Pharmacy First: Services ‘bundle’ required by March 2025 for monthly payments

Payments for Pharmacy First, the expanded Pharmacy Contraception Service and the re-launched blood pressure check service will be ‘bundled’ together by March 2025, meaning pharmacies will have to provide all three to be eligible for funding.

It was confirmed today that the highly anticipated Pharmacy First service is set to launch at the end of January, while the latest phase of the Pharmacy Contraception Service and a re-launched blood pressure check service will launch next month.

Here we unpack the funding announcements that have been made so far.

How much will pharmacies be paid for Pharmacy First?

Pharmacies that sign up to deliver the common conditions service ahead of the 31 January 2024 launch will receive an initial fixed payment of £2,000, which can be claimed from December 2023.

And from February 2024, pharmacy contractors delivering the service will receive a fixed payment of £1,000 per month, subject to delivering a minimum number of consultations.

Only consultations under the new clinical pathways will count towards the minimum number, which will increase month to month as the service progresses.

Speaking to press ahead of today’s announcement, Janet Morrison, Community Pharmacy England (CPE) chief executive, said the negotiator had worked to put ‘achievable’ thresholds in place ‘that weren’t going to frighten pharmacies about what they were expected to deliver’.

In total, funding is available to fund 12 million Pharmacy First consultations across the country per year.

From April 2024, a cap will be introduced, meaning that each contractor can be paid for up to 3,000 consultations per month.

And from 1 October 2024, the cap will be based on actual delivery of the service, with the aim of delivering three million consultations per quarter, and unused allocations can be rolled forwards to subsequent quarters.

This will be agreed jointly between CPE, NHS England (NHSE) and the Department of Health and Social Care (DHSC) and will be reviewed once the service has begun and more data on delivery is available.

Service fees for community pharmacy blood pressure checks will remain at £15 per patient receiving a clinic blood pressure check, and £45 for each appropriate provision of ambulatory blood pressure monitoring (ABPM) to a patient.

And payments for the contraception service will remain at £18 per consultation, despite pleas from the sector’s negotiator.

The expansion of these services will be funded by £75m per year allocated from the £645m additional funding promised to the sector in May.

NHSE, DHSC and NHSE said that this would mean ‘many more consultations under these services are affordable and will not put pressure on the wider contractual sum’.

Ms Morrison told press that CPE had pushed several times for the contraception service delivery fee to be increased ‘because of the activity involved with initiation’ and was ‘a bit disappointed’ that the government did not agree to this.

‘We've had a few goes at that one, and we just couldn't get an improvement,’ she said.

But she said that overall, the negotiator was ‘happy with what we got’, adding: ‘We really want to now get on behind the deal and to support business owners to make success of it.’

What does the new pharmacy services ‘bundle’ mean?

In order to qualify for the monthly Pharmacy First payments from the end of March 2025, pharmacy contractors will also need to be providing the expanded contraception service and blood pressure check threshold.

A joint letter from NHSE, DHSC and CPE sent to contractors today said that this requirement would be introduced by 31 March 2025 at the latest.

Ms Morrison told press that the idea of the ‘bundle’ was ‘very much driven by ministers wanting the public to understand what kind of pharmacy you are, and what's available there’.

‘It's very much driven by what will make sense to people in the high street in terms of going into the pharmacy,’ she added.

And she said that CPE had negotiated for this ‘bundling’ to be delayed to avoid any disincentive to pharmacies signing up and ‘to allow us to learn from the growth of the services’.

‘We hope that Pharmacy First is going to be a long running and successful service, we had to get the conditions right for that,’ Ms Morrison added.

Will the funding go far enough?

Dr Leyla Hannbeck, chief executive of the Association of Independent Multiple Pharmacies (AIMp) described the services as ‘a step in the right direction for patient care’.

But she added: ‘The success of these service will very much depend on the level of red tape and whether pharmacists’ time is compensated appropriately, because we cannot take on any more underpaid services.’

And she warned that many pharmacies were closing due to the financial pressures on their business, which could hinder patient access to the new services.

‘Unfortunately, due to years of underfunding despite the rising inflation, more and more pharmacies are closing their doors for good at a worrying pace in many areas of the country,’ she said.

‘We have highlighted to the officials that our sector has a shortfall of £1.2 billion in funding.

‘Unless this shortfall in funding is addressed by the government, more pharmacies will continue to close in the coming months, particularly in areas of high deprivation and less pharmacies will be available and accessible to deliver these valuable services for the NHS.’

And Nick Kaye, chair of the National Pharmacy Association (NPA) said that the new funding was 'not going to be enough to address the serious shortfall in core funding', adding that 'many independent pharmacies are still going to be operating at a loss'.

'The combined issues of contract reform, core funding and pharmacy closures must therefore stay on the negotiating table,' he said.

And he added that Pharmacy First would 'only work for as long as there is a vibrant network of pharmacies left to provide it'.

'Hundreds of pharmacies have been forced to close in the past year alone,' he warned.