changed its approach to funding cuts this year and alarmed that further cuts have been announced for next financial year. “Funding cuts will not improve the quality of care for patients delivered through community pharmacy. Pharmacists will not be reassured by this two-year deal which guarantees less resource for front line care. We fear for patients, the public and pharmacists who may be significantly affected by changes in opening hours and staffing levels in community pharmacy, as well as the knock on impact on already pressured GP and A&E NHS care.

What happens next?

Following the October announcements the Department of Health may propose a revised package, or may impose their proposed funding changes on England’s community pharmacies without further negotiation. The Department of Health has previously stated these changes must come into effect by 1st Dec 2016.

Are any other changes being proposed?

Yes the Department of Health have proposed other changes to the community pharmacy framework including  A Pharmacy Access Scheme This scheme is designed to protect patient access to pharmacies that may otherwise not be viable under the new funding proposals.

What does the RPS think of the pharmacy access scheme?

How the Pharmacy Access Fund, which the Government says should guard against reduced public access to pharmacy and increased health inequalities, will operate, is still unknown. We need certainty around which pharmacies will receive support from the Pharmacy Access Fund before the scheme is implemented.

What has happened to the Pharmacy Integration fund?

In December 2015 the Department said it would introduce a new Pharmacy Integration Fund (PhIF) to help transform how pharmacists, their teams and community pharmacy will operate in the NHS and that the proposal for year one of the PhIF will be to focus particularly on the key enablers to achieve integration of community pharmacy’. The fund, was expected to be worth £20m in 2016 rising to a total of £300m by 2020-21, and was intended to help pharmacists and their teams to be fully incorporated across NHS planning and service delivery. There is no mention of the pharmacy integration fund in either the October 2016 PSNC letter or DH announcement.

What is the RPS view on the pharmacy integration fund?

 The lack of news on the promised Pharmacy Integration Fund defies logic at a time when greater integration of primary care services to improve patient care is such a priority for the NHS.  We call on the Government to make good on its promise made in the original letter of December 2015 “to bring pharmacy even closer into the wider primary care and community health system”, so we can see improved patient care through better use of pharmacists in care homes and urgent and emergency in the years to come.

More changes around phasing out of the establishment fee and introducing a “single activity payment” for dispensing alongside change to the drug tariff have also been proposed. You can find more detail about these changes in the letter from the PSNC to the Department of Health.


Changes to community pharmacy in 2016/2017 and beyond

In a letter to the Pharmaceutical Services Negotiating Committee (PSNC) in December 2015, the Department of Health and NHS England announced there would be a 6% reduction in funding through the community pharmacy contractual framework.

We recognise that this reduction in funding will have a substantial impact on pharmacy business owners, their employees and locums. This is a worrying time for many of our members, who are concerned about what these reforms might mean for their future and that of their profession.

We believe it is our role as your professional body to ensure that as many pharmacists as possible are able to make the transition from the current arrangements to a future that will put pharmacists at the heart of patient care.

We will be working hard to influence the consultation process ahead. We are setting our aims high to improve patient care through better access to high quality care, advice and access to medicines through pharmacy, and creating additional jobs for pharmacists in the NHS.

Hear from English Pharmacy Board Chair, Sandra Gidley, discussing the community pharmacy reforms, our response and next steps in this short video:

You might also be interested in our Giving pharmacists a voice: Community pharmacy reforms webinar.


What is meant by community pharmacy reforms?

The NHS has been tasked with finding £22 billion of efficiency savings by 2020/21.

On the 17 December 2015, it was announced that funding to community pharmacy would be cut by at least 6%, equating to £170 million; lowering the funding available through the community pharmacy contractual framework from £2.8 billion to £2.63 billion. It is anticipated these changes will take effect in October 2016.

Alongside the cut in funding, the letter, from Will Cavendish (Director General, Innovation, Growth and Technology, DH) and Keith Ridge (Chief Pharmaceutical Officer for England), mentions further changes that the Government would like to see, including:

  • To better integrate pharmacy into the wider primary care and community health system – such as closer working with GP surgeries, care homes and urgent and emergency care departments - so that patients can benefit from pharmacists’ clinical skills through a "Pharmacy Integration Fund".
  • A "Pharmacy Access Fund", which would provide more NHS funds to certain pharmacies compared to others, considering factors such as location and the health needs of the local population.
  • The potential for automation and centralising dispensing to provide efficiencies. Also, in some areas, the distribution and number of pharmacies does not match local patients' needs.
  • The view of the Government that patients would like to order prescriptions online and that “click and collect” and delivery options would be easier to arrange.

