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Opinion: After-effects of the pharmacy cuts

21 February 2017

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Practice managers could benefit from tapping into the opportunities on offer in their local pharmacies, argues Steve Williams

General practices and pharmacies operate under separate contracts. Both organisations are independent contractors who hold a contract with the NHS. However, both types of organisations can benefit by mutual working relationships. This is why some pharmacies undertake medication reviews and offer some basic consultations. Conversely, some practices dispense or have a pharmacy on site or nearby.

Historically, both general practice and pharmacy have developed side by side and the unique contractor status means that they will at times be competing for the same patient market.

General practice has faced cuts before and the Royal College of General Practitioners (RCGP) predicted that it could lose £33 million in this financial year alone and a further £760 million by the year 2020.1 Practice managers need to concentrate on how these cuts could affect their business.

In comparison, the 6% fall in overall pharmacy funding represents an average funding drop of more than £14,500 for every pharmacy in England. It is understandable that pharmacists are saying that this will have an effect on their day-to-day business, but if a general practice finds that it must do more work, then it needs to establish whether this falls under the standard contract or if it is additional work for which funding could be claimed.

Ironically, at the time of writing, NHS England is involved in a pilot project that aims to create 400 clinical roles to work within general practice. This pilot is expected to test the role of clinical pharmacists working in general practice over a three-year time span.2 This initiative is supported by both the RCGP and the Royal Pharmaceutical Society.

General practice has been identified in the Five-Year Forward View and, in particular, the General Practice Forward View, is expecting a renewed investment. This includes the above role and a variety of other initiatives. How and when this investment actually reaches the front line might be a more pertinent question to ask.

Practice managers can only work with the resources that they have. If another organisation faces cuts or reduced income, then while they need to be aware of what is happening to local services, they can only concentrate on their own organisation. Indeed, perhaps it would be more sensible to look at what opportunities are being created and how they might be able to tap into these.

The argument has always been that more services can or could be provided in a community setting rather than in secondary care. However, this will only happen if funding follows the patient and organisations such as general practices and local pharmacies receive this accordingly. 

NHS England has clearly indicated how it sees integrated services working between pharmacy and general practice. Ultimately, it is designed to generate cost savings, but the effect of implementation may be felt by both types of organisation. Practice managers need to think about what services pharmacies are looking to compete for, rather than creating a greater workload for general practice.


1. General practice loses £33m in funding (accessed 9 November 2016)

2. (accessed 9 November 2016)