Ninety day prescriptions are among the models being considered as part of the government’s drive to secure efficiencies from community pharmacies in England.
In a stakeholder information document, the Department states that many prescribers already prescribe 90-day repeat prescriptions where it is clinically appropriate. Where there is no clinical need for a 28-day repeat prescription, this represents inconvenience to the patient and an avoidable cost to the taxpayer. It says: “We will be looking at steps to encourage optimising prescription duration, balancing clinical need, patient safety, avoidance of medicine waste and greater convenience for patients.”
The effect of the measures on rural pharmacies has also been discussed. In a report from the All-Party Pharmacy Group, the minister is cited as saying that between 1,000-3,000 pharmacies could close, as a result of financial measures including the phased withdrawal of the establishment payment. This is worth around £25,000 per year to a pharmacy. And, when asked specifically about rural pharmacies, pharmacy minister Alistair Burt is quoted as saying: “The Pharmacy Access Scheme [funding] could apply to pharmacies after taking account of their location and local health needs”.
But, he also made clear that the government could not decide which pharmacies would close. A formula approach could have ‘hard edges’, and local decision-making may be more appropriate, he said. And, as for compensation, he added: “Pharmacies would need to decide whether they were viable in light of the change to the funding level. Multiples are likely to have more resilience. Smaller pharmacies will be ‘squeezed’ and that was a matter of concern, so the government would look at that.”
The document, which is open for consultation until February 12, also reiterates Government support for ‘hub and spoke’ dispensing across different legal entities. The minister announced that there will be consultation on changing legislation intended to allow independent pharmacies to capture the efficiencies stemming from automated dispensing and reduced stock holding, and the economies of scale in purchasing and delivery of stock to the hubs. “These efficiencies could help pharmacies lower their operating costs and enable pharmacists and their teams to provide more clinical services and to improve and support people’s health,” the minister said.
The community pharmacy funding proposal, announced in December, looks to reduce pharmacy funding by 6% to a maximum of £2.63bn in 2016/17. Explaining the reduction, the minister said: “Efficiencies can be made without compromising the quality of services or public access to them because there are more pharmacies than are necessary to maintain good patient access. Most NHS funded pharmacies qualify for a complex range of fees, regardless of the quality of service and levels of efficiency of that provider.”