Asked by: Kevin Barron (Labour - Rother Valley)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, how much and proportion of pharmacy funding has been spent on (a) dispensing and (b) enhanced services in each year since 2015-16.
Answered by Steve Brine
The Government has been clear that it wants to change the focus of the health and care system onto prevention and Ministers have also set out an ambition for local pharmacies to play a stronger role in helping people stay well in the community. The Department has committed to publishing a Green Paper on prevention that will set out how these plans will be achieved in more detail. An assessment specifically focusing on the potential merits of nationally commissioning more public health services through community pharmacy has not been undertaken.
An updated list of the 1,413 pharmacies found to be eligible for the pharmacy access scheme was published in January 2018, this is publicly available and can be found at the following link:
A small proportion of the pharmacies eligible for the scheme will not receive a payment because they do not meet the payment criteria as set out in the Drug Tariff. This means their income in 2016/17 is greater than their 2015/16 income less a 1% efficiency saving, and/or their estimated income in 2017/18 and 2018/19 is greater than their 2015/16 income less a 3% efficiency saving. The number and proportion of pharmacies on the scheme in receipt of a payment, for each year that the scheme has been running, is set out in the following table.
| Total number of eligible pharmacies | Total number of pharmacies receiving zero payments | Total number of pharmacies in receipt of payment |
2016/17 | 1,402 | 47 (3%) | 1,355 (97%) |
2017/18 | 1,415[1] | 57 (4%) | 1,358 (96%) |
[1]Two additional pharmacies have been accepted on to the scheme since the publication of the updated list. This explains the difference in the figures of 1,413 and 1,415 for 2017/18.
The fees and allowances paid under the Community Pharmacy Contractual Framework (CPCF) for the provision of essential services, including dispensing, provided by community pharmacies each year from April 2015 to March 2018 are detailed in the following table, based on data provided by NHS England. The structure of fees and allowances does not allow payments just for dispensing to be isolated. These payments do not include the medicine margin that community pharmacies earn as part of the payment for essential services, which is paid through reimbursement within the drugs’ bill.
Enhanced services are locally commissioned. As such they are funded outside of the national CPCF and the Department does not hold the information sought.
Time period | Total essential services funding2 /£ | Total national CPCF funding (essential and advanced services) less medicines margin/ £ | Funding for essential services as a proportion of total national CPCF funding (essential and advanced services) less medicines margin/ % |
2015/16 | 1,881,828,149 | 2,000,000,000 | 94 |
2016/17 | 1,769,216,586 | 1,887,000,000 | 94 |
2017/18 | 1,668,141,583 | 1,792,000,000 | 93 |
2This comprises the fees and allowances paid under Part IIIA: Professional Fees (Pharmacy Contractors) and Part VIA: Payment for Essential Services (Pharmacy Contractors) of the Drug Tariff, and through the Quality Payment Scheme and Pharmacy Access Scheme. This does not include medicines margin.
Within the NHS Long Term Plan, Government has committed to expanding the number of pharmacists in Primary Care Networks. These pharmacists are well placed to work alongside the wider medical team to optimise the use of medicines, promote medicines adherence and improve the clinical and cost effectiveness of prescribed medications. Identifying and supporting patients on complex polypharmacy and those with long term conditions necessitating repeat prescriptions will form an important part of their role. Alongside this, in August 2018, NHS England, announced plans for a new pilot scheme, with investment of £1 million from the Pharmacy Integration Fund to develop system leadership within pharmacy across all settings. These pharmacy leaders will set the vision to systematically tackle medicines optimisation priorities for the local population within GP Network and Integrated Care System foot prints, further supporting medicines adherence, and in turn reducing medicines wastage.
Asked by: Kevin Barron (Labour - Rother Valley)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what steps are being taken to (a) increase medicines adherence for repeat prescriptions and (b) reduce medicines wastage from repeat prescriptions.
