New improved rules on control of entry announced
Out-of-town shopping centres will gain exemption but town centres
will not |
New rules on control of entry to pharmacy contracts were announced this week by Health Minister Rosie Winterton.
It marks the Government’s final response to the Office of Fair
Trading’s report into control of entry and follows last year’s
proposed “balanced package of measures” (PJ, 6 September
2003, p285).
The new rules were described by Sue Sharpe, chief executive of the Pharmaceutical
Services Negotiating Committee, as a substantial improvement on last
year’s proposals. “The minister has listened to our case,
and I am sure she has worked hard to persuade her Government colleagues
to adopt this proposal,” she said. “We are very pleased that
she has been quite explicit about her determination to protect local
pharmacies. They will be essential to delivery of the new contract and
to offering better care to patients.”
The exempted categories
· Pharmacies located in shopping centres over 15,000 square metres
but only in out-of-town developments and not in town centres. A
provisional list of 124 exempted developments has been published
on the DoH website (PDF 65K)
· Pharmacies that intend to open more than 100 hours per week.
PCTs will be required to remove from their pharmaceutical list
any pharmacy granted a contract on this basis that consistently
fails to meet these opening hours
· Pharmacies set up by consortia as part of new one-stop primary
care centres. The centres must offer more than usual GP services
(eg, dentistry, optometry, podiatry or other social and community
based services), serve a substantial population of around 18,000–20,000
patients and be part of the local PCT’s strategic service
development plan
· Pharmacies that are wholly mail order or internet-based. These
pharmacies will be required to provide a fully professional service
within the provisions of the new contract |
Although the four exemptions
to control of entry proposed in the “balanced
package of measures” are to be implemented, they are now subject
to a number of amendments that should offer some protection to existing
contractors (see Panel). In addition, all exempted pharmacies will still
need to offer a full and prescribed range of services which will be determined
locally or by the DoH in the case of internet and mail order pharmacies.
The DoH suggests that apart from dispensing prescriptions these services
might include managing repeat medication, helping patients to get the
best from their medicines and promoting healthier lifestyles.
Further reform of the current system will allow primary care trusts to
invite applications from contractors, require PCTs to reach a decision
on an application within four months and require PCTs to consult on applications.
An automatic exemption on minor relocations under 500 metres will be
introduced and further applications for minor
relocations will only be allowed after a
minimum 12-month trading period. PCTs will be able to override these
rules where there is good cause. A current restriction, that prevents
minor relocations across PCT boundaries, will be removed.
The chairman of the Government’s advisory group on control of entry,
Anne Galbraith (also chairman of the Prescription Pricing Authority),
commented: “NHS PCTs will be able to take account of the benefits
that greater competition and choice for patients may bring when assessing
new applications from pharmacies. The current PCT assessment process
will be further streamlined to make it quicker, more transparent and
promote more consistent decision making.”
The Royal Pharmaceutical Society said that it would be considering the
impact of the Government’s plans and would be discussing them with
the minister at the earliest opportunity. The President, Nicholas Wood,
commented: “Throughout the long gestation of the Government’s
package of measures, we have sought reassurance that people will continue
to have access to a local community pharmacy convenient for where people
live and work and the range of health services that pharmacists provide.” He
added: “It is crucial that pharmacists continue to be accessible
to everyone.”
John D’Arcy, chief executive of the National Pharmaceutical Association,
voiced concern over the unpredictable impact of the exemptions. “What
we mustn’t have is deregulation through the back door,” he
said. “The opening of new pharmacies under the new exemptions could
serve to suck business away from existing pharmacies. If this happens,
existing pharmacies may be forced into
reducing the level of service on offer. And, in extreme cases, existing
pharmacies may be forced into closure.”
The All-Party Pharmacy Group has also noted this concern. The chairman
of the group, Howard Stoate, commented: “If [the changes] fail
to protect the services provided from local community pharmacies, we
will expect ministers to review the changes urgently.”
But John Vickers, OFT chairman, said: “We regret that the Government
has now
decided on even less liberalisation for the time being, but we look forward
to the further review of the rules in 2006.”
The Government plans to implement the reforms to control of entry in
tandem with the new pharmacy contractural framework. |
The
Pharmaceutical Journal
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