The monthly target for the number of Pharmacy First clinical pathway consultations needed to trigger the £1,000 activity payment will be frozen at 20 for the rest of this year, NHS England announced earlier today at a talk in which it acknowledged the ‘clear message’ it has received from the sector regarding its acute funding struggles.

Speaking at the Pharmacy Show in Birmingham this morning, NHSE director for pharmacy Ali Sparke revealed that for November and December the target of 20 consultations per month will remain in place, rising to 25 per month in January and February 2025 and 30 per month from March 2025.

“We made a decision to revise those [targets],” said Mr Sparke, explaining that Community Pharmacy England had been “really clear about the importance of making some of these changes” and that NHSE recognised the “levels of pain” felt by many businesses.

He commented on NHSE’s repeated decisions to adjust these targets downwards in response to feedback from contractors, saying: ‘it’s always fair to say we always knew we would be learning from what happened. We haven’t had a service launch like this at all in the last few years, everything [before Pharmacy First] has been done within the fixed [funding] envelope.”

The lower targets are a “big departure” from the original plans to raise the payment threshold to 30 from October 2024, Mr Sparke commented.

Mr Sparke also addressed concerns raised by audience member and National Pharmacy Association integration lead Michael Lennox, who said that although NHSE is helping to bring about a “golden age” of pharmacy practice through its professional development agenda, the current contract is “literally killing us” before those ambitions can be realised.

Mr Sparke replied: “We don’t want to underplay the challenges you’re describing. It’s really clear we need to stabilise what we have right now before we distract ourselves with lots of shiny new things. That message has been heard and given very clearly.”

He said that while NHSE is determined that pharmacies should “deliver on some of the ambition that has been set out by Government… we need to make sure the funding supports that level of ambition”.

Commenting on the difficulties faced by pharmacies in some parts of the country to persuade GP surgeries to refer into the Pharmacy First pathways, Mr Sparke said: “We’re not naïve about the challenges. We’re spending a lot of time on GP engagement and recognise that there are a couple of pharmacies who have absolutely brilliant relationships with general practice… [but] we know that’s not the case everywhere.”

He said NHSE is “doing a lot of work” with regional bodies “to support those relationships,” adding: “There’s often no substitute for clinical trust between teams.”

The freeze of the Pharmacy First thresholds was broadly welcomed by the community pharmacy sector.