A poll of independent pharmacy contractors has found that just 18 per cent believe they will hit the Pharmacy First payment threshold of 20 clinical pathway consultations this month.

The survey of “more than 100” Avicenna members, which was presented at the Avicenna conference in Heathrow on Sunday September 8, pointed to significant concerns around NHS England’s increasingly strict criteria for qualifying for the monthly £1,000 fixed payment.

A previous poll in August had found that 57 per cent did not believe they would hit the target of 15 consultations that month, said Avicenna chair Salim Jetha, who commented that the “level of confidence has dropped”.  

Asked whether Community Pharmacy England expects to see a “whole host” of contractors miss out on the monthly payment once the target rises to 30 consultations in October, CPE’s NHS services director Alastair Buxton said: “Absolutely we will”. 

Mr Buxton said that when CPE was negotiating Pharmacy First with the NHS and Government, it had presented evidence from similar services in Wales and Scotland, which have been running for a number of years, demonstrating that a target of 30 clinical pathways per month is “just not realistic”.  

However, CPE’s interlocutors have so far been unwilling to countenance any reduction in this target, he said. 

Explaining the thinking within Treasury, he said: “If you divide the £30 by the £1,000 plus the fees, you would get £15 fees; it gets you to something around the notional cost of a GP appointment.” 

Avicenna sales and purchasing director Brij Valla said that Avicenna member pharmacies in Wales where there are more than 17 clinical pathways to choose from “we never go over 25”.  

Mr Buxton said the £1,000 payments are of vital importance because the service is creating more work “which has not been funded properly”.

The negotiator has been highly critical of what it describes as NHS England’s failure to promote Pharmacy First to the public effectively. 

CPE chief Janet Morrison recently commented: “It is our strongly held view that community pharmacy has carried out its side of the bargain in launching the Pharmacy First service, but NHSE need to match that commitment through more effective advertising and ensuring that GPs refer as many patients as possible.”