This month's news...

A new deal for community pharmacy!

The Community Pharmacy ContractualFramework in England is broken and cannot be repaired in its current form, the National Pharmacy Association has declared. We’re calling for a fundamental rethink, to end the financial crisis facing pharmacies and allow them to thrive and deliver for patients.

Tinkering at the edges of the current arrangements cannot achieve the transformation that is needed. Instead, we need a radically different, fair and properly funded new deal. Such a new deal would underpin the NHS Plan promise to “make greater use of community pharmacists’ skills and opportunities to engage patients”, as an integral part of the NHS – building a more ambitious, modern primary care offering.

It must also create a level playing field, so that independent contractors are no longer unfairly treated by the ‘averaging’ processes on which the current arrangements rely.

'Real terms cuts are slicing away at this most accessible part of the health service and patients are losing out. We need a new deal for pharmacies that fi lls our gaping funding gap, stabilises the network and stops the closures.' NPA chief executive PaulRees

Pharmacy funding is at a record low

To incentivise change, the Government must be prepared to direct more money into community pharmacy. Instead of moving forward into new clinical roles, which the NHS and DHSC say they want, pharmacies are currently forced to focus above all on maximising dispensing income, where the vast majority of the income opportunity still sits.

There has been no increase in core funding for community pharmacy since 2014. In fact, it was cut in 2016 and the lack of any increase since has meant a real terms cut of more than £1 billion over the past 10 years. Over the same time, the amount of work being asked of pharmacies (in terms of prescription volume) by the NHS has increased by 10 per cent.

No wonder pharmacies are closing in record numbers and as many as three quarters are in defi cit. That’s why we need a boost to funding now! A multi-year deal should then contain guaranteed uplifts in line with infl ation as a minimum. Meanwhile, is it too much to expect that pharmacies are paid on time?

The current system of ‘excess margin’ and ‘clawbacks’ is a barrier to investment and forward planning. It undermines confi dence to modernise and implement new clinical services. How can it be acceptable to be told that you made too much money one or two years ago so you are getting abill?

That’s why we are calling for a moratorium on clawbacks until there is a new contract and a fair funding model. There should be no more ‘dispensing at a loss’ – for any items. It is an absurdity that pharmacies often buy blind and e ectively lose money the harder they work to track down stock. Overall, the NHS dispensing service should pay for itself and service income should be additional to dispensing income.

Pharmacies closing in record numbers

Record numbers of local pharmacies were lost last year – as shortfalls in NHS funding and pressures on the high street hit vital local services. Nearly 400 pharmacies were lost in England during 2023.

Under our proposed new deal

• Community pharmacy would get 2.5 per cent of the overall NHSbudget
• There would be a moratorium on clawbacks until a new contract and funding model are delivered
• Year on year infl ation linked increases guaranteed
• A new contract based on payments for dispensing, clinical services, de-prescribing and social prescribing
• An end to the situation where community pharmacy is treated as a second class within the NHS and a route though which to squeeze out cost, when other clinicians are treated with respect and as clinical experts
• An end to forced pharmacy closures.

Your NPA: Fighting for a New Deal

The NPA is pressing the case for a new deal in the national media andin parliament and with government. We have twice been to No.10 Downing Street in the last three months and appeared frequently across the major broadcast networks.

If you want to help us withour media and advocacy work, please email independentsvoice@npa.co.uk.

We are stronger together!

Latest Medication Safety Officer report

The NPA is formally recognised in England as Medication Safety O cer (MSO) for community pharmacies with fewer than 50 branches. As part of this leadership role, we are a member of the Community Pharmacy Patient Safety Group, where MSOs unite in their commitment to advancing patient safety culture and practice across community pharmacy.

As leaders in a caring profession, we take our responsibilities for patient safety very seriously. If you haven’t already done so, please read the latest Medication Safety Officer report on the NPA website and also our patient safety hub.

The main categories of errors reported in Q3 2023 (the latest data available) were those involving medication errors such as wrong drug/medicine, strength or formulation. ‘Work and environment factors’ (40 per cent) continue to be the main contributing factor reported – this category includes time pressures and poorly organised working environments.

Look-alike-sound-alike (‘LASA’) was the second largest contributing factor to the errors reported. Please continue to report, investigate and analyse patient safety incidents, and share learnings from them with your pharmacy teams.

Let’s get together!

For the first time since the pandemic, we will be going out on the road in England to engage with our members face-to-face to fi nd out what they want from the modern NPA. The Meet the NPA events will be addressed by our new chief executive Paul Rees, our chair Nick Kaye and members of our board.

We will talk about the new deal we want for community pharmacy, share top tips for delivering Pharmacy First and open the floor to questions. Our first events will be held on April 17 and 25 in London, hosted by Nick, Paul and board members Sanjay Ganvir and Sukhi Basra.

We will then be in Manchester on May 15 and Birmingham on May 16. We will let you know the venues as soon as we can. We will also deliver a series of masterclasses across the country to help tackle the many challenges of running a community pharmacy in this era.

