You know there’s good news to impart when a government minister holds a press conference on a Sunday.
And so it appeared, on first glance anyway, when pharmacy minister Stephen Kinnock joined CPE’s stoical Janet Morrison to reveal the outcome of its recent funding negotiations.
The headlines look good and I do think surpassing the £3bn mark for baseline funding of the Community Pharmacy Contractual Framework in 2025/26 is an achievement.
The write off of some £193m of medicines margin is also really important as I know it was (understandably) weighing heavy on many contractors minds.
CPE comes in for a lot of criticism (and as I say this I can hear the comments) but they have the devil’s own job walking the line between government and providers.
And because this process has taken so long to get done, remember CPE don’t determine when government is ready to talk, they’ll be back in negotiation for next year by the Autumn!
Read more: ’CPE is falling into a trap’
CPE said it was in an “almost impossible position” during these negotiations and that it “reluctantly accepted” the offer which I think speaks to the point I’ve made several times before; this negotiation is more ‘how can we make this work’ than ‘what do we need to make it work’ given public demand and the three shifts Wes Streeting wants to see.
As the minister, I have overseen the CPCF process and that’s why I didn’t rush out an opinion on what it means.
Rather like a budget, there are headlines and there are details. The increase in the single activity fee, the uplift in Pharmacy First payments and simplifications to the new medicines service – all good.
The widening of Pharmacy First (although not as wide as I’d like to have seen it), changes to the pharmacy contraception service and stop-smoking service as well as some of regulatory changes to more trust those at the front-line – also good.
Read more: Funding breakdown: Write-offs, service payments and activity fees
But the thing about working within a tightly controlled envelope, let alone one which an independent economic analysis has said falls well short, is you have very little room for growth.
My hunch is, and of course HMT made sure this was the case from the very start, which is why negotiations with CPE couldn’t start until after the budget, once you factor in what the NPA have called a “swathe of new costs” due to hit pharmacies this month, the cost to Rachel Reeves will be exactly the same.
Indeed, Stephen Kinnock was asked in that press conference where the ‘new’ money has come from, to which he said the uplift awarded to DHSC in that Autumn Budget.
As one pharmacy owner told C+D, it’s not easy to say if this is a good deal, OK deal or a bad deal as the devil is in the detail and, crucially, the implementation is over a period of time.
Read more: ’Staring down the barrel’ or a ‘positive first step’?
And those key cost pressures – staff pay, utilities, rent and business rates and of course the National Insurance rise – will both take time to show as much as they will determine which pharmacies just can’t hang on any longer.
All of this takes us to what comes next for those who are able to keep the doors open.
I sense the government’s much heralded long-term plan has now become more ‘Summer’ than ‘Spring’ but, either way, I wonder whether we can expect more for community pharmacy from that document and the Spending Review, which will come first.
The minister said he is absolutely committed to turning pharmacy around and stressed the vital role they have to play “at the heart of our 10-year plan for the future of our NHS‘.
Read more: Contract: It’s fair to say the deal agreed is simply not enough
He added that a “very important moment” will be the comprehensive spending review and said there’s “another big set of decisions that need to be made about funding for the rest of this Parliament.”
Judging by what the economic analysis said, the number of pharmacies dropping below 10,000 for the first time in 20 years and the qualified welcome that accompanied every pharmacy representative response to this new deal, there had better be more to come.
Ministers will, I know, be eager to realise their manifesto commitment to transform Pharmacy First into a ‘Community Pharmacy Prescribing Service’ and grant more pharmacists independent prescribing rights, but neither of these are a given right now, is my understanding.
If there’s not more, or DHSC aren’t successful in making the case to the treasury, the Sunday press conference might turn out not to be quite as remarkable as first thought.
Steve Brine is a consultant, podcaster and trustee, and a former MP for Winchester & chair of the Health Select Committee.