You can find the letter, a slide set explaining the proposals along with a foreword by Keith Ridge, and other documents relating to the reforms, on the Department of Health's Putting community pharmacy at the heart of the NHS page.

In April 2016, the Department of Health shared their current thoughts around the Pharmacy Integration Fund, Pharmacy Access Scheme, modernisation and of pharmacy and quality services in a set of slides
They also shared some background papers which have helped to inform the discussions they are having.

Find out more about the community pharmacy reforms, what the impact could be, and the work we are doing in response in our podcast:


What is the RPS doing?

Our position and responses Our position and responses

The RPS English Board believes that any cut to community pharmacy, and primary care generally, is short sighted if the Government is committed to its stated aim of investing in primary care and prevention of ill health.

It is important to note that the Government has indicated that there will be investment in a "Pharmacy Integration Fund" to help transform how pharmacists and community pharmacy will operate in the NHS and a "Pharmacy Access Fund" to ensure local communities, especially rural and deprived areas, have good access to community pharmacy. We welcome both of these initiatives and will be playing our part in ensuring both are adequately funded and effectively implemented.

All of us in pharmacy, through the forthcoming consultation on changes to the community pharmacy contractual framework, have an opportunity to shape our own future. We will be working with you to make sure we maximise the role of pharmacy in the changing world of primary care.

As one of the organisations that will be formally consulted on the changes, we will provide pharmacists with a voice to inform and influence the consultation and to advocate on their behalf to ensure that there are more roles for pharmacists. We will be working collaboratively with all pharmacy trade bodies and unions to ensure a united and strong voice.

Sandra Gidley, RPS England Board Chair has given the Board’s reaction to the announcement and set out our initial response.

On Friday 12 February, we submitted our initial response on the Community pharmacy in 2016/17 consultation to the Department of Health.

We have also submitted additonal commentary on the Pharmacy Integration Fund (PhIF), detailing how we would like to see it used, and what it should not be used for.

We submitted our final response to the Community pharmacy in 2016/17 consultation, on Tuesday 24 March 2016.

Our role Our role

The RPS has been formally recognised by Government as an organisation that will be consulted on these reforms. We will also work to support you through this turbulent time, and help you adapt to the changes to community pharmacy in 2016 and beyond.

The RPS will continue to campaign for a greater number of roles for pharmacists, including pharmacists in care homes, pharmacists in GP surgeries and urgent care settings, as part of our work on the Shaping Pharmacy for the Future project.

Our campaigns

We have been pleased to see funding for NHS England’s clinical pharmacists in general practice pilot scheme double to £31 million, resulting in the creation of 403 clinical pharmacist roles.

We also recently launched our vision for the pharmacy workforce in Great Britain. This document sets out a direction of travel for the workforce over the coming years that we believe puts patients at the centre of all that we do; promoting proactive, compassionate pharmaceutical care and encouraging professionals, services and organisations to work together.

The RPS is a member of National Voices, the leading coalition of health and social care charities. Through National Voices we will listen to patients and the public to ensure our position, role and response to this change takes their views into account.

Our work Our work

Updates from the English Pharmacy Board Chair, Sandra Gidley

In the media

English Pharmacy Board Chair, Sandra Gidley, has been speaking to the media to raise awareness of the potential impact of these cuts, and to give the view of the Royal Pharmaceutical Society.


What can I do, and how can the RPS help me?

Understand changes to the NHS Understand changes to the NHS

Wider changes are currently taking place across the NHS, driving initiatives like the community pharmacy reforms. We're putting together a number of easy-to-understand guides to some of these changes, and how they'll affect you as a pharmacist.

Get involved Get involved

We’ll be updating this community reforms webpage with information and resources as soon as we have them so be sure to check back regularly.

You can email us to share your thoughts and comments about the reforms with the English Pharmacy Board.

Members working in the community pharmacy sector in England will also receive emails from EPB Board Chair, Sandra Gidley to keep them up-to-date with any developments. Update your sector details and communication preferences in My Profile to ensure you receive these communications. 

Additionally, The Pharmaceutical Journal will help you keep well-informed of any developments with news and opinion pieces in their dedicated Cuts to community pharmacy funding in England section.

Make sure your skills & professional development are the best they can be Make sure your skills & professional development are the best they can be

Membership of the RPS

Your Society membership gives you access to professional development and guidance to support your practice and patients, including many of the tools and resources listed below. 

