Pharmacies being ‘unreasonably penalised’ for not meeting Pharmacy First thresholds, says Community Pharmacy England

The monthly minimum threshold pharmacies must meet to receive the fixed £1,000 monthly payment is set to increase to 30 consultations by October 2024.
Sign showing NHS pharmacy services

Pharmacies are being “unreasonably penalised” for not meeting monthly Pharmacy First minimum consultation thresholds, according to Janet Morrison, chief executive of Community Pharmacy England (CPE).

In an update on the service, published on 2 July 2024, Morrison said the ability of pharmacy contractors “to reach the monthly payment thresholds is a major ongoing concern”.

“Pharmacies are reliant on NHS England and the [Department of Health and Social Care] (DHSC) to drive people to the service, but following an underwhelming public marketing campaign, we don’t think we are seeing the numbers of walk-ins or referrals needed,” she added.

In addition to the £15 consultation fee that contractors are paid for offering Pharmacy First, pharmacy owners are paid a fixed monthly payment of £1,000 if they provide a minimum number of consultations per month.

In May 2024, this minimum threshold increased from five consultations to ten each month.

CPE previously highlighted in April 2024 that the threshold increase was an “area of risk”, while a survey by the Independent Pharmacy Association (IPA) in March 2024 revealed that nearly two-thirds (60%) of pharmacists said they would struggle to achieve the minimum thresholds.

Pharmacists took to social media in June 2024 to say the situation “needs addressing urgently” and that they were “desperately” trying to meet the minimum thresholds, while struggling with low referral rates and clinical pathway consultations that do not cross the gateway point.

From August 2024, the minimum threshold is set to increase, with pharmacies required to give 20 consultations per month to claim the payment, with a further increase to 30 monthly consultations expected from October 2024.

Morrison added in her update: “It is completely unreasonable to penalise pharmacies financially for the NHS’ failure to drive public and general practice behaviour changes.”

She added that many questions remained, including about the full impact of seasonality on the service, with discussions between the DHSC, NHS England and the pharmacy negotiator ongoing “to find solutions”.

“During the original negotiations on Pharmacy First, we had to argue very strongly for the upfront and monthly payments and we will continue to stress to the new government just how critical these payments are.

“It is completely unreasonable to penalise pharmacies financially for the NHS’ failure to drive public and general practice behaviour changes,” Morrison added.

Paul Rees, chief executive of the National Pharmacy Association, said pharmacies “are keen to engage with the Pharmacy First programme and ensure it is a success”.

“They’ve made huge strides and the number of consultations is going up all the time, but we clearly need to review the rollout in the light of experience,” he said.

“Fixed monthly targets for consultations are leading to a number of community pharmacies not receiving funding that they should be able to access. This is adding to the existing financial pressures facing so many pharmacies.”

Leyla Hannbeck, chief executive of the Independent Pharmacies Association (IPA), said that there were already pharmacists who were “really struggling” to meet the current thresholds, which she suggested would have been more achievable during the winter months.

However, she was critical of what she said had been a rush among some to welcome the service. “From the beginning, [IPA] said Pharmacy First is not a panacea. We said it’s the right direction, because it’s not going to solve our problems,” she said, highlighting community pharmacy’s funding shortfall.

Last updated
The Pharmaceutical Journal, PJ, July 2024, Vol 313, No 7987;313(7987)::DOI:10.1211/PJ.2024.1.322781

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