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NHS England has announced that the Pharmacy First consultation threshold for monthly payments will remain at 20 consultations until December 2024.
Speaking at The Pharmacy Show on 14 October 2024, Ali Sparke, director for pharmacy, optometry, dentistry and the NHS standard contract at NHS England, said that, following discussions with Community Pharmacy England (CPE), “we are going to confirm the 20 minimum activity requirements in October [and] keep it at that level for November and December”.
“We’re going to move it to 25 [consultations] in January and February, before reaching 30 [consultations], as planned by the end of this financial year [March 2025],” he added.
“It’s quite a big departure from where we were before, but we think it’s really important to balance the levels of payment going in the sector, to continue to support pharmacies during this kind of establishment period of Pharmacy First.”
The threshold is the number of consultations participating pharmacies must complete per month to trigger a £1,000 monthly payment, which was due to increase to 30 consultations in October 2024, as outlined in the Department of Health and Social Care (DHSC)’s pre-planned schedule.
However, CPE confirmed on 30 September 2024 that the October threshold would be reduced to 20 consultations, following concerns from the negotiator that contractors would miss out on the monthly payment.
The decision followed a similar one taken to cut the planned threshold for consultations in August 2024 from 20 consultations to 15 consultations.
In September 2024, analysis of NHS Business Services Authority (NHSBSA) data by The Pharmaceutical Journal revealed that community pharmacies have missed out on almost £10m in funding since the launch of Pharmacy First on 31 January 2024 because they have not been hitting monthly thresholds.
The analysis revealed that 9,600 pharmacies in England missed the consultation threshold to qualify for the monthly fixed payment of £1,000 between February 2024 and May 2024.
After March 2025, the government announced in November 2023 that pharmacies will also need to provide the NHS ‘Community pharmacy contraception service’, and NHS ‘Blood pressure checks service’, in addition to Pharmacy First, to qualify for the £1,000 payment.
Sparke confirmed to Pharmacy Show delegates that around 7,300 pharmacies (69%) have so far signed up to deliver all three services.
“We’ve got a really, really high proportion of pharmacies who are signed up to Pharmacy First,” he said.
“But also, really importantly, we’ve got 7,300 pharmacies, about 69%, that have signed up to all three proposed services.
“I think [this] helps us along that road in providing a really clear message to patients on the kinds of services they can get… that’s something to really be celebrated,” he said.
Commenting on the government’s decision to reduce Pharmacy First thresholds, Janet Morrison, chief executive of CPE, said: “Whilst not as large a reduction in the thresholds as we wanted, these changes at least indicate ministers are taking a much more pragmatic approach to Pharmacy First payment thresholds.
“This has been one of the key issues that we have been raising with the new government, alongside the desperate wider financial position for community pharmacies, so we are grateful that some longer-term adjustments have now been made.
“We still need NHS England to effectively advertise the service to the public on an ongoing basis and to increase referral rates from general practices.
“It is critical that this now happens to allow patients and the public to receive care closer to home; to help improve access to general practice; and to allow community pharmacies to maximise the amount of allocated funding that they can earn from this important service,” she said.
Paul Rees, chief executive of the National Pharmacy Association, commented: “This latest revision to the Pharmacy First thresholds shows that the government and NHS England are at least listening to the sector’s concerns and recognise that the situation on the ground is incredibly challenging.”
