The Pharmaceutical Services Negotiating Committee is hitting the road to give contractors in England an opportunity to learn more about the new national community pharmacy contractual framework, and the trade offs in five years of guaranteed, but flat funding. But it’s worth remembering that no change exists in a vacuum.
The PSNC operates at the national level, yet the NHS, community pharmacy’s prime source of revenue and purpose, is increasingly structured and managed locally. As contractors learn more about the Community Pharmacist Consultation Service and the new Pharmacy Quality Scheme over the next few weeks, they also need to have an eye on what’s happening in primary care closer to home.
Every pharmacy in the country is now located within a primary care network area. Over the next year, PCNs will recruit neighbourhood teams, including pharmacists, and they will begin to deliver enhanced services. It is expected that, over time, community pharmacies in each locality covered by a PCN will work together and be integrated into it, and community pharmacies will be expected to work more closely to deliver local population health improvement with their eight to a dozen closest competitors.
This represents a huge challenge to the existing structures supporting community pharmacies. They risk being overwhelmed by the scale of the potential engagement tasks facing them over the coming year. Some local leaders have already appointed champions or PCN leads to start the process. But this will stretch local pharmaceutical committee resources at a time when contractors will already be looking locally for support with new patient services which are real game changers and for some, vital to their survival.
I fear that as PCNs emerge and network contracts for integrated care services take off, the task of pharmacy’s representative bodies is going to be made harder by the structure of pharmacy representation. PSNC draws its funding from LPCs and provides some support to help them function effectively. But it is not a formal structured hierarchy. LPCs are not accountable to PSNC, and PSNC can only ‘encourage’ them to do the right thing. The PSNC is hosting an LPC Conference on 25 September and facing into the new local dynamic is on the agenda. But it’ll take more than a one day meeting.
In medicine and optometry, the national representative and negotiating machinery has formal links to local representative bodies. The BMA’s General Practitioners Committee – a UK-wide body – includes eight members who specifically represent local medical committee interests. The Local Optical Committee Support Unit (LOCSU) goes further. It was established by the national optical bodies specifically to support local optical committee engagement – it has four dedicated LOC representatives on its board of 12.
The PSNC constitution enshrines the rights of different contractor groups to be represented around the table: national multiples, regional groups and independents. As PCNs create another contractor grouping, perhaps it’s time for a new deal for LPCs. I’m not saying the PSNC or its LPC implementation and support subcommittee are not doing a good job – after all, some of the members are LPC members too. But they might do a better one if the LPCs they are supporting were part of the conversation in their own right.