A new article from @HLPharmacist Deborah Evans can be read here.
Everyone who owns or works in a community pharmacy in England is experiencing a very challenging time, both professionally and commercially. The current funding settlement together with reinstatement of the temporarily postponed Category M overspend recovery, creates further cashflow and profitability issues for many owners, particularly independents.
This is on the back of almost three lost years whilst the judicial review of the previously imposed funding settlement was pursued when we were not asking the right questions of the right people to understand where pharmacy could support the struggling NHS and public health systems.
We have written many times about the need to change the contractual framework and the funding formula to incentivise the right behaviours and reward quality delivery through a fairer system that benefits a few and penalises many. However, this will take time as PSNC seeks to rebuild relationships and trust with the NHS and DHSC.
To support pharmacy contractors, Pharmacy Complete has developed a unique Business Development Programme. Planning for Growth enables owners and their managers to take control of their future by developing and then implementing a robust business development plan.
This course, which builds on our Leadership development programmes and the platform of Healthy Living Pharmacy, provides essential business knowledge, skills and tools at a time when community pharmacy can no longer wait for someone else to create their future business model nor be so dependent on the NHS for profitable income.
We have already successfully run workshops for some forward thinking small groups. Whether you are an independent owner, a small or medium sized group, or an LPC looking to support your contractors, the time to act is here and now.
Pharmacy Complete – enabling pharmacy for a healthier future
It is excellent news that we now have 9436 (88%) pharmacies in England declared as Healthy Living Pharmacies, this represents an additional 5% on the November 2017 declaration. For these pharmacies the key will be ensuring that all the HLP criteria continue to be met in order to maintain the status and thus be able to promote the quality mark.
Becoming an accredited HLP is just the beginning, its what HLPs then do differently, bigger and better that will define and differentiate them. This will then help them realise the benefits of the improved ethos, engagement, capability and activity that comes with doing the right things with the right people.
The next step is building on that capability and activity for a healthier future for their community and their pharmacy. Pharmacy Complete have a range of resources and courses to support this. Developing and demonstrating this capability and commitment should have its own benefits through increased productivity and delivery of both private and commissioned health promotion, prevention and protection services.
What we need to see now is the NHS and Public Health, at both national and local level, recognising the HLP asset to deliver against the Staying Healthy and other objectives within the recent NHS Plan consultation to reduce health inequalities and improve the health of the population. Good to see some early signs of engagement from PSNC and RPS with this consultation which requires new thinking focussed on NHS and public health needs both now and in the future.
What is it?
NHS Digital have released their latest report on services provided by community pharmacies in England between 2007/08 and 2017/18.
What does it say?
- The total number of community pharmacy contractors fell by 80 (0.7%) on 2016/17 to 11,619 with the proportion of independents (5 or less pharmacies) remaining at 38%
- The number of 100 hour contracts fell by 10 to 1,179
- The number of distance selling pharmacies rose by 29 to 350
- The total number of prescriptions dispensed in community pharmacies in 2017/18 was 1,013.3 million, a fall of 2.3 million on 2016/17 with the average number of items per pharmacy at 7,267 per month
- 97.3% of pharmacies provided the Medicines Use Review service (MURs) with the average per pharmacy being 299 which was no improvement on 2016/17
- 89% of pharmacies provided the New Medicine Service (NMS) with an average of 90 per pharmacy
- 77% of pharmacies provided the NHS Flu Vaccination service and delivered 1.34 million vaccinations (an average of 150 per participating pharmacy and a 40% increase on 2016/17) to improve the reach of this important protection intervention. This was worth £12.3 million in fees
- 3,930 pharmacies delivered one or more locally commissioned Enhanced Services, a 3% drop on 2016/17
What does it mean?
- Its tough out there!
- The number of pharmacies serving communities are declining, i.e. no longer viable and/or through consolidation
- The number of DSPs are increasing and the number of items they are delivering are increasing against the normal trend
- A potential 1.4 million MURs were not completed equivalent to £35 million left on the table, despite the funding cuts, to the detriment of patients and the contractors involved
- 318 (11%) pharmacies chose not to deliver the NMS
- 2613 (23%) pharmacies chose not to deliver the NHS Flu Vaccination service. If they all engaged and delivered the 2017 average of 150 vaccinations, this would be mean an additional 391,950 patients would be vaccinated which would be worth £3.6m in fees to those additional pharmacies
- We could move the flu median up by using the whole pharmacy team to effectively implement and promote the flu service
- Local services continue to be decommissioned for whatever reason, e.g. funding challenges, poor understanding of commissioners of the benefits of using community pharmacies, poor or inconsistent delivery by some pharmacies
Community pharmacy’s ‘cheese’ has moved and, in the rapidly changing health and consumer ecosystems in which we operate, we must constantly adapt to remain relevant and compelling to commissioners and consumers of our services. In addition to pursuing an effective contractual framework and new locally commissioned services, we must plan for a sustainable future, embrace the digital healthcare revolution, be more effective at supporting self care and explore opportunities for private services to reduce dependence on NHS revenue which is declining in value and profitability.
What next for community pharmacy?
This article I wrote for Pharmacy Magazine a couple of years ago explored what pharmacy might look like in the future. I speculated on two potential models which I called Nirvana and Amazonia. At the time I challenged the profession to create its own future and not be led by government and others to a place where we, and most patients, don’t want to go whilst being realistic when we operate in a healthcare ecosystem is changing at an increasingly rapid rate.
More recently, I played this back in one of our Viewpoint articles, Here and Now. With Amazon entering the pharmacy space in the United States with its recent acquisition of PillPack and some wholesalers, and rumours that it is in conversations with Pharmacy2U in the UK, it is very much here and now!
Doing the same thing and expecting a different outcome is not going to happen…