The major multiples of the CCA have set the cat among the pigeons with their wish list for David Wright’s review of community pharmacy representation (see here). If they have, as rumoured, mandated their nominated representatives on LPCs to back their corporate stance to try to swing LPC feedback into the review their way too, that’s not really playing fair.
I’m sure David Wright and his team will see through this, if it does translate into a set of samey responses to the survey. In my recent experience, some of our LPC leaders have a much clearer handle on what needs to be done next to help contractors navigate what is an increasingly ‘national plus local’ world.
As the statutory bodies named in NHS legislation, LPCs are going to take some convincing that they need less money to operate, or that more of the money they raise from contractors should go to the centre, further away from where it is needed to prepare community pharmacies, independent and multiple alike, for a primary care transformation. And since the levy is topsliced from community pharmacy remuneration by the NHS Business Services Agency, NHS England and NHS Improvement might have something to say about that too.
LPCs are a patchwork quilt. Some are great, some are very good and some may be bang average. Lines of accountability could be clearer, and enhanced by better local governance, but many LPCs have been quietly transforming themselves. Better connected into the local health service, many with fully functioning provider network bodies alongside, making commissioning from community pharmacy a potential one-stop shop.
LPCs understand local in a way PSNC has never had to – three goes, at least, at provider company models, anyone? The last LPC leader to take a job in the Hosier Lane bunker left within a year to go back to frontline action where she can make more of an impact. And it doesn’t take a genius to work out that national multiples won’t relish having to deal with up to 1,000 new centres of NHS power, where local relationships could really count. But £6bn extra going into primary care can’t really be ignored, can it?
David Wright and his team will, I am sure, recognise that form should follow function. The LPC leaders who have called me for insight get it. They are gearing their teams up to respond to the local needs of their contractors. Some knew that Pharmacy Voice recommended to PSNC in 2012 that national bodies get together to better support LPCs ahead of more NHS localism – a suggestion that was ignored at the time. The last thing LPCs need is a bunfight over the existing funding they receive from contractors, or another raid on their reserves – especially if that is to fund an organisation that has proved too often to be tone deaf to the practical needs of the organisations that fund it.
One last thought. Those who want more say over what happens locally will need more than goodwill to make things happen in community pharmacies. The Wright Review team could do a lot worse than ask steering group member and Local Optical Committee Support Unit chief officer Richard Whittington about the value of having representatives of those who directly fund an organisation sitting on its governing body. No taxation without representation, as somebody once said.