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MODERNISING NHS COMMUNITY PHARMACY IN SCOTLAND

SECTION 7: FUNDING OF PHARMACEUTICAL SERVICES

The Policy Intention

7.1 To provide Scottish Ministers with powers to designate which elements of community pharmacists’ remuneration are to be met from Boards’ unified budgets.

The Need for Change

7.2 Paragraphs 16 to 19 of Section 1 describes the arrangements for remunerating pharmacy contractors and the funding flows for doing so. Although Boards draw down their funding requirements from the centrally held ‘global sum’ on a needs basis, i.e. against priced dispensing data, they are given an annual ‘indicative allocation’ against which they should monitor spend for budgetary control purposes. In practice this achieves very little effect as Boards currently have no direct control in planning and securing the configuration and range of services relative to their perception of patients’ needs.

7.3 However, as detailed in Section 3, it is proposed to make Boards responsible for planning and securing pharmaceutical care services and, therefore, there is a need to provide them with the financial flexibility to deliver and manage those plans.

The Proposals

7.4 It is proposed that Scottish Ministers are given powers to determine those elements of the ‘global sum’ that are to be allocated to Boards as part of their individual Unified Budgets (see 1.16).

7.5 The intention is that all elements of the global sum, i.e. covering the Core Services outlined at Section 2.4, would be allocated to Boards but as indicated above it would be open to Ministers to limit the allocation to selected or designated services. Until such time as the New Contract arrangements are settled it is not possible to suggest the circumstances in which limited allocations might be necessary.

7.6 Resources would be allocated to Boards on a needs based formula using the same principles employed in the National Review of Resource Allocation for the NHS in Scotland.

7.7 As with previous arrangements for introducing weighted capitation/needs based funding, a ‘pace of change’ policy would be adopted to ensure that any initial variations between the formula calculation and payment levels to contractors (at individual Board level) can be managed through over an appropriate period of time. It is envisaged that the pace of change will not exceed 10 years.

7.8 Boards will assume full financial responsibility and control for the national contract services (as designated) but will not be allowed to vary the remuneration terms, i.e. Boards will be required to remunerate pharmacy contractors fully in accordance with the nationally negotiated contract arrangements. However, as stated at paragraph 13 of Section 3, Boards will be able to pay additional sums where, for example, a more enhanced service is offered by the proposed provider.

Question

• Are there any other options for assisting Boards to financially manage the planning and delivery of pharmaceutical care service requirements as proposed at Section 3?

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