The DDA Podcast
The DDA has created its own series of podcasts with information and analysis of dispensing doctor matters in conversation with DDA Board Members and invited guests.
The DDA Podcast
11. DDA 2026 Conference Preview: 2
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In this episode, we put DDA Chief Executive Matthew Isom on the spot over a recent question to our DDA Best Practice Facebook group on PA and VAT. You can also find out why we might be supplying you with eggs and flour on that subject in the free breakout session at the DDA 2026 Conference (day 2).
In this episode, we also give you our CEO's thoughts on the implications for dispensing of the new PM and health team, as well as some predictions for the Budget and some important news about the dispensing fee adjustment that might even be available to be announced at the conference itself.
Referenced in this episode are:
Dr Richard West interview (GP Online)
Management in Practice article
Join the DDA Best Practice Facebook group (member only)
DDA 2026 Conference registration
MediP DDA 2026 Conference Special Podcast
Welcome to the DDA podcast. I'm Elsa Cahun, the DDA's communications officer, and today I'm speaking to the DDA CEO, Matt Isom, about our conference, which at this time of recording takes place in eight weeks at the end of September, September the 30th to October the 1st. This is our second podcast talking about the DDA 2026 conference. So far, delegate numbers are going well. We have nearly 370 delegates signed up to come across the two days and almost 40 exhibitors. So it's going to be a great show. Matthew, thank you very much for joining us today. Tell me about who's signed up and what they're all going to see.
SPEAKER_00Well, the breakout sessions are looking very good. The most popular so far are those on understanding the drug statements, surprise, surprise, MDS trays, DMD browser, and ones on the DSQS. And they're nearly full. And I'd like to thank all those people who have signed up so far and would encourage those who haven't to avoid disappointment to sign up soon. Otherwise, you might be disappointed on the day.
SPEAKER_01So our strong advice is sign up now, tell us which session you want to go to, and we'll do our very best to accommodate you. Another thing, obviously, since our previous podcast is a new Prime Minister, yet another one.
SPEAKER_00Unbelievable. Yes, yes. Mr. Andy Burnham, who is a former Secretary of State for Health in the previous Labour government, and former shadow health secretary in opposition, is our new Prime Minister. So health and indeed social care are no strangers to him. And he's got a lot of the old hands from the previous Labour government in and around number 10. So I think it's going to be quite interesting to see what happens there. Yvette Cooper, who is the new Secretary of State for Health Social Care, was previously a minister, a junior minister in the Department of Health. So there's a lot of experience coming into the department. They've not actually said a great deal about the NHS itself since he took over. It's been more, as you know, about social care. But I'm sure that as the weeks and months progress, we will be hearing more about their NHS plans. We have, of course, written to them, welcoming them to their positions, informing them if they didn't already know of dispensing doctors and the issues around rural health and care. And it was interesting, I'm sure you noticed this also. In his acceptance speech as leader of the Labour Party, Andy Burnham specifically referred to rural and coastal communities as part of the so-called left-behind areas of the country that he wants to focus on. And I took that as a very positive development, and it's one that we will be pursuing in our discussions. I would also like to mention the shadow health minister, the Conservative MP Luke Evans, who is a GP, who has been very, very helpful in recent months in raising dispensing doctors, both uh with ministers directly and in specific debates. In Wales, the new government is about to legislate to ensure that there's rural proofing of all public policy, but including health, which again I think is a very important development.
SPEAKER_01Yeah, lack of rural proofing is a drum that the DDA has has been banging for a very long time, since its inception, really. What have has the DDA been doing in that respect in terms of trying to move forward that whole rural proofing? The meningitis B program in pharmacy is perhaps an area where it looks like rural proofing didn't happen as it should?
SPEAKER_00No, it didn't. And in fact, we know for a fact that it didn't happen because we submitted a Freedom of Information Act request to NHS England and the Department for Health and Social Care. And it's really interesting. The Department of Health came back and flatly told us they didn't hold that information at all, which I think is an indictment of the Department of Health not having any rural view or ideas. NHS England, of course, who hold the currently still hold the GP contract and the dispensing doctor contract, they did respond. And they said quite flatly in their responses that they did not consider dispensing doctors at all in relation to who would be providing this vaccine, this crucial vaccination scheme. So we have been pursuing that and we will continue to pursue that. And I think that's a stick that we will be beating them with for some time to come.
