Last week, Community Pharmacy England announced that negotiations for the next Community Pharmacy Contractual Framework (CPCF) had finally started. Our Head of Marketing, Shelley Gibbins, explains why these negotiations cannot simply be another short-term settlement. They must address the structural funding challenges that have left community pharmacy under intense financial pressure for years.
There is no doubt that community pharmacy has evolved rapidly over the past decade with pharmacies across the country delivering more and more clinical services to relieve pressure on the wider NHS. However, the funding model underpinning the sector has not kept pace with this transformation.
Real term funding for community pharmacy has fallen significantly over the last decade, with sector leaders recently warning that funding levels are around £800 million lower in real terms compared with 2015–16. This is compounded by the fact that, at the same time, costs are continuing to rise sharply. Pharmacies faces hundreds of millions of pounds in additional operating costs, including rising business rates, staff costs and medication costs. It is therefore crucial that negotiations deliver a roadmap to recovery.
Investing in clinical services
Pharmacies are now the front door to the NHS, delivering more clinical services than ever before. Pharmacy First, the contraception service and long-term condition support means that community pharmacy has moved towards a more clinically focussed role while continuing to be dispensers of medication. This move towards clinical services has been well received by members of the public, with data from the Office of National Statistics showing that 90% of patients are satisfied with the service they receiver from their pharmacy.
If pharmacies are to continue to deliver clinical services at scale, then these services have to be properly funded and structured in a way that recognises the true cost of delivering care and a way that provides stability and predictability for contractors. If this doesn’t happen then more and more pharmacies will remain at risk of closure, reducing patient access to services close to home and putting more pressure on the pharmacies that remain.
Efficiency requires investment
In addition to better service funding, the infrastructure needed to modernise pharmacy operations must be addressed. Community pharmacy has enormous potential to become more efficient and cost-effective for the NHS. But unlocking that potential requires investment.
Both hub and spoke models of dispensing and technology and automation have the power to truly transform the way pharmacies operate. It allows pharmacies to take high volumes of dispensing out of branches so that staff have more time to deliver patient facing services. It also has the ability to improve patient safety and create significant stock savings.
However, without upfront funding these key transformation tools remain a far off dream for a lot of smaller, independent pharmacies. For ALL pharmacies to become more efficient and deliver more clinical care, they must be given the means to invest in new ways of working.
Breaking the cycle
For too long now, the community pharmacy sector has been caught in a frustrating cycle:
Breaking this cycle requires a strategic funding approach. If the Government genuinely wants community pharmacy to become a cornerstone of NHS primary care, reducing pressure on GPs and hospitals, then it must invest in the infrastructure to make this possible. That means a funding model that is truly fit for the future.
A crucial moment for the sector
The start of negotiations has been a long-time coming and it doesn’t leave a lot of the time before the start of the next financial year. Community pharmacy continues to be one of the most accessible parts of the NHS, but accessibility alone is not enough, the sector has to be sustainable. This round of negotiations is an opportunity to close the widening funding gap, effectively resource clinical services, invest in technology and modern dispensing models and build a future-ready pharmacy sector. Without this, the sector risks continuing to operate in survival mode, stuck going round in circles rather than moving forward.