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contractsOctober 14 2015

Formal responses to proposals that community pharmacy and GP services could be better integrated have highlighted concerns over possible implications for the pharmacy contract.

PSNC has warned that replacing the existing funding system for pharmacy services would be “reckless” and could damage community pharmacies. Numark has criticised the consultation which asserted that “the community pharmacy structure does not facilitate easy engagement with new care delivery models” saying “nothing could be further from the truth.”

The consultation was issued by the Royal Pharmaceutical Society and the National Association of Primary Care in August. It proposed that service commissioners should look to commission what the local population needs rather than what can be offered by existing pharmacy and medical contracts.

It set out two key principles that there should be development of:

  • an underlying approach that binds the contractual frameworks of community pharmacies and general practices together
  • potential schemes and programmes that could increase collaboration between general practitioners and community pharmacists.

The consultation period closed on October 9. PSNC has published its response saying that the RPS/NAPC document “sets out a range of proposals for the extension of community pharmacy services, but also supports the removal of a ‘one size fits all’ central contract and funding for pharmacies.”

While PSNC said it supports many of the suggestions for service development and for better integration between pharmacy and general practice outlined, it believes that “a national core contract allows this and also offers protection for community pharmacy owners. We also believe it is vital for all patients to be able to access a reliable core service including the dispensing of medicines from any pharmacy, anywhere in the country.

“Abolishing this system in favour of an untested and unknown alternative would be reckless and could cause great damage to community pharmacies and the local populations that they serve.”

PSNC does not support a “joint population health framework” as outlined in the consultation. “Rather than sweeping away the current contractual framework and funding, these should be retained but with the GP and community pharmacy frameworks better integrated,” says the PSNC response.

“This would allow pharmacists and GPs to offer complimentary patient care, with the network of community pharmacies being utilised to a higher degree, without introducing major shocks to either health system which could adversely affect patient services and care.”

Numark’s take on the proposals is that it agrees with the over-arching ambition of the consultation in that more needs to be done to improve links between community pharmacy and general practice, but has concerns associated with the suggested general approach.

Commenting on the assertion that “the community pharmacy structure does not facilitate easy engagement with new care delivery models,” Numark said: “The clear inference in these statements is that the community pharmacy contract acts as a barrier to change.

“Nothing could be further from the truth. We will leave it for general practitioner bodies to comment on the general practitioner arrangements, but for pharmacy, the contract has changed enormously over recent years.”

The change has been enhanced by the UK devolution agenda and the development of four separate UK contracts, said Numark. “The fundamental recent shift in all the contracts has been driven by a focus on improving patients’ understanding of and adherence to prescribed medicines.  

“This has led to service developments including in particular, the introduction of medicines use reviews and the new medicine service in England and the chronic medication service in Scotland.”

Numark warns against the type of “wholesale approach” advocated by the document. “We would suggest that the proposed ‘binding’ of the two contracts into a proposed new ‘Population Health Framework’ would be to play fast and loose with a system that whilst not perfect, has worked well for many years ensuring that from a community pharmacy perspective, patients gain access to not only the medicines they need in a safe and timely manner, but also to the depth and breadth of healthcare services available from their local pharmacy.”

Numark members can access the full response by logging in to the Numark website.

Links:

PSNC statement

PSNC response document

Numark

RPS NAPC consultation document

Today’s Pharmacist coverage of RPS/NAPC consultation launch

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