Will PCTs be able to cope?
It is impossible to say definitively that the distribution of funds under the terms of the new community pharmacy contract will benefit all contractors in England. That is not because the terms, outlined in a News feature on p637, do not seem attractive and equitable (they do) but because the distribution formulae are so complicated that it will take even the most astute businessmen and women time to work out what income they can expect.
For a start, the new payment system is very different from the current
system, so making direct comparisons will be hard. But, no doubt in the
next few weeks, as contractors get to grips with the detail they will
find where the small pots of gold lurk, and discover the areas where
the money does not flow as deeply as they may wish.
Most likely, contractors will heed the advice of the Pharmaceutical Services
Negotiating Committee and will back the new contract when they are balloted
next month. However, the warning from Barry Andrews, PSNC chairman, that
other groups will step into the breach if pharmacists reject the contract,
is not, in itself, a reason to support it. GPs rejected the first version
of the new general medical services contract offered to them and it does
not seem to have done them much harm.
More worrying, and again there is a lesson to be learnt from general
practice, is how primary care trusts will cope with implementation. Speak
to any GP colleague and he or she will have some tale of woe about how
hard the local primary care trust has found it to adjust to the new GMS
contract. Even now, seven months after the new GMS contract went “live”,
the waters are still muddy in places.
The upside of all this for pharmacy is that at least PCTs will have been
able to use the implementation of the GMS contract as a dry run. Many
aspects of the two contracts are similar and PCT executives will have
found some of the pitfalls in the GMS contract that they will be able
to avoid for pharmacists.
The downside — and it is a huge downside — is that since
PCTs will have an important role to play in both implementing and monitoring
the new contract (p8 and p9 in the PSNC guide to the new contract outline
these responsibilities), many pharmacists who have had limited contact
with their PCTs in the past will have to develop constructive relationships
quickly And, when both sides are under huge pressure, this may lead to
unexpected tensions.
It is incumbent upon the Department of Health to make sure that PCTs
are fully supported in the next few months and thereby ensure that pharmacy
becomes fully integrated into the primary care service.
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