New GP contract may contribute to further pharmacy closures



The negotiating body for community pharmacy contractors in England (PSNC) has raised concerns about the impact of the new GP contract on the community pharmacy network in England.


PSNC Chief Executive, Simon Dukes, commented:


“Whilst investment into primary care is always welcome, this latest general practice funding deal will hardly feel like good news to community pharmacies. Channelling all investment into primary care via general practice is a crude response to the much wider problem of rising demand for healthcare and the strain on resources in the NHS. We know that GP practices are struggling, and we want to see the NHS looking further afield, and thinking about how best to use all providers of NHS services alongside GPs, for solutions.”


The Government and NHS England have committed at least an additional £1.5 billion in total for general practice over the next four years for additional staff, a key step towards delivering 50 million more appointments in general practice by 2024.


In addition to the Government’s commitment to invest in general practice under the Long Term Plan, this funding is for the recruitment of 6,000 more primary care professionals as well as for initiatives to support the recruitment and retention of doctors in general practice.


In agreement with the profession, the General Practice Contract for 2020/21 will also offer more check-ups for new mums as part of a major deal with England’s family doctors.


The contract includes a roadmap for delivering the numbers of doctors in general practice by 6,000 and bring in 26,000 new staff to bolster surgeries. This will include pharmacists, physiotherapists, dieticians and occupational therapists, who will become a core part of local primary care teams, reducing pressure on general practice and ensure patients can see or speak to the right clinician.


Also included in the agreement are regular visits for care home residents, assessing medication and new incentives to increase uptake of vaccinations and learning disability health checks, expand social prescribing referrals, and improve prescription safety checks.


Expanding the new workforce will allow GPs to focus on the sickest patients and will in time allow them to provide longer appointments to people who need one.


Health Secretary Matt Hancock said:


“I want the NHS to be there for everyone when they need it, and to take pressure off hospitals by expanding primary care. This new contract is the first step to delivering our manifesto commitment to make it easier to get a GP appointment when you need it by delivering 50 million more appointments a year in general practice.


“The significant additional investment means GP surgeries can recruit more pharmacists, physiotherapists and other health professionals so patients get the right care for them when they need it. It’s all part of our commitment to ensure the NHS is always there for everyone.”


Sir Simon Stevens, NHS Chief Executive, said:


“This agreement funds a major increase in general practice staff – including GPs, therapists and pharmacists – so that patients can get quicker appointments with a wide range of skilled health professionals at their local doctors’ surgery.


“These extra staff will in turn be offering expanded services, including regular health checks for people living in care homes, action to boost vaccination uptake, earlier cancer detection, and better support for people with learning disabilities.


“Coming on the heels of the highest ever number of young doctors now choosing to train as GPs, this is a vote of confidence in general practice that goes with the grain both of what patients need and what GPs themselves want to provide.”


Dr Nikita Kanani, NHS medical director for primary care and London GP, said:


“This agreement means better care for patients, and will help relieve pressure in general practice. This contract is good news for practicing GPs, and supports our practices in the new Primary Care Networks to bring in extra skilled staff, and recruit and retain our GPs.”


Ian Dodge, NHS national director of strategy, said:


“Today’s deal is another important moment, when general practice is given the practical support it needs to expand patient care. And with a much bigger team, and more GPs, it becomes possible to provide new services and improve access for patients.”


Simon Dukes continued:


“One of the key priorities of the Secretary of State and current Government is prevention. This is a long-neglected area but one which is becoming increasingly important if we are to tackle the rising pressures on all health services. To have an impact, the NHS must start investing in this area through community pharmacies. Pharmacies already see some 1.6 million people every day: investing in services that make the most of these interactions and indeed drive more of them could mean that every person in England is regularly seen by a health professional close to their home, helping them to stay healthy and avoid the need to see GPs and other health services in the first place.


“It is also encouraging to see the NHS recognising the value of pharmacists and pharmacy technicians, but the impact of investment in further roles for them linked to general practice will be negative for community pharmacies. It will create yet more demand for pharmacy staff and raise the cost of labour, a position which seems all the more untenable given the complete refusal of the Government and NHS to recognise pharmacies’ costs in delivering their ambitions set out in the Community Pharmacy Contractual Framework (CPCF).


“PSNC will be examining the deal in detail and looking very carefully at the possible impacts on community pharmacy and how, as a sector, we can mitigate some of the risks. We have already begun preparation for the first annual review process, making the case for the sector’s costs and capacity with regards to the CPCF, and some of these factors will undoubtedly feed into those discussions. But overall we think this deal will put yet more financial stress on a sector that is in an increasingly unsustainable fiscal environment, increasing the risk that we will see further pharmacy closures happening randomly and affecting those patients who need their community pharmacists the most.”


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