Introduction

This is the response of the National Pharmacy Association (NPA) to the Government’s Implementation of the Health Act 2006 - Fees for applications to provide NHS pharmaceutical services in England – published February 2007.

The NPA represents the owners of virtually all community pharmacies in the UK. We have, in voluntary membership, virtually all pharmacy owners. The overwhelming majority of our members contract with the NHS for the provision of NHS pharmaceutical services.

Consultation Response

Do you agree the types of applications for which the proposed fees will be payable?

The key driver behind the introduction of fees to be included onto the pharmaceutical list is to prevent ‘speculative’ and / or ‘fishing’ applications – as stated in paragraph 24 of the consultation document. The introduction of fees should not be seen as an income generator for the NHS – this is supported by the fact the fees are set at a level that contribute to the actual costs of PCTs in determining applications.

Taking into account the above arguments it does seem illogical for applications for change of ownership to be levied a fee. Analysing the approximate costs of pharmacy applications in Appendix 2 of the Partial RIA, it is very unlikely that the majority of the steps listed in the table would be applicable to change of ownership applications. Therefore the NPA would like to see no fees levied for change of ownership applications. 

There are also fees proposed for minor relocations – again the NPA would like to see no fees levied for these types of applications. The rationale behind this is that again levying a fee in these cases is inconsistent with the aim of introducing charging – namely preventing ‘speculative’ and / or ‘fishing’ applications. Furthermore there may be genuine healthcare benefits in the pharmacy moving to a new location – for example, newer and / or bigger premises that may result in more innovative services.  There are of course other reasons that may necessitate the movement of a pharmacy – premises becoming unsuitable due to un-natural causes (e.g. fire, flood etc). Therefore, it is unfair to penalise pharmacies by imposing a fee for moving premises.

Do you agree the types of applications for which the proposed fees will not be payable?

The NPA is pleased that there will be no fee levied in respect of changes in services from a premises on the pharmaceutical list. Previously the DH had indicated that these types of applications may well have a fee attached to them .

The NPA is disappointed that fees are not going to be levied for doctor dispensing applications - as it is unjust that only pharmaceutical applications are being singled out. Community pharmacy continues to play an important part in the primary healthcare team – and therefore one needs to ensure that community pharmacy is being treated equally amongst all primary healthcare providers.

Do you consider the proposed fee levels fair and reasonable? If not, with which of the proposed fees do you disagree and why?

The aims of introducing fees for inclusion onto the pharmaceutical list are to prevent the following types of applications:

• Speculative bids which can be classed as ‘fishing’ expeditions. These are bids which may not be thought out adequately in terms of pharmaceutical service provision. 

• Blocking applications which have the effect of simply delaying and/or blocking other applicants.

Therefore once a fee is set one should see the numbers of the above two applications decrease. The NPA recommends that the numbers of the above applications are monitored closely. This will then dictate if in fact the introduction of fees has the desired affect of reducing speculative and / or blocking applications. If the level of the fee has to be increased to meet the above objectives – then the increases should be incremental and capped at the rate of inflation. However, it is important that the level of the fee contributes to the costs of processing the pharmaceutical application and it does not recover full costs.

The NPA is supportive of the proposed increase in fees where an applicant re-submits the same or similar information in a duplicate application within 6 months of the PCT refusing an original application.  The NPA is also pleased that this increase in fees will not be levied at applicants, who having had a previous application rejected, submit a revised application which addresses a PCT’s reasons for rejecting the original application. 

The NPA would like to reinforce its previous comments made to the consultation paper – Proposals to reform and modernise pharmaceutical services legislation in England (Gateway number: 5141) September 2005:

The NPA does not believe that contractors should be required to pay for ‘genuine applications’ which are granted on the basis of their improving the health needs of the local community however we do support charging where the application can be seen as speculative or blocking. The NPA appreciates that this differentiation in applications is difficult to monitor therefore the NPA proposes that all applications for a new contract should have a charge levied.  But where the application is subsequently successful then the charge should be refundable.

Do you have any other comments?

The NPA does not have any other significant comments to make.