Pharmacy comes out fighting over contraception service
By Neil Trainis
The pharmacy sector has come out fighting over NHS England’s launch this week of the contraception service despite concerns financial and capacity constraints have left pharmacies in no position to provide it – with one chain insisting it will not roll it out until government funding improves.
Day Lewis executive director Jay Patel (pictured) accused NHE England of forcing it “to ration services to a few patients” and revealed his business spent £100,000 in January this year to train its pharmacists to deliver the service, which launched on Monday, on the assumption it would be “fairly funded.” The PSNC has said NHS England pushed ahead with Monday’s start date despite not reaching an agreement with pharmacy’s negotiator on that.
“All our pharmacists are now trained. However, we will not be launching the service until progress is made with pharmacy funding,” Patel said.
He insisted Day Lewis is always “keen and proactive to deliver pharmacy services” but warned it was “unsustainable” for pharmacies to continue doing more for less and providing services that are funded, not with new money, but by community pharmacy’s already squeezed global sum.
“As a family business it’s distressing that NHSE has forced us to ration services to a few patients so that we can continue to support our critically ill and chronic patients whose lives depend on us,” he said.
NPA urges members and NHSE to ‘pause’
The National Pharmacy Association urged its members and NHS England to “pause and reflect” before continuing to implement the service. It said its Board, which met on Tuesday to discuss the issue, decided it could not support its roll-out because community pharmacy was “at breaking point.”
“We can’t tell pharmacy owners what they can and can’t do. But we can tell them the facts; fact number one is that with no new funding currently available everyone will be a loser from the implementation of this service on the current terms,” the NPA said.
Its vice-chair Jay Badenhorst said pharmacies “cannot be expected to take on more and more services without the increase in funding necessary to deliver them effectively.”
The NPA said it will continue talking to the PSNC, NHS England and Department of Health and Social Care on ways to proceed with the service. Badenhorst warned patient safety could be jeopardised if pharmacies take on a level of work that exceeds their capacity.
“We still believe this could, in future, be a great new pharmacy service, but not without the extra funding necessary to deliver it safely and effectively. We want to offer women this extra support, but if it’s worth doing it’s worth doing properly,” he said.
PSNC: Contractors should 'think really hard'
PSNC chief executive Janet Morrison told P3 Pharmacy this month that contractors should “think really hard” when deciding whether to provide the service, with reports that some have made up their mind not to.
“These are not essential services, so contractors have the choice not to do them – and that’s not easy,” she said. “I totally understand that if you’re a contractor, you’re effectively in competition with other pharmacies, and they might have an advantage if they do provide a given service.
“The problem is, the more money they might earn on that, the higher the chance it could be taken away from somewhere else. People would be extremely unhappy if the single activity fee per prescription went down, but that could be a consequence if we sign up for too many services within this funding envelope.”
RPS: Pharmacists are under 'huge pressure'
The Royal Pharmaceutical Society did not say if it would advise its members to provide the service or not but the England Pharmacy Board chair Thorrun Govind told Independent Community Pharmacist it recognised “pharmacists are under huge pressure” and would not “shy away from calling that out.”
“Improving access to contraception and advice through community pharmacy will make good use of the clinical skills of pharmacists in partnership with GPs and existing sexual health services,” she said.
“For this new NHS contraception service to be a success, the rollout must be backed and enabled by appropriate additional government funding and technology to allow pharmacists the time and space to deliver great care to patients and the public.
“We want these barriers to be overcome so all women can access NHS contraception services through pharmacy.”
CCA: 'Worrying disregard' of the reality
The Company Chemists' Association has said community pharmacy has huge potential to meet the contraceptive needs of women, increasing access and creating much-needed capacity across primary care.
However, it warned that pushing through a roll-out of the service, despite the warnings of the PSNC, representative bodies and contractors, showed “a worrying disregard for the reality within the community pharmacy sector”.
“With ambitious commissioning, joint implementation with the sector, and the critical new investment needed, community pharmacy could make a huge impact on women’s contraceptive care. Pharmacy has a history of delivering at scale, and at speed. But the sector cannot continue on goodwill alone,” the CCA said.
Its chief executive Malcolm Harrison pointed out that the money hypothecated within the contractual framework for the delivery of services has already been used to fund other services. That meant funding for the delivery of any additional services will have to be taken from money currently allocated to the single activity fee.
“In effect, contractors will be undertaking more activity without any additional funding,” he said.
Boots has been contacted for comment.
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