Community pharmacy could consider 'working to rule', say CPE and NPA

Community pharmacy could consider 'working to rule' under GP-style collective action, sector leaders have suggested.

Speaking at the Avicenna Heathrow conference yesterday (8 September 2024), both Community Pharmacy England (CPE) and National Pharmacy Association (NPA) leaders said that 'working to rule' and legal action against the government remained a possibility for the sector.

Since 1 August, general practice teams have begun taking collective action, which can include limiting each clinician's daily appointments and refusing to engage with unfunded pathways.

Regarding community pharmacy, Alastair Buxton, CPE's director of NHS services, told the conference yesterday: 'We are in an absolute dire state as a sector.'

While he suggested the sector was 'starting to see progress' with the new government, he emphasised the need to fix the funding crisis facing the sector.

He said that in a committee meeting this week, CPE would be considering what it would do 'if we don't get the right answers from DHSC' during community pharmacy contract negotiations.

'We need to think about all matters, all options there,' he said.

'We can look at what the GPs have done in terms of working to rule and how that could potentially work, for example.'

'Potentially, legal action could be something that could be considered as well,' he said in response to an audience suggestion.

Although he acknowledged that legal action taken by the sector previously had been unsuccessful.

And Mr Buxton suggested that rather than 'slapping [the government] with a writ' straight away, 'we need to give a little bit more time to the new government'.

'The problem we've got [over] the last few years has come from the old government. So, we do need to give the new government a chance to try and find some funding, to start to make good on their promises within the pre-negotiation period that there should be a greater use of pharmacy, but hence it needs to be funded properly,' he said.

The community pharmacy sector still does not have a contract in place for the current financial year 2024/25, but negotiations on what is expected to be a one-year interim contract are meant to resume 'soon'. 

Community pharmacy leaders have described the delay to the contract as 'frustrating' and 'ridiculous'. And contractors have said they are struggling to operate on a fixed funding deal agreed more than five years ago.

Speaking separately, Paul Rees, chief executive of the NPA, told conference delegates that the NPA was 'also thinking about issues around work to rule' and other potential actions.

'We will be thinking about that in the coming weeks, because we need to make the case very strongly,' he said.

Highlighting the NPA's upcoming day of action, Mr Rees added: 'I know from speaking to politicians that when they see a big day of action, and they see a lot of support for that day of action, in their minds, that is a unified sector taking action, and they take it a lot more seriously.'

During the conference, delegates and speakers also raised concerns about the Pharmacy First monthly thresholds, which are considered by many to be unrealistic.

Last week, CPE called for urgent support to help community pharmacies reach the rising thresholds required for the £1,000 monthly payment. The latest figures suggested that around three in 10 participating pharmacies did not meet the threshold of 10 clinical pathway consultations in May, according to analysis by The Pharmacist.