Council support for under-threat community pharmacies

Elected Members of Fermanagh and Omagh District Council have been briefed by a representative of Community Pharmacies NI (CPNI) and a number of pharmacists who provide community based pharmacy services in the Fermanagh and Omagh District Council area on the significant pressures faced by community pharmacies as a result of underfunding and funding cuts.

Outlining the severity of the crisis facing the community pharmacy network, those present heard many pharmacies are facing closure as a direct result of underfunding from the Department of Health (NI).

Council Members were made aware that funding has been an issue for a considerable time and has been the subject of three judicial reviews following the implementation of a new payment mechanism introduced in 2011. The outcome of the judicial review required the Department of Health (NI) to carry out the necessary financial investigations to realise the level of funding required to provide fair and reasonable remuneration to community pharmacy contractors.

Fermanagh and Omagh District Council is very concerned that the Department has not implemented the recommendations which came out of the subsequent reports which the Department itself, had commissioned.

The representatives from community pharmacies further advised that funding cuts implemented by the Department of Health (NI) in the 2017/18 financial year removed £20m from the community pharmacy funding package at a time when further investment in the service had been highlighted through the reviews that had been carried out. The pharmacists present outlined the following measures which community pharmacies had implemented as a result of the funding cuts:

•reducing the number of staff,
•freezing salaries for existing staff resulting in the loss of more than 200 staff to newly created GP practice pharmacies leading to difficulties recruiting and retaining staff,
•reducing opening hours,
•reducing services to patients and reducing stocks of medicines, with knock on consequences and
•extending working hours.

The overwhelming sense was that the service was now at crisis point and that urgent action is required to sustain this vital community based service which people have become increasingly reliant on given the current difficulties accessing GP services at a local level.

Council Members were advised that CPNI now had serious health and safety concerns for patients and community pharmacy contractors. It was further contended that the closure of community pharmacies was now a very real possibility which would have a serious impact in both urban and especially rural areas.

To compound the problem, there is no certainty regarding the long term availability of the rural funding stream currently available for some rural pharmacies. The Council is of the view that community pharmacies urgently need a new, properly resourced funding model to be put in place which provides them with appropriate funding to make all pharmacies sustainable and removes the need for the rural funding enhancement which isn’t mainstream funding. In the interim an urgent injection of funding is required before we start to see the closure of community pharmacies.

The representatives from CPNI concluded by stating that community pharmacies should be “front and centre” of the Department’s transformation programme.  They went on to state that the role of community pharmacies should be maximised to allow early intervention with referral and signposting to GPs, healthcare professionals and other sources of community support, thereby alleviating the pressure on GP practices. The Council fully supports the CPNI position on this.

A representative from both the Department of Health and the Health and Social Care Board were present at the meeting and confirmed that measures are being considered particularly in relation to transformation funding.

The view of Fermanagh and Omagh District Council is that these measures are insufficient and lack the urgency required to address the current crisis. The Council is calling for an immediate injection of funding to meet the current needs of the service and is calling on the Department to progress a new funding contract which properly addresses the findings of the independent research commissioned by the Department but which the Department has failed to address to date.

Expressing support for community pharmacies, Council Members recommended that the Council writes to the Permanent Secretary of the Department of Health (NI) requesting that the Department takes immediate action to stabilise the local community pharmacy network, given its importance to rural communities.  Members also are asking the Permanent Secretary to instigate further talks with CPNI as the representative body and to put in place solid steps towards developing a new, appropriately funded, community pharmacy contract, with new community pharmacy-based services, as a matter of urgency. Clarification is also being sought from the Permanent Secretary as to how current proposals comply with rural proofing requirements.

Council Members recommended that the Council raises awareness of the issue and outlines its commitment to and support for community pharmacies. The Council will also seek to garner support from other Councils for this very important issue.

Speaking following the meeting, the Chairman of Fermanagh and Omagh District Council, Councillor Howard Thornton said:

“My colleagues on the Council were unanimous in their support of the role of the community pharmacy in the delivery of healthcare. Any threat to that network would have serious consequences for our residents and as a Council, we are very concerned with the current crisis facing the community pharmacy network.  At a time when we are being urged to use the services of the community pharmacist to ease the pressure on GPs, the Council finds it difficult to understand the rationale behind the underfunding and funding cuts to this service”.