SPEAKER_01And is something that Richard West, our chairman, has picked up on in an interview with GP Online. And I'll put the link and I'll put the link to that in the episode information. Obviously, we have a budget coming up in October as well, the end of towards the end of October. Any thoughts at the moment as to what this might mean for dispensing or small businesses?
SPEAKER_00I don't know, is this is the short and honest answer to your question. Given that they've been talking about small businesses needing a boost in the past and how they spectacularly failed to provide adequate compensation to dispensing practices and in DGPs generally when they increased employers' national insurance contributions in the 2024 budget. It would be nice if they could take some action to help these very important small businesses, especially since we've been talking about uh the needs of rural and coastal communities and rural proofing. I suspect they probably won't, even though we will bring it to their attention. I suspect that we might even be in for tax rises across the board. We'll have to wait and see.
SPEAKER_01And another key event in October, of course, is the dispensing fee adjustment, which historically takes place kind of on or around October the 1st, which of course is the second day of our conference. Do we have any indications of of what we might be expecting in October?
SPEAKER_00As ever, no, but and this is a crucial but this will be the first year that the DDA will have been involved in discussions around the calculations that underpin the publication of the fee scale. And under under although we will be under Chatham House rules and we mustn't, you know, speak to anybody or share any information, at least we'll for now we will be in inside the tent looking at the figures, understanding how they've been arrived at. So it may well be the case that by the time we meet in at the end of September, beginning of October, we will be in a better position to know what the answer to that question will be.
SPEAKER_01In the conference, there is a session on day one, kicking off the conference actually on Wednesday, the 30th of September at 9.30, entitled The State of Dispensing Across the Nations. And I will be in conversation with Richard West, our chairman, the chair people of Wales and Scotland as well to catch up on all things political. The dispensing field will most certainly be raised as part of that. I mean, what are the issues with the envelope and the methodology that we we hope to change?
SPEAKER_00Well, the total budget, or for the what's called the envelope, they don't call it the budget, the envelope, but Fertig has been a fixed amount of money since 2012 when the arrangements, the current arrangements, were put into place. And they were only ever meant to be temporary arrangements back then, which, as you will remember, if you can remember that far, was a period of low inflation. Well, since then, you know, inflation has gone through the roof most recently after the COVID pandemic and the Ukraine dispute. And again, it's rising and possibly may rise further as a consequence of what's going on in Iran and the Straits of Hour Moose. So basically, it needs an injection of money, is the very first thing we would expect. And it it basically is a temporary scheme that uh has uh, to all intents and purposes become fixed, and it just requires, I think, a complete route and branch examination to update it for the latter part of the 2020s and into the 2030s. I think it's a tribute to the efficiencies of dispensing practices that they've managed with this this this fixed envelope uh for so long as they have. There is a lot of catching up to do. And I think there was uh there was an article Impulse, was there not saying that I think the catch-up would be about 17.5% if if we were to sort of make things right. So that there is there is a lot to be done, and you know, it it just requires us to get around a table with people. And those freedom of information requests that I referred to earlier in our discussion, one of the other questions I asked was who is responsible for dispensing doctors and rural general practice in the Department of Health and NHS England? And the answer came there, none. There is no one individual in the whole of the civil service and the NHS management team who has sight of the issues for our practices, and that is shocking and disgusting, and it shouldn't happen, and it's one of the things I hope that we can change.
SPEAKER_01And there is also an article in Practice Management magazine as well, relating to the dispensing fee, because it is a stock reply from the Department of Health, or I should say the previous incumbents at the Department of Health, that the dispensing fee can cover every single piece of expenditure that a dispensary might have, including, and perhaps most notably the electronic prescription service, which of course is a four-figure sum to uh install and then another four-figure sum to run. So it is something that frankly we are bringing to the attention of officials, and it's something that really does need to be re-costed in.
