A new contract for high street pharmacists in England and Wales is being introduced tomorrow - despite fears that it could be the death knell for the small independent chemist.
All pharmacists will be expected to provide a range of essential core services to patients under the new £1.76bn community pharmacy contract which will apply to more than 10,000 pharmacies from April 1.
Under the old contract, pharmacists who dispense fewer than 2,000 prescriptions a month currently receive a payment of up to £18,000 a year.
But under the new contract, these small pharmacists will see this annual income slashed to a maximum £3,000.
Core services which will be available at every pharmacy include dispensing medicines, arranging repeat prescriptions and providing healthy lifestyle advice.
Pharmacists will also have the chance to boost their income by offering patients a regular consultation to review their medication, which is expected to take pressure off GPs. They will have to provide a private consultation area and have undergone accredited training,
Some pharmacists will also be paid more under the new contract for providing enhanced services, which have to be agreed in consultation with their primary care trust and meet a local need.
This could include pharmacists offering health screening for diseases like diabetes and high blood pressure as well as helping with minor illnesses.
But some pharmacists are worried that the new contract penalises small independent pharmacists, particularly those in rundown inner cities, and fear they may no longer be financially viable after April 1.
Pharmacist leaders in Camden and Islington in north London predict 39 of its 109 chemists will be effected by the 2,000 prescription threshold and believe up to 1,000 could be affected in England and Wales in total.
Pharmacist David Kent, who is secretary of the local pharmaceutical committee in Camden and Islington, which represents pharmacists, said today: "These are small pharmacies not on the high street, but in secondary positions such as council estates where they are dealing mostly with the elderly, the infirm and mothers with young children.
"They know their patient population well and although they are small they are not providing any less a service than other larger pharmacies." He said unless the payment scale linked to the number of prescriptions dispensed is changed then small pharmacists will be forced out of business and patients will have to travel further for pharmacy services.
Pharmacist national negotiators said today that the contract offered pharmacists the opportunity to provide more services for patients as well as enhancing their professional status in the primary care team.
But head of services at the Pharmaceutical Services Negotiating Committee (PSNC) Alastair Buxton rejected criticism that the new contract penalised smaller pharmacies.
He said the negotiators have agreed a three-year protected payment scheme for pharmacies, which dispensed fewer than 2,000 prescriptions as well as giving them an exit payment option as well.
He said: "We do believe that the new contract does offer opportunities for pharmacies that dispense very low volumes of NHS prescriptions and PSNC will continue its work to support them."
