Outsourcing hospital scripts to community pharmacies

[Pharmguru]

What are the benefits of this?

[Gordon Mackenzie]

Community pharmacies would have more work. Hospital pharmacies would have less. So it depends who you want to support.

[Pharmguru]

Community pharmacies would have more work. Hospital pharmacies would have less. So it depends who you want to support.

would it not be losing it out on money for hospitals though, how does it work for retail, do they cash in more?

[Gordon Mackenzie]

I am sure that retail companies would not want to take on hospital work if they did not gain a financial advantage from it and their negotiators would wish to gain some profit from it. There would probably be less work for hospital pharmacists. The NHS would surely want to have some gain also and would look to see if the work could be done at a lower cost out-sourced than keeping it in house.

[Pharmguru]

I am sure that retail companies would not want to take on hospital work if they did not gain a financial advantage from it and their negotiators would wish to gain some profit from it. There would probably be less work for hospital pharmacists. The NHS would surely want to have some gain also and would look to see if the work could be done at a lower cost out-sourced than keeping it in house.

exactly what I want to know, how is it that NHS saves money by outsourcing?

[Gordon Mackenzie]

You would need to get an economist to work it out. What would be saved in the cost of staff, redundancy costs for pharmacists and technicians not needed in the NHS, costs saved in not needing NHS buildings, revenues from sale of such buildings or conversion to other uses, revenue to be paid to the private sector for carrying out the service. Not sure if anyone has actually worked it out. Presumably the government must have done some studies.

[hibernia]

exactly what I want to know, how is it that NHS saves money by outsourcing?

The real saving in any type of outsourcing be it dispensing, cleaning, catering, laundry or whatever is that the people doing the work are no longer NHS employees. They may get paid about the same but they won't enjoy the same benefits, esp pension rights. Almost all NHS staff are unionised, much less so in the companies providing outsourced services.

[Band6]

1. It's cheaper. Hospitals pay VAT on their drugs for some reason, so having a community pharmacy dispense the meds at 20% less makes sense. The drugs we are trying to outsource are the expensive ones - imatinib, sunitinib, maybe even capecitabine if the clinical governance issues could be sorted. Thats just the oncology/haemato-oncology drugs - I daresay there are plenty more. The FP10HP's get costed back to the hospital, not the PCT. We have to be careful that we don't out-source meds that we buy in 'on contract' though, because of the large discount that the NHS regions are able to negotiate.
2. It's easier for the patient - hospitals are rubbish at dispensing out-patient prescriptions quickly. Community pharmacies are simply better at it that we are, as that's what they are set up for in the main. Patients not waiting about are happier patients. A side benefit is that we can throw more staff at in-patient and TTA dispensing.

[Asterix]

VAT on drug they bring in?

do the hospital get a fee from community for dispensing then

[Band6]

We pay VAT on the drugs that we buy in. Not sure why. As I understand the payment process (and I'm not great at this stuff), the community pharmacist gets paid as usual, but the cost of the prescription is charged to the hospital by the NHS Business Services Authority (or whatever they are called these days), not to the PCT. Which is weird when you think about it, as the hospital usually charges the PCT for these drugs anyway. Still, by it being dispensed in the community, we get to save money.