SPEAKER_00Absolutely. And that the you know, the pharmacy contract, they were given a specific amount of money to buy their PMR system. We have never had anything approaching a similarity with with their contracts, and it's quite wrong.
SPEAKER_01Changing the subject slightly, we also have a breakout session on day two of the conference. That's Thursday, the 1st of October, at 10:15, looking at PA and VAT. Now, this is the number one topic question that gets brought up to the office and to board members for answering as part of our DDA member services. And uh it's also a very common conversation thread in the DDA member only best practice Facebook group. We recently had a question in that group, which was as a dispensing practice, can we dispense PROSTAP for a patient to be given outside of the surgery by district nurses? How does that work with claiming PA at the end of the month as we won't have administered it? So, Matthew, putting you on the spot here.
SPEAKER_00Oh my goodness.
SPEAKER_01As a non-clinician, but an expert guru in all things dispensing, can you answer it?
SPEAKER_00Well, I think I might need a PA item of an adrenaline shot or something just to just to deal with this, Elsa. Thank you very much. I think I think the short answer to your question is if you haven't already signed up to this session at the conference, I strongly recommend that you do. The answer to the question is it's classed as a PA, even if it's not technically a PA. I would draw everybody's attention to the very helpful flowchart that is on our website that was, I think, drawn up by the estimable Dr. Fiona Porter. At the top of that, it says, Does the prescription item leave the surgery in or on a patient? In this case, as it's described in the question, the answer is no. We then go to the DM and D browser. Does the item attract an administration fee? If the answer is yes, which I believe, and I'm very happy to be corrected, and you'll have to come to the session at the conference to be sure. Then the PPA classes this drug as a PA, but the HMRC does not. When you send off your prescription, the PPA will automatically give you an administration fee in lieu of VAT. You will receive both a VAT rebate and a payment in lieu of VAT from the PPA. That's two payments equivalent to the VAT being paid on the drug. So this is a win-win situation. If you believe, dear listener, that the chief executive of your organization has got that answer wrong, then I think the only thing that you can do is to keep your high dudgeon in check, but register for the session on day two at 10:15 and all will be revealed. And if I have given you the wrong answer, then you can you can egg and flower me on the stage in uh Birmingham on the 1st of October. How does that sound, Elsa?
SPEAKER_01I would I would say queue up in a polite fashion and uh excess power will be supplied. Do look at the flow chart on the on the DDA's website, and I'll put the link to that in the episode information. And do come along to that PA and VAT session because I can guarantee there will be a discussion on all the nuances and all the possibilities and all the all the things that can happen with regards to PA and VAT. And hopefully, DDA chairman Dr. Richard West is taking that session and he'll be able to answer all of your questions. And I would also urge all those DDA members who are listening to this podcast, if you're not already, please do visit the Facebook page where the DDA Facebook page where you'll find the link to the best practice group. It's a Facebook group, so you can search for previous answers. There's 860, almost 860 members in that group. So you're bound to find somebody who can help you answer that question. So there's really just one thing to say about the conference, which is not only do you get this wonderful conference education program, the opportunity to ask all your questions, there's an opportunity to sit down and have quiet one-to-ones with the DDA board members. There'll be a seat with a banner right next to the DDA stand, and it'll be manned throughout the show. You won't be able to miss the board member that's on duty. No appointment needed. Just go and ask that board member the question that you want to have answers. Another thing is the exhibition. 40 exhibitors going to be there, covering the whole range of dispensary needs, support services, etc., etc. And as you'll know, if you listen to our Medi P conference special podcast, DDA special offers at the show and for DDA members only. So this is a great opportunity to shop, not only for the things you think you need, but to buy the things that you definitely need for a special DDA member price. So I think that's it, Matthew.
SPEAKER_00Eight weeks indeed.
SPEAKER_01You've got eight weeks left at the time of recording to sign up for conference, book your breakout sessions, make sure you've got your place for those so that we know we can accommodate you and come and take advantage of all the show only offers. I mean, what more could you want? Great. So thank you very much, Matthew. Uh, it's been a pleasure. We will see you all at the conference on the 30th of September in Birmingham. Do come along, armed with your eggs and flour.