New NPA chief executive Paul Rees has repeated his call for a new deal and “fair treatment” for pharmacy contractors in England, saying the current funding model is “broken and cannot be repaired in its current form”.

The contractual framework needs to be ripped up and started again, he told delegates at the opening session of Sigma Pharmaceuticals' annual conference in Sun City, South Africa.

Mr Rees said that 2.5 percent of the total NHS budget should be spent immediately on community pharmacy (the share of spend is currently 1.6 per cent) and there should be a “moratorium” on clawbacks until a new contract is delivered.

Year-on-year inflation-linked increases should be made to the global sum and a new contractual framework introduced based on payments for dispensing, clinical services, deprescribing and social prescribing.

“Treat community pharmacy as a clinical service, not simply a route for squeezing cost out of the NHS,” he said.

Outlining some principles for a sustainable future for the sector, Mr Rees there should be no more dispensing at a loss and services should be built on supply.

“The contract must allow contractors to be masters of their own destiny. Current arrangements put pharmacy owners at the mercy of circumstances largely beyond their control, be it wholesale price rises or the reluctance of some GPs to refer into services such as the CPCS [part of the new Pharmacy First service].”

There should be a level playing field so that independents are not disadvantaged, while the Government must be prepared to direct more money into community pharmacy to incentivise change, he said.

“The Government must value the whole of our care, supply and service – end to end, not transaction type by transaction type. Current payments do not properly reflect the level of healthcare advice provided [by pharmacy], nor our public health value in relation to wider society.”

It is “unacceptable” that a sector that works so hard and does such vital work has had no increase in funding in 10 years and consistently fails to get the support it deserves. “Local pharmacies are the front door to health in this country,” he said.

‘Hard to be optimistic’

Community Pharmacy England chief executive, Janet Morrison, told delegates via video link that while the new Pharmacy First service helps to “build leverage and the imperative for sustainable funding”, the negotiator is not expecting any further major developments with the contractual framework for 2024/25.

“Inevitably our negotiations, which have now started, will be framed by spending review parameters, NHS demands and overall public spending pressures, as well as perceptions of ‘new money’ already in the system,” she said.

Among CPE’s “asks” in the new negotiations are:

• Additional funding to the core contract sum
• An agreed mechanism for an annual uplift to funding and fees
• A write-off of any owed money
• Margin delivery framework reform and an economic review of the medicine supply chain
• Operational changes and promised efficiencies to ease workloads, as well as further improvements to the price concessions system.

Describing the pressures and challenges facing the sector, Ms Morrison admitted it was “hard to be optimistic” about the future. The National Living Wage alone is expected to cost the sector between £150m-£195m when the latest increase takes effect from April, she said.