The Pharmaceutical Journal
Vol 280 No 7499 p495
26 April 2008

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News summary

IPF calls for radical restructuring of community pharmacy contract

Radical restructuring of the community pharmacy contract in England is required to translate the White Paper proposals (PJ, 12 April 2008, p423) into action, according to the Independent Pharmacy Federation.

The IPF advocates a capitation system, underpinned by a pharmacy quality and outcomes framework, rather than an item of service approach for remuneration of services such as a national minor ailment scheme.

“A capitation approach can reflect both volume and quality relationships, be introduced in stages and provide for contractors the significant advantages of stability and security. Also, through adopting registration facilitated by online support services, a closer relationship with patients and earlier payment of fees become possible,” it says. This approach, it believes, would ensure equity of access and provide stability in funding.

Future funding will need to be commensurate with the work that contractors will be expected to do, the IPF says. However, it appreciates that funding streams will not be immediately available for the work involved in the transition period following the White Paper and resulting legislation.

Concerns about the proposed shift of dispensing funds into new clinical services are also raised in the IPF’s response to the White Paper. “Additional clinical services, however desirable and effective, will escalate costs and require extra resource input needing appropriate mechanisms and levels of funding. IPF has already demonstrated that savings can be made through patient-focused services, but we are not suggesting that they are cost neutral in the short to medium term,” it says.

The IPF would be disappointed to see the new initiatives fail because extra funding was not available, it adds.

The IPF believes that the White Paper focuses on five main areas, which it suggests can be taken forward relatively quickly and marketed to NHS stakeholders, patients and the public in a straightforward and understandable way. These are:

• Core dispensing service and future enhancements
• Minor ailment scheme
• Long-term conditions and their management
• Public health screening and education
• Support to develop and enhance services

The IPF pledges to work in partnership with the Government to speed implementation of the White Paper proposals and to advocate contractual arrangements that will inspire change on a stable foundation.