Answered by Steve Brine
The Government has been clear that it wants to change the focus of the health and care system onto prevention and Ministers have also set out an ambition for local pharmacies to play a stronger role in helping people stay well in the community. The Department has committed to publishing a Green Paper on prevention that will set out how these plans will be achieved in more detail. An assessment specifically focusing on the potential merits of nationally commissioning more public health services through community pharmacy has not been undertaken.
An updated list of the 1,413 pharmacies found to be eligible for the pharmacy access scheme was published in January 2018, this is publicly available and can be found at the following link:
A small proportion of the pharmacies eligible for the scheme will not receive a payment because they do not meet the payment criteria as set out in the Drug Tariff. This means their income in 2016/17 is greater than their 2015/16 income less a 1% efficiency saving, and/or their estimated income in 2017/18 and 2018/19 is greater than their 2015/16 income less a 3% efficiency saving. The number and proportion of pharmacies on the scheme in receipt of a payment, for each year that the scheme has been running, is set out in the following table.
| Total number of eligible pharmacies | Total number of pharmacies receiving zero payments | Total number of pharmacies in receipt of payment |
2016/17 | 1,402 | 47 (3%) | 1,355 (97%) |
2017/18 | 1,415[1] | 57 (4%) | 1,358 (96%) |
[1]Two additional pharmacies have been accepted on to the scheme since the publication of the updated list. This explains the difference in the figures of 1,413 and 1,415 for 2017/18.
The fees and allowances paid under the Community Pharmacy Contractual Framework (CPCF) for the provision of essential services, including dispensing, provided by community pharmacies each year from April 2015 to March 2018 are detailed in the following table, based on data provided by NHS England. The structure of fees and allowances does not allow payments just for dispensing to be isolated. These payments do not include the medicine margin that community pharmacies earn as part of the payment for essential services, which is paid through reimbursement within the drugs’ bill.
Enhanced services are locally commissioned. As such they are funded outside of the national CPCF and the Department does not hold the information sought.
Time period | Total essential services funding2 /£ | Total national CPCF funding (essential and advanced services) less medicines margin/ £ | Funding for essential services as a proportion of total national CPCF funding (essential and advanced services) less medicines margin/ % |
2015/16 | 1,881,828,149 | 2,000,000,000 | 94 |
2016/17 | 1,769,216,586 | 1,887,000,000 | 94 |
2017/18 | 1,668,141,583 | 1,792,000,000 | 93 |
2This comprises the fees and allowances paid under Part IIIA: Professional Fees (Pharmacy Contractors) and Part VIA: Payment for Essential Services (Pharmacy Contractors) of the Drug Tariff, and through the Quality Payment Scheme and Pharmacy Access Scheme. This does not include medicines margin.
Within the NHS Long Term Plan, Government has committed to expanding the number of pharmacists in Primary Care Networks. These pharmacists are well placed to work alongside the wider medical team to optimise the use of medicines, promote medicines adherence and improve the clinical and cost effectiveness of prescribed medications. Identifying and supporting patients on complex polypharmacy and those with long term conditions necessitating repeat prescriptions will form an important part of their role. Alongside this, in August 2018, NHS England, announced plans for a new pilot scheme, with investment of £1 million from the Pharmacy Integration Fund to develop system leadership within pharmacy across all settings. These pharmacy leaders will set the vision to systematically tackle medicines optimisation priorities for the local population within GP Network and Integrated Care System foot prints, further supporting medicines adherence, and in turn reducing medicines wastage.
Asked by: Kevin Barron (Labour - Rother Valley)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what steps his Department plans to take to reduce the geographical variation in access to high quality bacterial and viral diagnostic technology.
Answered by Caroline Dinenage
Public Health England (PHE) operates a number of microbiology laboratories across England which provides national coverage, regardless of geographic location, and works closely with Scotland, Wales and Northern Ireland’s devolved administrations. These laboratories complement and expand on the testing that is undertaken in a larger laboratory network operating throughout the National Health Service to provide frontline diagnostics.
