1. “Promoting the interests of Dispensing Doctors and the excellence of doctor dispensing for the benefit of patients”

2. Conference 2010 • Pharmaceutical needs assessments (PNA) • Control of entry • Dispensing fee • Cat M • Cost Of Service Inquiry (COSI) • Shortages • White Paper • Scotland • Wales • Lobbying • The year ahead

3. Pharmaceutical Needs Assessment • Should all be out for consultation • Need to check accuracy • 1983 regulations and controlled areas

4. Control of entry • Changing (for pharmacy) from April 2011 • Little or no change dispensing doctors • Pharmacy entry will be based on the PNA • Necessary or desirable(expedient)

5. Dispensing fee • Based on fixed size envelope • Split 40/60 pay/ expenses • Pay 0% (based on DDRB award) • Expenses increased by volume • Envelope up by about 2.2% • Volume up by 2.975 % • Thus fee per item down by 0.5%

6. Pay [not sure you need this slide] 2010/11  The agreed changes for 2010/11 are outlined below and are effective from 1 October 2010: the dispensing envelope is £168.7 million - the agreed fee scales for 2010/11 were calculated to deliver this amount the average volume increase of fees is 2.975 per cent changes to each of the bandings in the fee scales and a 0.5 per cent reduction to each fee, so the new fees will deliver the remaining fee envelope if the financial envelope is exceeded or under spent by one per cent, GPC and the NHS Employers GPC will discuss the reasons why and, depending on the reasons, this may lead to an alteration in that year’s payments

7. Cat M • Pharmacy mechanism for control of purchase profit • Decrease Oct/ Jan/ April • £60million/ £60 million and £20 million falls • No discussion with us or GPC before it was implemented • Average loss of £8000 per practice

8. COSI • Has reported • Use in discussions about the dispensing fee • Published in 2011

9. Shortages • On going • No solution • BAPW looking at 24 hour standard for delivery

10. Reimbursement • Reimbursement should meet cost of drug plus small profit • Doing the correct thing for the patient should be rewarded

11. Scotland • Review of Scottish Control of Entry • Major effort on lobbying • Will now be an LMC member on the group that makes the decision • Scottish government think that everyone should use a pharmacy

12. Wales • Lots of applications

13. White paper Provide integrated medical and pharmaceutical care for all rural patients not just some. Provide a stable national framework for dispensing in rural areas, underpinned by local decision making which facilitates novel service design and partnership, working to give patients convenient access to high quality pharmaceutical services. Facilitate greater local partnership working with pharmacy and other local partners through Health and Wellbeing Boards to drive better outcomes in rural public health. Implementing the White Paper: harness the expertise of dispensing doctors in fulfilling a dual clinical and procurement role to support the DH, and local commissioners in securing high quality goods and services, cost effectively. Ensure there is a fair reimbursement system for dispensing practices. Recognise that the income from dispensaries is reinvested to add value to the rural health system by assuring patient access to essential primary care services.

14. The White Paper • The DDA are happy to compete with pharmacies in the provision of medicine in rural areas under the notion of ‘any willing provider’ indicated in the White Paper. However, this competition should be on a level playing field. • DD believe that patients will choose their services in a scenario of open competition – the 2008 patient survey showed that 89% of patients wanted the choice to receive their medicines from their doctor.

15. White paper • Dispensing services centrally commissioned • Questions about rural funding • No more answers coming out.

16. Lobbying • Party conferences • Meeting MPs • MSPs • Pharmaceutical companies • Wholesalers

17. 2011 • Try to make the DOH think about dispensing doctor issues in a positive way • Campaign on reimbursement • Involvement with PNA regulations • Help with cost enquiry • Help practices with regulatory issues • Work with others to keep dispensing profitable

18. Actions The DDA needs information with evidenceon: • Cost pressures • Practices reducing services because of reducing dispensing income • Supply problems • How PNAs are working and what involvement you are having

19. “Promoting the interests of Dispensing Doctors and the excellence of doctor dispensing for the benefit of patients”