Agenda item

(To receive a report from Simon Evans (Health Scrutiny Officer) which provides information on how the Implementation of "Community Pharmacy in 2016/17 and Beyond:  The Final Package" is impacting on local pharmacies.  Steve Mosley (Chief Officer of the Lincolnshire Local Pharmaceutical Committee (LPC) will be in attendance for this item)

Consideration was given to a report from Simon Evans (Health Scrutiny Officer) which provided information on how the Implementation of "Community Pharmacy in 2016/17 and Beyond:  The Final Package" was impacting on local pharmacies.

Steve Mosley (Chief Officer of the Lincolnshire Local Pharmaceutical Committee) was in attendance for this item.

On 20 October 2017, the Government published Community Pharmacy in 2016/17 and Beyond:  The Final Package which set out the Government's response and decision on its consultation which closed on 26 May 2016 and to which the Health Scrutiny Committee responded on 27 April 2016.

The response from the Local Government Association; National Pharmacy Association; Royal Pharmaceutical Society; and Pharmacy Voice were also included within the report pack for the Committee's information.

The Committee had previously considered this paper and additional information from the Lincolnshire Local Pharmaceutical Committee on 20 April 2016 where it was agreed that a letter be sent to the Secretary of State for Health from the Chairman of the Committee on behalf of the Committee noting the Committee's concerns.

A response to that letter was received from the Rt Hon Alistair Burt MP, Minister of State for Community and Social Care on 10 June 2016 acknowledging the concerns of the Committee and assuring the Chairman that all correspondence had been passed to the relevant officials who were considering the consultation responses.

The Chairman wrote to the Minister of State for Community and Social Care on 21 June 2016 confirming that the Committee had been advised of the Pharmacy Access Scheme referred to in his letter of 10 June 2016.  The Chairman also requested that, in future, local authority overview and scrutiny committees be directly consulted for their views on any such potential change in funding arrangements which could impact on local health provision.  The Chairman reiterated the position that the closure of up to 30 pharmacies in Lincolnshire would constitute a substantial variation in health service provision within the County and would strongly urge the Department of Health to make sure that the Pharmacy Access Scheme ensured that rural areas were not left without community pharmacies.

The announcement by the Secretary of State for Health calling for GPs to open seven days per week would have detrimental impact on pharmacies.  Pharmacies were able to play a key role in making the NHS more efficient and a competitive buying market had driven down medicine prices for the NHS more effectively than a single model had previously. 

The level of rurality meant that this package had impacted less in Lincolnshire than in some other areas as the Pharmacy Access Scheme protected rural communities better than urban areas with high deprivation.  A key driver of healthcare need was demand.  For example, a large GP practice and two pharmacies within 100 yards of each other within Lincoln was due to patient demand rather than commercially driven.

Two judicial reviews were ongoing against the decision of the Department of Health.

Members were invited to ask questions, during which the following points were noted:-

·       There was little which could be done at present as the impact of the scheme and the way in which payment titles worked would be unknown until the summer months.  This would also be dependent on the outcome of the judicial reviews which were expected to be heard within the first week of March 2017;

·       It was anticipated that all clustered pharmacies would be severely impacted within this period.  Should independent pharmacies become unviable, NHS England had the ability to procure service provision dependent on the needs identified within the Pharmacy Needs Assessment (PNA).  Therefore, should one pharmacy close, it would be the decision of NHS England whether that provision needed to be replaced;

·       There had always been difficulties with recruiting pharmacists into Lincolnshire with varying efforts made to improve that, including the establishment of a school of pharmacy.  Lincoln University had yet to produce its first cohort of qualified pharmacists;

·       Within the STP, a lot of emphasis had been put on preventative intervention which was required to prevent hospital care.  However, patients were to be signposted to community pharmacists for this care but the impact of this package was not yet known and therefore there may not be a sufficient level of community pharmacists available to support the STP proposals by 2021;

·       Paragraph 3.28 of the document referred to four gateway criteria which pharmacies must meet to qualify for payment.  This included the ability for staff to send and receive NHS Mail.  It was explained that the pharmacies were able to request an 'NHS' email and that the deadline for this was in early February 2017.  It was now also the responsibility of individuals to check their own details on NHS Choices and ensure that they were up to date.  Pharmacies also had to offer at least one advanced service which not all were doing at present;

·       The Pharmacy Access Scheme was a complicated formula based on different metrics including isolation, car ownership, deprivation, etc., all of which applied to rural Lincolnshire;

·       Up to six advanced services could be provided by pharmacies including Medicines Use Reviews; Flue vaccination; New Medicine Service (NMS); Appliance Use Reviews (AUR); Stoma Appliance Customisation (SAC); and NHS Urgent Medicine Supply Advances Service (NUMSAS).  Flu Vaccination did not qualify for the gateway criteria;

·       On 20 October 2016, the Department of Health and NHS England announced that as part of the 2016/17 and 2017/18 community pharmacy funding settlement, money from the Pharmacy Integration Fund (PhIF) would be used to fund a national pilot of a community pharmacy NHS Urgent Medicine Supply Advanced Service (NUMSAS).  The service was being commissioned as an Advanced Service and would run from 1 December 2016 to 31 March 2018.  The Department of Health proposed that the PhIF could be used to fund a pilot scheme to test and evaluate such a service in order to inform possible future commissioning.  This pilot had been running in Lincolnshire for 15-18 months with non-recurrent funding from NHS England to support winter pressures through pharmacies who chose to do so;

·       It was confirmed that 24 of the 122 pharmacies within Lincolnshire were signed up to the Pharmacy Access Scheme.

The Chairman suggested that a letter be sent to the Minister of State for Community and Social Care reiterating the Committee's disappointment at the lack of consultation on this issue and the points previously made in relation to the document and to express concern that a service vision could be finalised without awareness of the full outcome and effects of that change.

RESOLVED

1.    That the Community Pharmacy in 2016/17 and Beyond:  The Final Package and the implementation of the impact on community pharmacies in Lincolnshire be noted; and

2.    That authority be delegated to the Chairman of the Health Scrutiny Committee for Lincolnshire to write to the Minister of State for Community and Social Care confirming the Committee's disappointment at the Community Pharmacy in 2016/17 and Beyond:  The Final Package and the absence of direct consultation with Health Scrutiny Committee's in the first instance; to reiterate the point relating to the implementation of service revision/change without knowledge of outcomes; and the lack of criteria or consideration to rurality.