In March 2020, as the COVID-19 pandemic began, the head of NHS England said in a letter that all providers should claim for “genuine and reasonable additional marginal costs” owing to COVID-19, including additional staffing and equipment.
It was unclear how community pharmacy would go about this, but at the time the Pharmaceutical Services Negotiating Committee (PSNC) said it was in “complex and ongoing” discussions with ministers to address the impact on community pharmacy of COVID-19.
Around the same time, the health secretary was extolling community pharmacies as a “vital part of our NHS family” and paying tribute to them as “the front line in this war against this virus” at one of the daily media briefings at Number 10.
Pharmacies in England were given £6m in additional funding to carry out deliveries to the most clinically vulnerable. In addition, £370m of funding from later on in the year was advanced to help with the cash flow problems partly caused by unprecedented demand from patients for medicines and the expenditure required to keep running during a pandemic — although with the proviso this must be paid back.
In an interview with The Pharmaceutical Journal in June 2020, the pharmacy minister, Jo Churchill, said that a “very strong” business case backed up by “robust data” was submitted to the Treasury for additional funding to recognise the pressures that community pharmacy faced. But nearly three months after, community pharmacies are still waiting.
GP practices in England have been offered a ‘COVID support fund’ from NHS England to assist with the “legitimate additional costs” of the pandemic borne by GP practice, which reportedly amounts to around £3 per patient. Why not pharmacies?
The latest PSNC statement reveals that yet another case is being submitted to the pharmacy minister for an “urgent uplift” to community pharmacy funding in England. Simon Dukes, chief executive of the PSNC, says that contractors should not “mistake a failure to make fast agreements for a lack of activity”, but any contractor looking at progress so far would be forgiven for thinking the main movement is in a backwards direction.
Indeed, Dukes admits that although government ministers have “heaped praise” on community pharmacy throughout the pandemic, some “officials still question the value of pharmacies”. But this is not the case in other parts of the UK.
In Scotland, the vital role of community pharmacy during the pandemic was recognised with an additional £2.6m of funding back in March. In Wales, albeit negotiated before the pandemic, £18m of additional funding for community pharmacy was announced over three years.
And there have been some great innovations made in community pharmacy across the whole country in response to the pandemic.
But, at present, the NHS is asking community pharmacies in England to do even more to ease the pressure on the NHS, all with the current funding envelope — which is frozen for the next four years — and with no recognition of the additional expenditure and stress faced during the first few months of the pandemic.
Community pharmacies are being asked to take on the “biggest ever” flu vaccination campaign; expand the community pharmacist consultation service; implement a new discharge medicines support service from January; and play a “massive role” in any COVID-19 vaccination programme, whenever a vaccine arrives; all while winter and a second spike of infections looms.
But this is unrealistic now that many community pharmacy teams in England are simply exhausted from mopping up demand from elsewhere in the NHS, and are already starting to cut back. Warm words from ministers only go so far: it is time that the government puts its money where its mouth is. Otherwise they may find this “vital part of the NHS family” will be missing in action when the health service most requires its assistance.