Pharmacy association from all the countries in the PGEU survey said they had experienced medicine shortages in 2019

A report on pharmacy contractor representation and support has concluded that the Pharmaceutical Services Negotiating Committee (PSNC) and local pharmaceutical committees (LPCs) will need to overhaul their governance structures to “provide value for money for contractors”.

Released last week (June 19), the report recommends radical changes, including rebranding of PSNC and LPCs, to create what the reviewer called “a national vision and strategy for community pharmacy in England”.

The independent review, which was led by David Wright, Professor of Pharmacy Practice at the University of East Anglia, made a total of 33 recommendations to ensure that the national network structure is efficient and is fit for the future.

Create a new council

It recommended that the current PSNC committee should be replaced by a council constituted by elected LPC chairs who are either contractors or contractor representatives. The role of the council will be to discuss, debate and vote on major issues such as accepting or rejecting a negotiated contract.

The LPC council will also have the power to sign-off important decisions before they can be implemented. For example, while the levy to be paid by contractors will be proposed by a central finance team, it will go ahead only if approved by the council.

Negotiations

The recommendations also include creating a smaller negotiation strategy committee (NSC) which will be tasked with responding to day to day queries from a separate negotiating team (NT) which will be comprised of contractors and their representatives but led by the chief executive of PSNC. This was recommended because the current PSNC committee was recognised as being too large for effective working and responding to rapidly changing negotiations.

For the purposes of checks and balances and “to develop one vision and voice for community pharmacy,” creation of an independent governance and strategy board was also recommended.

“If we put that governance board correctly together, it can be a strategy board as well, Wright told the press a virtual meeting ahead of the report’s official release. He added that if “we have the right people on there, they can then help with making sure things are done at a national level.”

Smaller LPCs should merge

The recommendations also include measures to bring local and national representations closer together as well as to foster better networking with more centralised and improved systems to support the development of innovative community pharmacy services and assess their impact.

It was also suggested that that the LPCs representing fewer than 200 contractors should consider merging to ensure better value for money and each should have a maximum of ten members, focusing on representation rather than support.

For contractors, this would mean that some of the local guidance and support offerings from the LPCs would be delivered nationally, and LPC activities would likely become more standardised.

Patient voice

Another significant recommendation was to bring the patient voice into representation work as it would have a stronger impact. “There is nothing more powerful in a meeting with the NHS than the voice of a patient representative,” the report noted highlighting how the NHS operates around ‘no decision about me without me’ mantra and seeks to include the voice of the patient in all its activities.

Covid-19 experience

The report said while both PSNC and LPCs have had problems with respect to trust and listening to each other, the experience of dealing with an unprecedented crisis due to the Covid-19 pandemic clearly demonstrated the benefits of closer work between the two.

Rebranding

The report set out its recommendations by asking PSNC, in the first instance, to be renamed as Community Pharmacy England (CPE) – in the same way as the other national pharmacy negotiating bodies are called in Scotland, Wales and Northern Ireland.
The reviewers felt local pharmaceutical committees would also need to rebrand to reflect the locality they represent, following a new naming convention: ‘Community Pharmacy [followed by the name of locality the represent]’ or CP[L].

The report recommends a significant increase in funding to CPE to support the negotiation processes.

Reaction from pharmacy bodies

Mark Lyonette, chief executive of the National Pharmacy Association, said: “It’s great that Sir Simon Stevens visited an NPA member this week and publicly acknowledged the vital work of pharmacies during the COVID19 pandemic. It’s also significant that he recognised the clinical skills of community pharmacists, which is a good basis for discussions with his senior team about the future of community pharmacy within the NHS.

“This week we have seen very senior figures in the NHS and government visit pharmacies. We want this positive dialogue to continue and lead to real improvements on the ground, for pharmacies, patients and the NHS as a whole.”

Leyla Hannbeck, CEO of the Association of Independent Multiple Pharmacies, said: “AIMp welcomes the findings of the PSNC/LPC review conducted by Prof. David Wright which we commend as very thorough and detailed. Over the coming weeks we will be engaging with our members to discuss the proposals outlined in the report to plan our next steps and engage positively with the process.”

Malcolm Harrison, chief executive of the Company Chemists’ Association, said: “We fully support the overall focus of the report’s recommendations on improved governance and value for all contractors.

“The scale of the change recommended is considerable and will take time to translate into action. We need to maximise the unique opportunity this report gives the sector and to work together to deliver the changes that will benefit all contractors.

“Success will mean that all parts of our sector are fairly represented at a local and national level, and the right governance is in place to support the delivery of better value for money for contractors.”

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