The Department of Health (DH) is planning to implement a 12% cut to community pharmacy funding in England from December 2016 that could result in the closure of a quarter of pharmacies and the removal of free health services from community pharmacies, according to the Pharmaceutical Services Negotiating Committee (PSNC).
The DH reiterated its plans to forge ahead with the cuts in a confidential letter (dated 9 September 2016) to the PSNC, which negotiates the pharmacy contract with the government.
It proposes to reduce funding for community pharmacy by 12% from December 2016 to March 2017, which means funding for 2016–2017 will be £2.69bn, and cut it by 7.4% (compared to current levels for the next financial year), to set funding at £2.59bn for 2017–2018.
The PSNC has rejected the DH’s proposals in a letter, dated 13 October 2016. This means that the DH will have to come back with a revised package or it could impose the funding cuts without the support of the sector’s negotiating body.
The DH first proposed cuts to community pharmacy funding in December 2015 and since then the pharmacy sector has offered alternative proposals that would save the NHS equivalent sums. The sector has also come back with proposals for new pharmacy services that could save the NHS money by reducing demand in A&E and GP surgeries. However, all of these proposals have been rejected.
In September 2016, the PSNC released research showing that 12 pharmacy services generate an annual £3bn net benefit for the NHS and that the proposed funding cuts would hit areas with greatest health inequalities hardest. The DH has not responded to this research and has not provided any published evidence to support its own plans to reduce pharmacy funding.
The DH has always acknowledged that its proposals would mean that some pharmacies would become unviable, and estimates have put the number of pharmacies at risk of closure at up to 3,000.
A Pharmacy Access Scheme (PhAS) is planned to protect community pharmacies where patient need is greatest, but the PSNC has warned that the proposals for this “do nothing to protect the pharmacies in areas of the greatest health need or those with high ethnic minority populations who often depend on the pharmacist to get advice in their own language”.
“The support within the proposed PhAS is directed towards pharmacies in more affluent areas,” it says.
Source: National Pharmacy Association
A spokesperson for the DH says: “We have worked collaboratively with the PSNC and have listened to their suggestions and counterproposals over the course of many months.
“Ministers are considering a proposed package for the sector and no final decision has been taken, but we are committed to offering more help to those pharmacies people most depend onâ€Ž compared to others.”
The spokesperson added that the DH would not be publishing details of that proposed package at the present time.
Meanwhile, pharmacy leaders have reacted with anger and disappointment to the news about the cuts.
Sandra Gidley, chair of the English Pharmacy Board at the Royal Pharmaceutical Society, says: “We are deeply disappointed that the government has not changed its approach to funding cuts this year and alarmed that further cuts have been announced for next financial year.”
Gidley also warns that the cuts will have a detrimental effect on the quality of patient care delivered through community pharmacy. “We fear for patients, the public and pharmacists who may be significantly affected by changes in opening hours and staffing levels in community pharmacy.”
Source: Pharmacy Voice
Ian Strachan, chair of the National Pharmacy Association (NPA), the trade association for independent community pharmacy in the UK, branded the government’s plans “a dangerous experiment”, and says that the lack of official evaluation “shows a complete disregard for the well-being of patients”.
“There is a flat contradiction at the heart of the [DH’s] position — asking pharmacies to develop new roles and services whilst stripping away the investment necessary to make it happen. Pharmacies cannot deliver more if they have to cut back staff. They cannot deliver a service if they have been forced to close,” he adds.
Claire Ward, chair of Pharmacy Voice, a trade association that represents community pharmacy in England, says that it was “a bitter blow” that after all the hard work through the counterproposals and the ‘Community pharmacy forward view’ to demonstrate the value community pharmacy could bring, the government appears to be “unwilling to match our ambition”.
“Attempts to justify these cuts with superficial arguments about pharmacy clustering, inefficiency and investment in ‘pilot schemes’ have been misleading, and are quite simply not supported by the facts. I fear that the burden of these changes will now fall on those least able to bear it,” she says.
“I continue to urge the government to halt these damaging and costly plans, and instead take up the sector’s offer to work in collaboration and partnership.”