Five year deal for community pharmacy in England worth almost £13bn

Following negotiations between PSNC, DHSC and NHSE&I, HM Government has agreed to make a five-year investment in community pharmacies. The deal secures funding of £2.592bn per year for community pharmacies. The agreement also sets out a vision for the expansion of clinical service delivery through pharmacies over the next five years, in line with the NHS Long
Term Plan.


The deal is in line with the GP contract, providing 5-year stability and reassurance to community pharmacy. The Government have said that this should allow businesses to make long term business decisions and to discuss investment with banks and suppliers.


The Government have said that this deal confirms community pharmacy’s future as an integral part of the NHS, delivering clinical services as a full partner in local Primary Care Networks.


There have been a number of new pharmacy services announced as part of the deal. Amongst the new services is the new national NHS Community Pharmacist Consultation Service, connecting patients who have a minor illness with a community pharmacy which should rightly be their first port of call.


The deal seeks to recognise that an expanded service role is dependent on action to release pharmacist capacity from existing work. It seeks to rationalise existing services and commits all parties to action which will maximise the opportunities of automation and developments in information technology and skill mix, to deliver efficiencies in dispensing and services that release pharmacist time. The deal also aims to continue to prioritise quality in community pharmacy and to promote medicines safety and optimisation.


Matt Hancock Secretary of State for Health and Social Care commented:


“Soon after becoming the Secretary of State for Health and Social Care, I set out my ambition to unlock the huge potential within community pharmacy. I outlined that I wanted to see the clinical skills of the teams that work in pharmacies better utilised and to make best use of the accessibility of the 11,500 pharmacies throughout England. I am now delighted to set out this landmark 5-year settlement for the Community Pharmacy Contractual Framework (CPCF) which, from October 2019, will expand and transform the role of community pharmacies and embed them as the first port of call for minor illness and health advice in England.


“Community pharmacies are a vital and trusted part of our NHS. We need to draw on your expertise, your experience, and the invaluable human connection you have with your communities. Through this deal I expect to see community pharmacies further integrated within local primary care networks, doing more to protect public health and taking on an expanded role in urgent care and medicines safety.


“This deal sets out a clear future vision for community pharmacy, a vision which NHS England & NHS Improvement and the Pharmaceutical Services Negotiating Committee fully support and are committed to delivering in partnership with us. I invite and encourage community pharmacy and other primary care contractors to work with me to deliver integrated and accessible community health services for all and to help people live happier, healthier lives for longer.”


Claire Anderson, Chair of RPS in England, said:


A shift to a major clinical future is encouraging and is absolutely the right direction for community pharmacy. We have long called for pharmacists in the community to play an expanded clinical role and there is much to welcome in the new contract with focus areas on urgent care, prevention, medicines optimisation and safety. The exploration of innovative and new services will showcase the enhanced roles that community pharmacy can play, such as enabling earlier detection of cardiovascular disease, Hepatitis C testing and supporting public health.


“Referring patients with minor illnesses who would have otherwise required an appointment with their GP to community pharmacists will be game-changing for our primary care systems. If successful, the Community Pharmacy Consultation Service will support the delivery of the NHS Long-Term Plan and make the best use of the clinical skills of community pharmacists through better integration. It will also have a positive impact on relationships within the multidisciplinary primary care team and in educating patients about the types of support and expertise that pharmacists provide.


“Medicines optimisation across the health service should be central to patient safety. As Medicines Use Reviews (MURs) are phased out, it will be vital that pharmacists in all settings, including within Primary Care Networks, are enabled to help people get the most from their medicines.”


“A five-year settlement will offer some certainty for contractors who want to plan for the future, although with funding remaining flat and contractors potentially facing rising costs, the sector will no doubt be keenly watching how further details on services and payments are negotiated each year.


“It will be vital for pharmacy leaders to engage with new NHS structures to co-create the design and delivery of local services, and so we welcome transitional payments to help meet costs associated with changes such as integration into Primary Care Networks.”


Mark Lyonette, Chief Executive at the National Pharmacy Association (NPA) said:


“We strongly support the emphasis on clinical services and the recognition that pharmacies can play a significantly greater role in urgent care and public health. What’s more, the five-year term of this settlement gives us the long view we asked for.


“But static funding year on year means it will be very difficult to deliver the transformational improvements we all want to see.  The government must be prepared to direct more money into community pharmacy if it becomes clear that funding is insufficient to maintain current core services and invest in positive new developments like the Community Pharmacist Consultation Service.


“We note the proposed annual review each October. To ensure the service levels required for patients, we suspect the £2.59bn needs to be a floor not a ceiling.”


Commenting on the agreement, Malcolm Harrison, Chief Executive of the Company Chemists Association (CCA), said:


“The CCA is supportive of a five-year settlement for community pharmacy. While we recognise that a further five years of flat funding will present significant challenges to what is already a financially strained sector, we are encouraged by the direction of travel set out by the agreement.


“The CCA and its members have been calling for a more clinically focused contract framework in recent years. We hope that the Community Pharmacist Consultation Service will allow community pharmacists and their teams to continue to refocus the sector on the delivery of care.


