New GP dispensing fee scales have been published, with decreases in payments having come in from 1 October.
This is despite the fact that on paper NHS England has uplifted the ‘profit element’ of the dispensing fee scale by 4.24% in response to the Doctors’ and Dentists’ Review Body (DDRB) recommendation.
Practices are paid for each item they dispense, with a dispensing fee calculated per doctor using a scale depending on how many items are dispensed.
The fees also differ for dispensing and non-dispensing practices.
According to the amended Statement of Financial Entitlement Directions 2023, published earlier this week and effective 1 October, dispensing GPs will be paid fees ranging from 207.4p per prescribed item for up to 464 items per month to 183.6p per item for more than 4647 items a month.
For non-dispensing practices, the fees now range from 216.1p per item for up to 464 items a month up to 192.3p per item for more than 4647 items a month.
Both represent a cut compared with fees paid from 1 April 2023. The bands at which the differing fees apply have also been changed.
However, fees will rise again in April 2024 (see box below).
The new fee scale represents an average 19.4% cut in the fee compared with April 2023, according to the Dispensing Doctors’ Association (DDA).
The new fees coming into effect in April 2024 will bring fees up by an average of 13.3%, it also said.
Chair of the DDA, and a GP partner in Suffolk, Dr Richard West said the ‘yo-yoing’ of dispensing fees has been going on for a number of years despite attempts to even it out.
He added that it can lead to a ‘feast or famine’ situation for dispensing practices and make it difficult to calculate cash flow.
Dr West explained that the annual dispensing fees envelope, the total sum available for dispensing services, is fixed for the year after negotiations between NHS England and the BMA GP Committee conclude. However, if the volume of items actually dispensed rises or falls that year adjustments then have to be applied to account for an overspend or underspend, resulting in changing fee scales.
‘For example, the increase in eligibility groups for the flu vaccine since Covid has affected the number of items dispensed,’ Dr West said.
‘And the problem is made worse because the fees envelope hasn’t been updated in line with DDRB annual inflationary GP staff pay uplifts since 2019. It is only the profit element that changes in line with the DDRB’.
The funding envelope requires urgent review, Dr West also said.
Last week the DDA urged the BMA to include an ‘expert dispensing practice representative’ in all contract negotiations to ensure they are not operating at a loss.
There are just over 948 dispensing practices in England, covering 9.28 million patients in rural areas, according to NHS Digital data.
Changes to dispensing fee scales (per item)
For dispensing GPs:
From 1 October 2023 –
Payments ranges from 207.4p for up to 464 items to 183.6p for more than 4,647 items
From 1 April 2024 –
Payments range from 235p for up to 464 items a month to 208.1p for up to 4,647 items
For non-dispensing GPs:
From 1 October 2023 –
Payments range from 216.1p for up to 464 items to 192.3p for more than 4,647 items
From 1 April 2024 –
Payments range from 244.8p for up to 464 items to 218p for more than 4,647 items
A version of this story was first published by Pulse’s sister title Management in Practice
