Local is “where the magic happens” says NPA, as pharmacy representation review enters new phase

29 Jan 2020

The National Pharmacy Association is recommending continued investment in local leadership and better accountability across the system, in light of a survey issued today (29 January) on behalf of PSNC and Local Pharmaceutical Committees.

In a statement published today, the NPA also emphasises the importance of equitable governance, to ensure that the voices both of independents and multiples are fairly represented in local and national leadership.

A key passage in the NPA statement reads:

“Local is where the magic happens; it’s where ideas are conceived, innovation is sewn and patient care is delivered. Local capacity for effective support and representation is especially important in the light of the funding that now exists (£4.6 billion) for primary care via Primary Care Networks.

The NPA highlights that the NHS has begun to move decisively in the direction of commissioning for population health needs at a local level. It follows that any monies released from LPCs consolidating should be reinvested to support local activity. This includes investing in a programme of support for the newly selected 1,259 Pharmacy Primary Care Network Leads, says the NPA.

At the same time, PSNC’s core role of negotiating the national contractual framework must be adequately resourced, as a crucial part of a coherent, end-to-end system of representation and support.

The NPA statement continues:

“There should be clear KPIs and lines of accountability throughout the system. Approximately £11.3 million of contractors’ money is spent annually by LPCs and PSNC. This is a substantial sum and there should be straightforward ways for contractors to monitor the appropriateness and effectiveness of that expenditure. We acknowledge that the total sum is considerably less than the amount spent by equivalent representative systems (notably BMA-LMCs representing medics).”

The NPA’s recommendations include:

  • Increase the capacity for local service development and implementation; the system at local level must be skilful in representation, efficient and responsive to change
  • Streamline the network of LPCs (ideally to reflect NHS structures), provided a thorough analysis shows that this would be cost-releasing, so that savings can be re-invested in local support and representation
  • Reform the PSNC mandate and accountabilities, focusing PSNC more sharply on negotiation of the national contractual framework
  • Invest in a local leadership development programme which includes PCN Pharmacy Leads; and potentially provides backfill funds to enable attendance at PCN meetings
  • Redefine what ‘good looks like’ for a contractor in terms of what they get for their levy investment into PSNC and LPC; and improving transparency and accountability in relation to its expenditure
  • Ensure that any forms of governance evenly and collectively serve all the contractor stakeholders in community pharmacy, i.e. independents and multiples
  • Pilot any changes before full-scale implementation and learn from early pathfinders
  • Consider how service development and innovation is handled by the sector. We think there could be merit in a new regionalised support structure, plus a national Community Pharmacy Service Development Unit.  Both would serve, not direct, local pharmacy representatives. This idea requires further thought and we will be taking soundings from NPA members, LPCs and other stakeholders about its desirability and feasibility

Read the Pharmacy Representation Review 2020 here in full.

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In November 2019, PSNC and the 69 LPCs in England jointly commissioned an independent national review of pharmacy representation in England, led by Professor David Wright. The review team today began a survey of LPCs and pharmacy contractors and will deliver its recommendations at the end of March.  The objectives of the review are:

  • To have an open, honest and transparent conversation about the future of pharmacy representation
  • to find models of representation that best serve contractors
  • to reduce duplication and increase efficiencies; and
  • to ensure collective resources are used in the best possible way

The NPA is urging its members to respond to the survey issued by the review team: “If the review does not lead to any changes, it will have been a missed opportunity and such an opportunity may not come again for a long time,” said a spokesperson today.

Click here to participate in the survey