Pseudoephedrine safety information

Following recent changes, pharmacy teams need to be aware of the updated MHRA safety information for all medicines containing pseudoephedrine. Pseudoephedrine comes in various formulations and has been widely used for many years to help with allergies, coughs, and colds.

The Medicines and Healthcare products Regulatory Agency (MHRA) and European Medicines Agency (EMA) have reviewed medicines containing pseudoephedrine due to the potential very low risk of reversible cerebral vasoconstriction syndrome (RCVS) and posterior reversible encephalopathy syndrome (PRES), both of which are conditions affecting the blood vessels inthe brain.

Key actions for pharmacy teams:

• Any patients taking pseudoephedrine should be advised to stop taking it and seek medical advice if they develop symptoms of RCVS or PRES, which may include: sudden onset of severe headache, nausea, vomiting, seizures, confusion, visual disturbances

• Advise concerned patients that side effects associated with pseudoephedrine are very rare, despite its wide use

• RCVS and PRES are reversible conditions; following relevant treatment most patients make a full recovery

• Remind patients to report any potentialside effect(s) of medicines including pseudoephedrine via the Yellow Card scheme.

NPA publishes general election manifesto

The National Pharmacy Association, Community Pharmacy England, the Company Chemists’ Association and the Royal Pharmaceutical Society have published a joint manifesto for community pharmacy, ahead of the general election expected this year.

The #VotePharmacy manifesto can be used by anyone in the community pharmacy sector, including all NPA members and LPCs, to engage with political parties and candidates in the run-up to the election. The document itself and other resources that promote pharmacy to parliamentary candidates can be accessed from an online general election hub: votepharmacy.org.

It includes practical advice to pharmacy owners about engaging with candidates. Wikipedia maintains an up-to-date database of candidates – however, most have not yet been selected. Election candidates will be asked to show their support and back a six point plan to unleash the potential of community pharmacy:

• Fill the funding gap and commit to long-term sustainable funding, so pharmacies can deliver more of the NHS care patients need

• Support and enhance the community pharmacy workforce to ensure that pharmacists and their teams can continue to meet the needs of patients, now and in the future

• Ensure that patients can access the medicines they need, including an end-to end review of the medicines supply chain

• Roll out an enhanced Pharmacy First service for England, mirroring the highly successful approaches taken in Scotland and Wales

• Empower community pharmacists to do more, with an ambitious roadmap for independent prescribing • Make pharmacies centres for public health, prevention and reducing health inequalities.

It’s important that all MPs in the new parliament understand the value of community pharmacy and give their backing to this vital sector. We will need their support to make progress on the many issues currently holding us back, including a stretched workforce and crippling fi nancial attrition leading to closures.

This joint manifesto spells out the many challenges requiring an urgent political response, to maximise our sector’s contribution to NHS patient care. The hashtag #VotePharmacy will be used to share updates throughout the election campaign. Further information and guidance will be available to all pharmacy owners and LPCs soon.

Modernising NPA values

We are modernising and renewing to deliver what our members tell us they want to see. As part of the modernisation process, our Board agreed in March that we will be a values-based organisation, steered by our new ‘PACIER’ values of:

• Professionalism

• Authenticity

• Collaboration

• Innovation

• Excellence

• Respect.

Moving forward, we are going to put our PACIER values at the heart of everything we do – and ensure that we are an organisation that has an empowering, positive and inclusive culture, where everyone – regardless of their background or characteristics – feels they belong.

Enrol now: 2024-25 foundation training

Our programme delivers an exceptional, fully supported blended learning experience, focused on the GPhC assessment syllabus and learning outcomes with a person centred approach.

NEW PHARMACY FIRST RESOURCES

We have created yet more resources to help you deliver Pharmacy First in England. Check out our triage checklist and much more at: npa.co.uk/pharmacy-first-service-england

NEW

NPA members should keep an eye on our resource hubs for the very latest business and practice resources, including:

• Pharmacy First Service (England) npa.co.uk/pharmacy-first-service-england

• Independent prescribing npa.co.uk/independent-prescribing

• NHS Contraception Service (England) npa.co.uk/nhs-pharmacycontraception-service

• Hypertension Case Finding Service (England) npa.co.uk/services/hypertension case-finding-advanced-service

• Women’s Health Hub npa.co.uk/womens-health-hub

• Patient Safety npa.co.uk/services-and-support/patientsafety-landing

Join the NPA PharmOutcomes Affinity Group

Are you using a PharmOutcomes accredited IT system to deliver Pharmacy First? Do you want to benefit from savings on transactional fees? The NPA can helpyou!

Pharmacies are given the option to signup to an Affinity Group when they register with PharmOutcomes. By becoming part of the group, you will be invoiced for your PharmOutcomes Pharmacy First usage by us rather than PharmOutcomes.

Due to the sliding scale of charges, thisreduces costs to individual pharmacies by being part of a larger provider group. Please contact our Member Services team at npamemberservices@npa.co.uk or call 01727 800402.