The New Pharmacy Contract – CPCF 2019/20 – 2023/24

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NEL LPC Profit and loss five year predictor

The profit/loss five year predictor can be downloaded at the bottom of this page

Contract settlement and funding for 2019/2020 to 2023/24:

PSNC’s views can be found here.

https://psnc.org.uk/our-news/contractor-announcement-funding-negotiations-result-in-five-year-cpcf-deal/

Changes for 2019/20 to 2023/24

  • ‘contract sum’, will remain unchanged at £2.592 billion for 2019/20, and for subsequent years until the end of 2023/24. ¡A new NHS Community Pharmacist Consultation Service (CPCS) with a fee of £14 per consultation.  will be introduced nationally as an Advanced service in October 2019.
  • A new Pharmacy Quality Scheme will be introduced (previously the Quality Payments Scheme) under which pharmacies can earn additional payments for meeting quality criteria. Funding for the scheme will continue at £75m a year. Some elements of the former Quality Payments Scheme will become Terms of Service requirements under the Community Pharmacy Contract Framework (CPCF) from April 2020.
  • Pharmacies will receive monthly Transitional payments in the second half of 2019/20 and in 2020/21 to meet costs associated with changes such as integration into Primary Care Networks (PCNs), preparation for Serious Shortage Protocols (SSPs) and implementation of the Falsified Medicines Directive (FMD).
  • MURs & Establishment Payments  will be phased out by 2020/21.  Replaced by clinical pharmacists working in PCNs start to undertake Structured Medication Reviews.
  • The Pharmacy Access Scheme (PhAS) remains with funding of £24m a year.

Funding for 2019/20 to 2023/24

  • The £2.592bn contract sum is distributed to pharmacies through a combination of fees and retained margin.
  • The proportion of funding delivered via fees and retained margin remains unchanged in 2019/20 at £1.792bn for fees and £800m in retained margin.
  • Category M prices are recalibrated retrospectively and will increase by £15m a month from August 2019.
  • CPCS will commence in October 2019. Funding of £4m is allocated for 2019/20. A fee of £14 per consultation. A supplement of £900 will be available to pharmacies signing up to provide the service by 1st December 2019, or £600 for those signing up by 15th January 2020.
  • Transitional fees will be paid from October 2019. The level of fees will be included in the October 2019 Drug Tariff. 
CP Funding distribution: April 2018 to March 2021
2018/19 2019/20 2020/21
£ % £ % £ %
SAF 1,315 50.73 1,315 50.73 1,315 50.73
Establishment Payment £167 6.44 123 4.75 0 0
Retained Margin 800 30.86 800 30.86 800 30.86
Other Items 97 3.74 97 3.74 97 3.74
MURs 94 3.63 59 2.28 24 0.926
Pharmacy Quality Scheme 75 2.9 75 2.9 75 2.9
NMS 23 0.89 23 0.89 23 0.89
Pharmacy Access Scheme 24 0.93 24 0.93 24 0.93
CPCS 0 0 4 0.15 9 0.35
Hep C Testing Scheme 0 0 2 0.077 2 0.077
Transition payment & new Clinical services 0 0 69 2.66 223 8.6
Total Funding 2,592 2,592 2,592
MUR+ Establishment Payment 10.07% of the gross income dwindles to 0.93% in 2 years

Dispensing

£1315 + £167 = £1482m

Devaluation £167/1882 = 11.27%

£167 + £94 = £261 m

£15,000 + £11,200 = £26,200

£26,200 / £14 = 1871(or 6.2/day) intervention per year

Time to find in each single opening day:

6.2 – 1.3 /day = 5 int/day = 70 additional mins/day

New services:

Advanced services:  

  • Medicines Use Reviews (MURs),
  • the New Medicine Service (NMS),
  • Appliance Use Reviews (AURs),
  • Stoma Appliance Customisation (SAC), and
  • (CPCS) the NHS Urgent Medicine Supply Advanced Service (NUMSAS)
  • Funding for the Flu Vaccination Service comes from NHS England’s Section 7A public health budget.

Pharmacy Quality Scheme (PQS):  

  • community pharmacies that are meeting certain Gateway and Quality criteria.
  • each pharmacy could achieve a maximum of 100 points, with the minimum value of each being £64 – meaning a maximum of £6,400/year

2A-2F Fees: This refers to Part IIIA of the Drug Tariff, where a number of professional fees are described. These are payments to cover the dispensing of:

  • unlicensed medicines,
  • certain appliances,
  • oral liquid methadone,
  • Schedule 2 and 3 Controlled Drugs, and
  • expensive items.

What about VAT?

  • Smoking cessation
  • Hypertension
  • AF service
  • What are the rules about VAT and how will they affect the pharmacy fiances?
  • Will they be coming from the Global sum or from outside the global sum?

Questions relating to dispensing

  • What is the prediction for dispensing volume over the next year, and 10 years?
  • What is the impact of the prescribing mix (i.e. generics, branded generics and branded products)?
  • At what point is dispensing breaking even?
  • Loss of £15,000/year. How to recoup?
  • Impact of technology? Robotics?
  • Impact of mergers

Reduction in prescription volume

  1. reduction in prescribeable OTC medicines
  2. de-prescribing initiative and reducing unnecessary poly-pharmacy 
  3. rethinking of medicines prescribing 
  4. technology: prevention and early detection agenda 
  5. Remission of e.g diabetes and other long term conditions and  
  6. early detection and lifestyle change.
  7. social prescribing
  8. Reduction in antibiotic prescriptions

Prediction: In 2025 – compared to 2018- there would be a prescription volume decrease of 40%.

Please download using the form below. Once downloaded, the document will be available in your usual downloads folder. As the tool in an excel sheet, it will download to your computer rather than open automatically. If you have any issues, please contact nellpc@outlook.com.

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