“We believe it is now critical that all community pharmacies embrace the new urgent care services and engage with Primary Care Networks so that the sector is more integrated within the NHS. We are also pleased to see the use of the Pharmacy Quality Scheme to support the sector-wide agenda for patient safety improvement.


“There is much still to be agreed within this settlement. We look forward to working with our colleagues from across the sector, through the PSNC, to help develop what the new framework will mean for contractors.”


You can view the PSNC summary of the new funding arrangements here.


Quicker access to the Summary Care Record for community pharmacies


Pharmacists can now access vital patient information quickly and simply through a new Summary Care Record (SCR) 1-click function.


The 1-click function allows pharmacy professionals logged in on their Smartcard to click straight through to a selected patient’s SCR, without having to log in separately and complete a manual search. This is expected to save time over the course of a day, making access to SCR an integral part of providing pharmacy services, such as medicine use reviews, the new medicines service, administering vaccinations and emergency supply.


Having access to a patient’s Summary Care Record speeds up care and reduces the need for phone calls to GP practices, delays to care and the need for referrals to other services, particularly out-of-hours. The new functionality is live across Sonar and Pinnacle advanced services systems. (1)


Tahmina Rokib Pharmacist and Clinical Lead for Digital Medicines & Pharmacy at NHS Digital said:


“SCR 1-click will allow pharmacists quicker access to critical information when carrying out community pharmacy advanced services. This is a great first step to integrating core clinical tools into systems to make things more efficient for busy health care professionals. It would be great to see the integration of SCR and other digital tools by more system suppliers in the future so that clinicians can fully reap the benefits. Improved access to SCR will support pharmacists to provide better and safer care for patients through more informed decision making due to quicker access to information.”


1. Certain systems from Sonar and Pinnacle are eligible for the new functionality.  Pharmacies using these systems should contact their supplier directly for more information.


NHS Skype use prevents thousands of avoidable hospital trips


A scheme in Tameside, Greater Manchester run by NHS doctors and nurses using Skype to help older people get faster care has reduced avoidable ambulance call-outs and helped people stay out of hospital.


In the last two years, they have prevented 3,000 avoidable visits to A&E and freed up 2,000 GP appointments by solving problems via Skype, meaning elderly people get the right support in their own home, avoiding the disruption and in some cases distress of an emergency hospital trip.


Working together and with patients, carers and local groups, health leaders in the area have developed:


  • The digital health and community response teams helping avoid unnecessary admissions.
  • The ‘Extensivist team’ – GPs and clinicians working closely with high need patients reducing A&E attendance by 58% within the cohort of patients that the team sees.
  • A £1.3m funding boost to the voluntary sector to provide 2,500 social prescribing referrals a year.
  • Home First, led by their Integrated Urgent Care Team seven days a week to help people get home in a timely way once medically fit.


The scheme is part of a programme of integrated services being rolled-out across the country as part of the NHS Long Term Plan, with smart use of technology enabling quicker, more personal care delivered as efficiently as possible.


Prof Stephen Powis, NHS England Medical Director, said:


“Putting every person’s individual care needs at the centre of joined-up services, supported by smart technology, is the heart of our Long Term Plan for the NHS. What matters most to every patient and their family is that they get the right treatment, at the right time, so integrating services – across communities and between councils, carers and hospitals – is not only good for the people we care for but a more efficient use of NHS resources.”


Peter Grace, a registered nurse who works taking calls in the digital centre, said:


“By setting up a direct link between services and the doctors and nurses at the hospital’s digital health team, we were able to offer guidance, advice and reassurance as well as being able to see the patient on Skype. Extending this to housing wardens, working with the council, has taken the project to the next level as now we can also help with issues in sheltered accommodation such as falls.”


Steven Pleasant MBE, Chief Executive of Tameside Metropolitan Borough Council and Accountable Officer for NHS Tameside and Glossop Clinical Commissioning Group (CCG), said:


“One of the most important changes to how we operate in the Tameside integrated care system is that we can risk share. We can move money round to support other organisations make savings around areas like prescribing and free up investment for preventative care. But it’s our culture that has changed – it’s about working as one team with no emphasis on the organisation you’re employed by – and empowering the workforce with permission to innovate. We’re totally open to change and with the back-up of an extensive leadership training programme we’re striving to develop the next generation of leaders from every level all the organisations.”


Trish Cavanagh, Chief Operating Officer at Tameside and Glossop Integrated Care NHS Foundation Trust, said:


“The strategic plans we have developed are aimed at improving access to care for people and looking to provide care in more innovative ways – including using technology to support this. In some circumstances, this reduces the need for people to attend the hospital but they are still able to access expert advice in a timely manner.”


Jon Rouse, Chief Officer of the Greater Manchester Health and Social Care Partnership, said:


“Tameside’s pioneering work is an example of what happens when you bring together teams from the NHS, local authorities and care home providers and give them the freedom and resources to develop new ways of doing things. Greater Manchester has a long history of collaboration between the 10 council areas. It is that focus on working across organisational boundaries to best serve the needs of ordinary people that will help them to live independently as long as possible and receive care when they need it.”