FUNDING


AS thE fINDINgS of thE coSt of SERVIcES INQUIRY (coSI) ARE fINAllY RElEASED, wE tAKE A looK At thE BAcKgRoUND to coSI AND ASK…


WHERE NOW FOR COMMUNITY PHARMACY?


By Debbie Orme S


even years ago, I wrote an article about the dire straits in which community pharmacy


found itself.


we were, you may recall, in between Judicial Reviews, the then health minister, Edwin poots, was contemplating closing 100 of Northern Ireland’s community pharmacies, and pharmacists across the province were reeling under dispensing fee cuts and the effects of category m.


fast forward seven years and community pharmacy has gone from dire straits to what could possibly be termed ‘no man’s land’. At least then we hAD a health minister…albeit a not very productive or proactive one. (let’s face it, a saving of £1.8 million in closing 100 pharmacies is nothing when you consider that £15 million could be saved in wastage and another £30 million in switching from branded medicines to generic!)


category m is still in full swing and contractors are still struggling without an NI Drug tariff, forced instead to operate with the English model and all of the delays and difficulties that that entails.


6 - phARmAcY IN focUS


to put it simply, while Scottish contractors are increasingly being moved to centre stage in the provision of an rapidly expanding portfolio of clinical services (funded of course!), NI’s community pharmacists are left contemplating which range of handbags, scarves or lipsticks they should be stocking. the province’s community pharmacy isn’t so much treading water as sinking deeper into increasingly murky waters.


one ray of light came in february 2015, when the Department of health (Doh) commissioned pricewaterhousecoopers llp (pwc) to undertake a cost of services investigation (coSI) of community pharmacy services in NI. this was in response to the Department of health’s assertion that the cost of providing pharmacy services in NI was in the region of £90 million.


from the outset, contractors across the province doubted this figure and hoped that coSI would finally prove to the powers that be that community pharmacy provided a


As in 2011, a firmly-established contract remains on most people’s ‘wish list’ – (and may have featured prominently on quite a few letters to Santa last month).


service that was both valuable to the community AND cost effective for the government. As it turns out, they may have been proven correct...


BAcKgRoUND to coSI when it was first announced at the beginning of 2015, the overall aim of coSI was to ascertain and report the total costs of providing community pharmacy services in NI for the fiscal year 2011/12.


During that year, there were 535 community pharmacies operating in NI, controlled by a range of owners from independent contractors to large multiples.


contractors across NI were asked to complete three information returns via an online tool.


In total, completed branch returns were received for 77 per cent of pharmacies in NI.


mAJoR fINDINgS Based on the agreed coSI methodology, the total cost of providing community pharmacy services has been estimated to be £183.3 million or £189.0 million in NI during the years 2011/12: a figure which consists of both operating costs and capital costs.


the operating costs were split into five components, including: • Staff payroll costs • property costs • other branch costs • head office • owner payroll costs


Among coSI’s main findings: • Branches belonging to the multiples accounted for 58 per cent or 61 per cent (depending on the fair return method used) of the overall total cost, compared to 33 per cent or 30 per cent for branches belonging to independent contractors and nine per cent for branches belonging to small chains.


• total branch costs (including staff, property and other branch costs) were £128.7 million. owner costs totalled £9.0 million and head office costs were £20.7 million.


• the average health and social care cost for a branch operating in an urban location was 33 per cent higher than for a branch operating in a rural location, which reflects the greater share of multiple branches in urban locations.


• total staff payroll costs for all community pharmacy branches in Northern Ireland were estimated to


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