We are here to support you with your professional development at every stage of your career, so that you can practise safely and confidently, and are ready to adapt to the ever evolving landscape of healthcare and pharmacy, including how to prepare professionally for the reforms to the community contract. Our professional recognition programme and professional development tools will support you to demonstrate your knowledge, skills and current competence as well as helping you to identity areas for further development.

Being a member, and use of the Society post-nominals also demonstrates your commitment to your profession to other healthcare professionals and your patients. Find out more about membership.


Faculty and Foundation

Make sure you’re using our Faculty and Foundation programmes. You can use your Faculty or Foundation portfolio to identify your current achievements and development needs, build your professional networks, and as a Faculty member you demonstrate to all healthcare colleagues your professional experience and expertise. Access to these resources and guidance will ensure you’re in the best place to make the most of your career opportunities. 

Building your Advanced Practice Portfolio and peer review will enable you to reflect on your practice and support your ongoing professional development in order to benefit your practice whether in a patient facing or wider pharmacy role. While the Foundation Programme will enable you to gain knowledge, skills and behaviours essential across all sectors and settings, so that you are better equipped to adapt and deliver safe and effective pharmaceutical care.


Ultimate guides

The community pharmacy reforms letter highlighted that:“We [Department of Health] want pharmacists to bring their skills more to GP practices care homes and urgent care, using those opportunities to improve and protect people’s health, aligning with the emerging new models of care.” 

We have developed an number of hubs and ultimate guides for a variety of care settings; including care homes and GP surgeries. The ultimate guides contain details of the role, practical guidance, information on the legal and regulatory framework, managing and optimising medicines, professional guidance and clinical guidance and support tools. 

We are in the process of developing resources for pharmacists working in urgent and emergency care, which will include information about how community pharmacists can support urgent and emergency care. 


Professional support tools

Pharmacists deal with a variety of issues on a daily basis whether working in community, hospital or other pharmacy sectors. We produce a range of concise and user-friendly resources to support you in your day to day practice, including quick reference guides and standards. Members can refer to these tools to develop their skills and expertise.

Community Pharmacy Hub

Our online community pharmacist support hub is designed to provide easy access to our suite of resources, mapped over four themes, providing information to support day to day practice and to empower professional, confident pharmacy practice.

MEP

Medicines, Ethics and Practice is the professional guide for pharmacists. It has been designed as an underpinning document to help pharmacists practise confidently and professionally. It embeds professionalism and professional judgement at the heart of the decision-making process.

The advice contained in the MEP intends to support day-to-day practice, rather than simply highlighting pharmacists' statutory obligations. As such it will empower pharmacists, helping them to make the right decisions.

Support alerts

We develop and publish regular support alerts to help support you in your day to day roles. These will cover a wide range of subjects ranging from legal and ethical issues to clinical matters and aim to be informative, supportive and user-friendly.

To receive these alerts via email please subscribe by visiting My Preferences. We also publish Support Alerts on our website.


Independent prescribing

An independent prescribing qualification will be beneficial for pharmacists and their patients in a variety of settings and is also a way of further developing your skillset.

We have developed support for pharmacists interested in becoming prescribers. We are currently updating the NICE/National Prescribing Centre single competency framework for all prescribers to reflect the current evidence base, health and social care organisational structures, professional requirements and user needs.

We have a Pharmacist Prescribing Discussion Group, where you can network with other pharmacists and post your own discussion topics.


Events and webinars

We deliver events to help you develop your knowledge and to further your career. Keep an eye on our upcoming events for conferences and courses that will help you stay up to date with the latest developments, and advance your career potential. 

We also have a number of webinars to help keep you informed of the latest developments in the world of pharmacy and keep your skills up to date. You can watch these pre-recorded videos at a time to suit you.


Pharmaceutical Journal and Clinical Pharmacist

The Pharmaceutical Journal keeps you up to date with the latest pharmacy news. The pharmaceutical-journal.com careers section provides articles on career insights, advice and case studies. You can also stay up to date with your CPD by reading learning articles and completing CPD modules

The Clinical Pharmacist is designed to support pharmacists working in clinical roles, keeping you informed of current advances in the clinical discipline and assisting in expanding your professional skills and knowledge.

Working more closely with other sectors of healthcare Working more closely with other sectors of healthcare

Pharmacists will often work as part of a multi-disciplinary team. This may involve training or mentoring multi-disciplinary colleagues, in prescribing and medicines optimisation.

We have developed a leadership framework and tools which includes a section on engaging your team which may be helpful. We have also created mentoring database & support tools to help train and mentor colleagues.

Other resources which may be useful include:

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