Delegates attending the Sigma conference in Aamby Valley City, India — including community pharmacists, pharmacy owners and drug manufacturers — have voted in favour of national minor ailments scheme for the UK.
“We need to get a sensible, coherent national minor ailments service,” said Sue Sharpe, chief executive of the Pharmaceutical Services Negotiating Committee (PSNC). Sharpe explained that the scheme would take people away from general practice appointments who do not need them, adding that such a scheme was an “absolute no-brainer”.
Delegates also suggested other programmes that could be nationally commissioned, such as an urgent care scheme and a “triage and treat” solution. Fin McCaul, chief executive of the Independent Pharmacy Federation, explained that the idea would be similar to a minor ailments scheme, but patients could be referred to the GP service the same day if necessary.
Garry Michaels, director and pharmacist at Dale Health Limited, suggested moving towards medicines use reviews (MURs) provided in patients’ homes, which would also provide an opportunity to assess whether patients have accumulated large amounts of excess medicines and could help reduce waste. However, Sharpe warned that such a service would be expensive and that under the current funding arrangements it would be paid for from the pharmacy budget. “Presumably you would want a relaxation of the budget cap to cope with that,” she said, adding that the cost of providing domiciliary MURs goes “up in multipliers over the cost of walk-in patients”, and that this was something for which “we need to really start to work on getting the funding right”.
During the session, Sharpe also discussed the electronic prescribing system (EPS). She said that, following the results of one study undertaken by a multiple pharmacy chain, the PSNC believed there was a significant cost burden associated with dispensing using the EPS. Some of this cost, she explained, came from the paper transfer from general practice to community pharmacy, while some was long-term systemic costs in the system. “The next step is to do a joint study with the Health and Social Care Information Centre, which runs the EPS programme, so that we can get an agreed data set of additional costs, so that we can then look at funding,” she added.
Sharpe, who spoke at the conference with Mike Dent, the PSNC’s chief financial officer, said that “read-only” access to the summary care record would be rolled out to all pharmacists following a successful pilot and acknowledged that this was a “small step in the right direction”. She added that the access would be particularly useful to help pharmacies meet urgent care needs.
The PSNC will be auditing the use of pharmacies for the urgent supply of medicines in March 2015. “The NHS is really beginning to wake up to the value that pharmacists have in reducing some pressures on the urgent care system, particularly those patients who are away from home or just haven’t realised that they’ve run out of medicines and need urgent supplies of their routine medication,” she said. “So we’re going to do this audit. It’s important that all pharmacies oblige to participate in it and really get recording and make it work.”
In reference to the recent settlement for 2014-2015 that the PSNC negotiated with NHS England, Dent explained that contractors would have seen the average item value rise by around 12p per item. “The corresponding adjustment we had to make to fees and allowances, we had to take £70m out of practice payments,” Dent explained. Therefore, practice payments decreased by 17p per item from November 2014 until the end of March 2015. “There will need to be a review of practice payments for 2015-2016 funding,” he said. But he warned that they would not return to previous levels.
In the longer term, Dent explained that the PSNC is trying to avoid the large step-changes in payments that are traditionally seen in October each year and is instead aiming for a smoother delivery of income for community pharmacy contractors. “What we are trying to achieve is more regular but smaller changes,” he said.