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Community pharmacy funding deal reached in Scotland

By Scotland Correspondent

Community Pharmacy Scotland has finally reached a settlement with the Scottish Government on a two-year deal for community pharmacy funding for 2013-15, it announced yesterday (29 July 2013)..

The agreement sees an end to transitional arrangements and a move to a simpler, permanent funding model by April next year. The new package represents a 1.74 per cent uplift on the global sum.

Speaking after the completion of the negotiations, which CPS described as “lengthy and at times challenging”, CPS vice chairman James Semple said: “The board was unanimous in its view that this was the best possible deal for contractors at this time. Stability of contractor income was at the forefront of our minds throughout our discussions with the department and we were determined not to accept any deal that would have jeopardised this.”

The big changes will come in October when funding will be re-structured around four payments:

  • Establishment payment — a single flat rate payment made to all contractors
  •  Dispensing pool payment — a share of a fixed pool, determined by historic dispensing volume
  • Complex dispensing payment — a payment to reflect more complex support delivered (see below)
  • Pharmaceutical needs payment — a payment to reflect the relative pharmaceutical needs of the pharmacy’s population

The exact details of these new payments are still being defined and will be clarified in the coming months. It is currently planned that the move to the new funding model will take place in two stages. Stage one, in October 2013, will involve half of existing payments being redistributed. The process will then be completed in the second stage in April 2014.

Complex dispensing payment

In preparation for the introduction of the “complex dispensing payment”, pharmacists will have to start flagging patient care records immediately. The types of support to be flagged are: monitored dosage system required by pharmacist; monitored dosage system requested by prescriber, social services or hospital; other adherence support required; instalment dispensing requested; and special monitoring and back required. This does not include methadone or care home patients.

Asked whether this payment would represent an incentive towards providing monitored dosage systems (in light of last week’s Royal Electronicjuice guidance), Elspeth Weir, CPS head of policy and development, said: “At the moment, this is an information gathering exercise. We have not yet decided how the funding will be divided. We would encourage contractors to flag records and provide us with this information.”

Other key changes

Other key changes to remuneration and reimbursement are:

  • The chronic medication service phasing payment will be replaced by a new “operations and development payment” from October 2013. It aims to encourage participation in interventions such as the new medicines support tool but also to allow for the introduction of new services, the first of which will be around the supply of gluten free foods.
  • The efficient purchasing and prescribing programme (EPPP) will be replaced by “margin sharing arrangements” from 2013-14. This will be a development of the current EPPP arrangements to share margins achieved on medicines listed in part 7 of the Drug Tariff between contractors and health boards.
  • A one-off non-recurring “regulatory support payment” of £200 will be paid to all contractors on the pharmaceutical list on 1 July.

In terms of immediate funding arrangements (from now until October), small changes have been made to the CMS phasing payments. Details are provided in an NHS circular which outlines the entire financial package. CPS will be producing a financial framework shortly to provide further detail.

Citation: Electronicjuice DOI: 10.1211/PJ.2013.11123854

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