Will the Minister make a statement on whether pharmacists are paid more than GP practices for the delivery of the same services?
There is a significant difference between the service models of GP practices and community pharmacies, which means a direct comparison is complex.
Community pharmacies and GP practices are both engaged in the annual influenza and Covid-19 vaccination programmes. A comparison between payments for these services is possible.
Covid vaccines are commissioned through a multi-contractor Primary Care Contracted Service: Immunisation (PCCS:I) (Covid-19) with a single Item of Service (IoS) fee of £10.03. GP practices and community pharmacies are able to work collaboratively, or independently to deliver Covid vaccines under PCCS:I.
Flu vaccines are delivered through a Directed Supplementary Service (DSS) by GP practices and through the Clinical Community Pharmacy Service (CCPS) in pharmacy. The cost models for delivery vary given the differing arrangements in place with an IoS fee of £10.03 for GP delivery and £10.08 for pharmacy delivery. Both GPs and pharmacies are reimbursed for flu vaccines purchased. However, GP practices are also paid an administrative/dispensing fee, which is, on average, £2.50 per dose.
Future arrangements for procuring and delivering flu vaccination are being considered as part of the national Vaccination Transformation Programme as set out in the National Immunisation Framework. Officials are working closely with Vaccination Programme Wales (NHS Executive) and primary care partners to co-develop an effective and efficient flu delivery model fit for the future.
There are some further services pharmacies provide, such as treatment for common ailments, which are also provided by GPs as part of their unified service where a comparison cannot be made. A price or IoS fee is not attached to individual services provided as part of unified services. Instead, GPs are paid a global sum payment based on a weighted sum for every patient on their practice list. Pharmacies are paid via the Community Pharmacy Contractual Framework (CPCF) which is negotiated annually. The global sum of the CPCF is apportioned into a number of elements, one of which is clinical services.
As a result of contract reform, clinical service activity within community pharmacies is at its highest ever level, and we are actively working to increase capacity further to support better access to primary care services. Ensuring people have a choice about where to get healthcare locally and being able to visit their pharmacy for less complex and routine needs is helping to reduce pressure on GP practices.