Clinical workload for community pharmacists will have nearly doubled in five years, says PSNC

The Pharmaceutical Services Negotiating Committee said that the changes promised in the 'Community Pharmacy Contractual Framework' to free up pharmacists' time have not taken place.
A pharmacist at work in the UK

Demand from clinical services on pharmacy staff time will increase by nearly 90% over the course of the current five-year pharmacy contract, the Pharmaceutical Services Negotiating Committee (PSNC) has said, calling for more funding from the government to support these changes.

Following a review of the ‘Community Pharmacy Contractual Framework: 2019 to 2024’ (CPCF), a PSNC briefing document, published on 28 January 2022, said that “limited progress has been made on releasing capacity within the sector” through legislative and regulatory changes since July 2019, owing to the COVID-19 pandemic.

The CPCF, which was agreed in July 2019, promised a range of legislative changes in an effort “to free pharmacists up to provide new services”.

These included changes to legislation around hub-and-spoke dispensing models and enabling better use of skill mix within the pharmacy.

However, these changes have not been enacted, while “costs and workload have continued to rise, and pharmacies have also taken on a range of new services”, the PSNC document said.

“To ensure the sector is sustainably funded in the future, it is crucial … that we plan for projected increases in demand.

“We need to work to increase capacity today so that pharmacies can continue to provide every patient with the high-quality care they need.”

The briefing added that PSNC modelling “estimate[s] that staff time demand for clinical services will have increased by over 87% by 2022/2023 compared against 2018/2019 levels (2.21 million staff hours versus 1.18 million staff hours)”.

“This is unsustainable and urgent action is needed to mitigate these challenges. Pharmacies want to continue to provide new services and increase patient access to healthcare — that’s part of their job. But they cannot do so without fair support and funding,” the PSNC said.

As part of the CPCF, the PSNC, Department of Health and Social Care (DHSC) and NHS England agreed to hold joint annual reviews of the contract to ensure value for taxpayers and the NHS, and its continued progress.

However, in a statement published on 28 January 2022, the PSNC said that the review took place separately from — and too late to inform — the PSNC’s bid for an uplift in funding, which was denied during negotiations ahead of the third year of the contract.

Mike Dent, director of pharmacy funding at the PSNC, said: “Perhaps, unsurprisingly, this annual review process involved some difficult discussions and debate about what the future holds for community pharmacy.

“The PSNC put forward data and analysis showing the capacity and cost constraints that pharmacies are facing, and we were pleased to gain agreement for this important context to be considered as we go into the year four negotiations.”

However, he added: “[The review] will fall short of contractors’ hopes in that it did not result in any immediate movement in terms of contractor funding levels, and DHSC and NHSE&I have also remained clear throughout that no funding uplift is available for years 4 and 5 of the CPCF.”

Mark Lyonette, chief executive of the National Pharmacy Association, said the sector “cannot possibly accept that outcome” and described the review as “an insult to pharmacy teams”.

“Costs are up, in some cases very considerably, public demand for pharmacy support has surged, workload pressures have intensified and many staff are demotivated,” he said.

“All this when the NHS needs a well-functioning sector to help it clear the backlog of care caused by the pandemic. This should be a time for investment in achieving stated goals, not for continued attrition.”

This was the first annual review of the contract to take place, having been delayed owing to the COVID-19 pandemic.

Read more: Work-related stress: the hidden pandemic in pharmacy

Last updated
The Pharmaceutical Journal, PJ, January 2022, Vol 308, No 7957;308(7957)::DOI:10.1211/PJ.2022.1.126304

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