Pharmacy services should also be commissioned from dispensing GPs, MPs conclude

When services are commissioned through community pharmacies, these practices should also be commissioned to deliver them where they have the skills and capacity to do so. This should be built into national programmes, particularly vaccinations and public health services, with the funding, training and support needed.

That is one of 15 conclusions made in a new report with cross party political support.

The Rural Penalty: How NHS funding formulas are disadvantaging rural and coastal areas and putting health devolution at risk concludes that recent government policy has overlooked dispensing GP practices, which it describes as “rural outposts”.

Informed by the DDA, the report highlights that dispensing practices were not even considered as providers in the recent Government-commissioned one-off MenB vaccination service for eligible young people. Dispensing Doctors Association Chief Executive Matthew Isom is quoted in the report, saying: “In remote, rural and coastal communities … the most logical place to go would be their local dispensing practice. Where the Government considers a service important enough to commission through community pharmacies, it should also commission that service through dispensing practices where local pharmacy access is limited. This should be a standard part of policy design, with the funding and support needed to deliver it.”

The report, published by political think tank Policy Exchange, also warns that the NHS framework for neighbourhood health which is built around populations fails to recognise the high travel distances and costs and limited choice which characterise rural areas.

Citing input from dispensing GPs and previous DDA Conference speakers Dr Emma Watts, in Shere (Surrey Hills), and Ed Kennedy, managing partner at Wickham Group Surgery, the report warns that one fifth of England, 116 constituencies, risk facing a “rural penalty” of lower NHS funding and less access to doctors under the NHS’s 10-Year Health Plan with funding formulas, workforce policy and the assumptions in the NHS 10-year plan around “neighbourhood health”.

To better reflect the reality of how healthcare is delivered in rural settings, the report makes 14 other recommendations including:

Implementing an additional weighting for rurality, within existing NHS budgets, for primary care services.
Introducing an ‘unavoidably small practice adjustment’ for very remote areas where closure risks would leave patients without access to care.
A mandatory new ‘local access test’ to take place before any community hospital or GP premise is closed.

In conclusion, the report says: “The credibility of the Government’s Choice Charter must be in serious doubt whilst health inequalities arising from geography remain unaddressed in policy. Expecting patients in these areas simply to go without, pay more or accept being overlooked would be a decision lacking in compassion and entirely disregarding patient choice.”

Political News Research Rurality