The Pharmaceutical Services Negotiating Committee
has accepted a 3 per cent increase to the global sum, rather than face a remuneration
imposition by the Department of Health. A meeting of the committee on November
8 also agreed that professional fees and allowances should generally remain
unchanged, because rising prescription numbers would consume the 3 per cent
increase. The only exception was the annual target payment under the Essential
Small Pharmacy Scheme, which would rise by 3 per cent. Speaking at a press briefing
on November 13, Mr Wally Dove (chairman, PSNC) said that the PSNC's view was
that to increase any allowances would demand a reduction in the dispensing fee
and that this would send the wrong message about a core service at a time of
possible developments, such as the introduction of medicines management. It
was also agreed that, from December 1, the method of calculating the 100 per
cent advance payment should include an adjustment to account for recent reductions
in the prices of generic medicines which were not reflected in the reimbursement
calculation. The adjustment would be removed once September prescriptions were
fully priced. Other matters considered at the November PSNC meeting are reported
below.
Pharmacy plan
Invited and participating members of a task group created to consider the National
Health Service pharmacy plan included representatives of the Company Chemists
Association, the National Pharmaceutical Association and the Co-operative Pharmacy
Technical Panel. The Royal Pharmaceutical Society's Secretary and Registrar
had also been invited to attend. The group had considered 70 per cent of new
topics in the plan, had affirmed PSNC policy in areas where it had one and had
formulated new policy where it did not. Issues had been prioritised according
to the Government's priorities, with recognition that the Government's top priority
was out-of-hours services. Mr Dove said that local pharmaceutical committees
should focus on this. Ministers and the NHS Executive wanted pharmacy out-of-hours
services to be available at, or close to, out-of-hours medical centres. Commenting
on the impact of the pharmacy plan and the proposed local pharmaceutical services
on the current pharmacy contract, Mr Dove added: "The Government is inviting
us to tear it up and start again. I am not sure that we can. The current service
has to continue to be provided and it has to be provided by the current network.
There has got to be a gradual evolution."
Fraud
During November, anonymous inspectors from the NHS directorate of counter-fraud
services would visit pharmacies to present prescriptions for low-cost items
to find out how well point-of-dispensing checks on prescription charge exemption
were being conducted. Mr Dove said that a significant minority of contractors
were not carrying out checks properly.
Nurse prescribing
The PSNC view was that expanded nurse prescribing should be restricted to general
sale list and pharmacy medicines, which would have to be included in the Nurse
Prescribers' Formulary (PJ, November 4, p673). Medicines to be used for treating
chronic conditions should be excluded because these were largely prescription
medicines and this would make nurses into medicines managers, rather than disease
managers. Pharmacists should be involved locally in training nurse prescribers.