PHE’s laboratories use many different diagnostic technologies, including traditional and molecular microbiological, serological and innovative genomic approaches to recognise pathogens and diagnose infections promptly. These cover infections caused by bacteria, viruses, fungi and protozoal parasites. The results of PHE laboratory testing are provided directly to the NHS to support patient management, to reduce risks of onwards transmission and to minimise threats to public health throughout England.
Asked by: Kevin Barron (Labour - Rother Valley)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what plans he has to ensure that NHS staff are appropriately trained to use new innovations in diagnostic technology.
Answered by Steve Barclay
The Cancer Workforce Plan for England, published in December 2017 by Health Education England (HEE), set out the actions needed to target additional training support for several priority professions, including diagnostic and therapeutic radiography.
There are several initiatives to prepare the healthcare workforce, through education and training, to deliver the digital future. For example, the Topol Review, led by cardiologist, geneticist, and digital medicine researcher Dr Eric Topol and facilitated by HEE, is exploring how best to enable National Health Service staff to make the most of technologies such as genetic diagnostics.
Asked by: Kevin Barron (Labour - Rother Valley)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what steps his Department is taking to increase access to pulmonary rehabilitation.
Answered by Steve Brine
Pulmonary rehabilitation is one of the most effective treatments for chronic lung disease. Respiratory care is one of the areas being considered as part of the National Health Service long-term plan currently in development and new guidelines from the National Institute for Health and Care Excellence are due to be published in December.
The Department supports the NHS to increase access to pulmonary rehabilitation and improve the quality of care for people with long-term respiratory conditions through the following actions:
- a national roll out of the RightCare programme by NHS England which directs clinical commissioning groups to offer pulmonary rehabilitation as part of an optimal pathway for COPD patients;
- the COPD best practice tariff encourages NHS providers to refer patients for pulmonary rehabilitation as a financial incentive;
- a pulmonary rehabilitation service accreditation programme run by the Royal College of Physicians.
Asked by: Kevin Barron (Labour - Rother Valley)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, with reference to the World COPD Day on 21 November 2018, what steps his Department is taking to ensure the NHS long-term plan includes an expansion of pulmonary rehabilitation services.
Answered by Steve Brine
Pulmonary rehabilitation is one of the most effective treatments for chronic lung disease. Respiratory care is one of the areas being considered as part of the National Health Service long-term plan currently in development and new guidelines from the National Institute for Health and Care Excellence are due to be published in December.
The Department supports the NHS to increase access to pulmonary rehabilitation and improve the quality of care for people with long-term respiratory conditions through the following actions:
- a national roll out of the RightCare programme by NHS England which directs clinical commissioning groups to offer pulmonary rehabilitation as part of an optimal pathway for COPD patients;
- the COPD best practice tariff encourages NHS providers to refer patients for pulmonary rehabilitation as a financial incentive;
- a pulmonary rehabilitation service accreditation programme run by the Royal College of Physicians.
Asked by: Kevin Barron (Labour - Rother Valley)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, with reference to his Department’s single departmental plan, for what reason the intention to work with Public Health England to deliver the new Tobacco Control Plan under Objective 1.1 was removed in the update of 23 May 2018.
Answered by Steve Brine
The Single Departmental Plan published on 23 May 2018 is a concise summary of the highest level objectives for the financial year 2018-19 rather than a comprehensive account of all the activities the Department is planning to undertake. The fact that a commitment or activity has not been included in the summary does not imply that there is no intention to work on it.
The Government is continuing to reduce harm caused by tobacco. Last year we published a new tobacco control plan to build on that success and on 7 June 2018 we published a delivery plan setting out actions for meeting the aims of the tobacco control plan and how progress will be monitored. A copy of the delivery plan is available at the following link:
https://www.gov.uk/government/publications/tobacco-control-plan-delivery-plan-2017-to-2022