Role of community pharmacies
There will be a debate in Westminster Hall at 9.30am on 2 October 2019 on the role of community pharmacies. This debate will be led by Holly Lynch MP. The Commons Library has prepared the following information ahead of this debate.
Since April 2013 NHS England has held responsibility for commissioning NHS primary care services, including community pharmacy services. Clinical commissioning groups (CCGs) and local authorities are also free to commission further services from community pharmacies over and above those commissioned by NHS England.
Community pharmacies in England provide services under the NHS Community Pharmacy Contractual Framework (CPCF), and can include a range of services categorised as ‘Essential’, ‘Advanced’, ‘Enhanced’ and ‘Locally Commissioned’:
- Essential services include dispensing medicines and appliances, providing advice on self-care and promoting healthy lifestyles.
- Advanced services could include the provision of Medicine Use Reviews, or offering NHS flu vaccinations.
- Enhanced services could include services such as anticoagulation monitoring.
- Locally commissioned services might include public health services commissioned by local authorities, such as smoking cessation services.
(See: PSNC, The Community Pharmacy: a guide, May 2019)
While pharmacy contractors must provide Essential services they can choose whether they wish to provide Advanced and Enhanced services.
Paragraph 4.21 of the NHS Long Term Plan (January 2019) noted that pharmacists will have a key role in delivering the objectives of the NHS in England over the next 10 years, and provided the following on community pharmacy:
In community pharmacy, we will work with government to make greater use of community pharmacists’ skills and opportunities to engage patients, while also exploring further efficiencies through reform of reimbursement and wider supply arrangements.
The Long Term Plan also supported the increasing role of pharmacists working with general practice and community health services. The latest position on proposals for community pharmacy reform can be found in an NHS England/NHS Improvement Board Paper dated 26 September 2019.
On 22 July 2019 the Government announced a five-year settlement for the Community Pharmacy Contractual Framework (CPCF). Overall funding for the CPCF is expected to remain at £2.592 billion per year (the same as in 2018/19) (see Written Ministerial Statement HCWS1777, 22 July 2019). The Department for Health and Social Care (DHSC) has also issued a press release, and NHS England and NHS Improvement have published a letter to commissioners and a short briefing about the deal. A further summary of the five-year settlement can be found on the website of the Pharmaceutical Service Negotiating Committee (PSNC), the representative body for community pharmacies in England that provide NHS services.
The following Parliamentary Question addressed patient access to community pharmacy services:
Asked by: Dhesi, Mr Tanmanjeet Singh | Party: Labour Party
To ask the Secretary of State for Health and Social Care, what recent steps he has taken to ensure that patients have adequate access to pharmacy services.
Answering member: Seema Kennedy | Party: Conservative Party | Department: Department of Health and Social Care
In December 2016, the Department introduced the Pharmacy Access Scheme (PhAS), as part of a wider package of reforms to the Community Pharmacy Contractual Framework. The PhAS helps to support the financial viability of pharmacies in areas where there are fewer pharmacies.
The Department continues to monitor closely the market to identify and address issues that may impact patient access to pharmacy services. Access to National Health Service pharmaceutical services remains good: there are over 11,500 pharmacies in England, an increase of approximately 12% in the last decade.
[PQ 252890, Pharmacy: Access, 15 May 2019]
The NHS community pharmacy budget was reduced from £2.8 billion in 2015/16, to £2.687 billion in 2016/17, and £2.592 billion in 2017/18. As noted above, the budget remained at £2.592 billion in 2018/19 and is expected to continue at this level. Background on changes to the CPFC announced in 2016 can be found in the Library briefing Community pharmacy funding (November 2016). Following the funding changes announced in 2016 there have been some reports of pharmacy closures and reductions in service – see for example:
Pharmaceutical Journal, PSNC analysis finds 233 pharmacies have closed in two years, 4 March 2019
Community Pharmacy Funding in Scotland, Wales and Northern Ireland
- In Scotland, an additional £2.6 million in funding for community pharmacies was announced for the financial year 2019/20 (Pharmaceutical Journal, 29 April 2019). A summary of Scottish Pharmacies is published by the Scottish Government. The Scottish Parliament held a debate on Community Pharmacies in May 2019 (Official Report, 16 May 2019, 12:43-13.19)
- The Welsh Government announced an additional £1.4 million for community pharmacies for 2018/19 (Chemist and Druggist, 3 April 2019). The Chief Medical Officer for Wales also announced in June 2019 that it intended to “fundamentally change the role of pharmacy” and shift it away from dispensing, with the aim of training pharmacists to become independent prescribers (Chemist and Druggist, 12 June 2019).
- In Northern Ireland, an additional £11.1 million was made available in the year to March 2019 for community pharmacies (NI Department for Health, 16 November 2018). Additional funding was announced by the NI Department of Health in September 2019. Community Pharmacy Northern Ireland, which represents community pharmacists, stated in September 2019 that they were experiencing a "workforce crisis’"(Belfast Telegraph, 26 September 2019)