Chief Executive’s blog: August 2020
Chief Executive’s blog: August 2020
August 28, 2020
“There is an ongoing tension between keeping custom and managing costs”
By Chief Executive Simon Dukes
Thank you to everyone who has emailed me about my comments the other week on ‘free services’ – those services carried out by community pharmacies up and down the country which are outside the Community Pharmacy Contractual Framework (CPCF), Terms of Service and any locally commissioned services. Services that are not funded.
Like all parts of the frontline NHS, community pharmacies are staffed by people who care about their patients: clinicians, health professionals, practitioners and assistants. People who serve their communities. Unlike the NHS however, community pharmacies and their staff do not get paid just for their time. They are businesses which have to run on business lines: they survive or fall on the strength of their bottom line. That means there is an ongoing tension between cultivating and keeping ‘footfall’ and ‘custom’ by going above and beyond what might be expected on behalf of patients – and managing costs. Overlay that with a volume-based funding model and a patient care-focused outlook and we have an issue which the sector has struggled with for years: MDS, free delivery, blood pressure measurements and much more.
I would never tell contractors how to run their businesses, but in a sector that is so diverse as ours we do need to think about where to draw the line. Of course these services have value: to the patient, to other parts of primary care, to the local community. But they seem to have no worth for our principal customer – NHS England and NHS Improvement (NHSE&I). We perhaps should look instead to our patients, local authorities and primary care networks to see what worth they would put on these services – otherwise we need to think very carefully about whether we can genuinely afford to continue to supply them.
This topic may well emerge at the forthcoming LPC Conference on 16th September. There will be a very different feel to this year’s event which 12 months ago was held at the Congress Centre in central London. Not just because it will held be online this year, but also because we are weaving-in some of the principles from the recent Independent Review of Contractor Representation and Support (‘The Wright Review’). The agenda is being overseen by a joint LPC and PSNC working group, and in addition to current key topics such as GP referrals to the Community Pharmacist Consultation Service, flu vaccinations, and the Discharge Medicines Service – LPCs will have the opportunity to propose topics and priorities to PSNC for the year ahead. The Wright Review and our experiences of the past six months have demonstrated the benefits of LPCs and PSNC working closer together and we need to make sure we build on those…
The Conference will also spend some time discussing the next steps for the Wright Review. I note that colleagues in the CCA, AIMP and NPA have all released statements in answer to the four questions I posed earlier this month. PSNC will do so shortly. As Professor Wright was keen to point out at the start of this process, we need a solution that works for the sector as a whole. He was very careful to ensure all parts of the sector had the opportunity to input into the initial review, and we must do the same as we move forward. I look forward to seeing the collated response from LPCs, contractors, trade bodies and PSNC which David Wright’s colleague, Associate Professor Michael Twigg, is overseeing.
I would like to draw your attention to our recently published priorities and negotiations actions list. As you know, much of what PSNC does is necessarily behind closed doors, but that does not mean we can’t be more transparent about some of the topics we are discussing with the Department of Health and Social Care (DHSC) and NHSE&I. I hope it will also give you some assurance that we are continuing to press (hard!) on a number of key issues on behalf of all community pharmacy contractors in England. In particular, I would like to flag recent conversations with DHSC on funding (with regard to the overall Contractual Framework sum, as well as COVID-19 costs), and a number of discussions on topics such as funding protection for pharmacies that have to close due to the coronavirus and emergency local supply service provision. As always, we will communicate the outcomes of these discussions as soon as we possibly can.
Finally, as I write, we have yet to finalise the service documentation for the Flu Vaccination Advanced Service with NHSE&I. This is particularly frustrating given the Government’s emphasis on the importance of flu vaccinations this year. We have already outlined some new flexible approaches that we have been pushing for and, hopefully, we will be able to confirm these shortly. Keep an eye on our website and make sure you’re signed up to our email newsletters (psnc.org.uk/enews) for updates.