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Pharmaceutical Services Negotiating Committee

Locally commissioned services

Enhanced Services IconTemplate service specifications for locally commissioned services (previously described as Enhanced Services*) have been developed using experience from locally negotiated services. LPCs and contractors are able to negotiate to provide services in accordance with these specifications where a local need for the service is determined. Alternatively LPCs, contractors or the service commissioner are free to develop their own local services in response to identified needs.

Service commissioners for local services include local authorities (including DAATs) and Clinical Commissioning Groups (CCGs).

* Enhanced pharmaceutical services can now only be commissioned by NHS England, but this does not impact on the ability of local authorities or CCGs to commission services from community pharmacies.

Template Service Specifications 

The nationally negotiated template Enhanced service specifications (developed and agreed by PSNC, the Department of Health and NHS Employers) and, where applicable, associated resources are available via the links below. An introduction to the nationally negotiated service specifications is available here.

EN1 Supervised Administration (Consumption of Prescribed Medicines)

EN2 Needle & Syringe Exchange

EN3 On Demand Availability of Specialist Drugs (Availability of Palliative Care or other Specialist Medicines)

EN4 Stop Smoking

EN5 Care Home (Support and Advice on Storage, Supply and Administration of Drugs and Appliances)

EN6 Medicines Assessment & Compliance Support

EN7 Medication Review (Full Clinical Review)

EN8 Minor Ailment Service

EN9 Out of Hours (Access to Medicines)

EN10 Supplementary Prescribing by Pharmacists

EN11 Emergency Hormonal Contraception

EN12 Seasonal Influenza Vaccination

EN13 Patient Group Directions

EN14 Chlamydia Screening & Treatment (updated April 2010)

EN15 NHS Health Check (Vascular risk assessment and management service)

The PharmOutcomes system can help community pharmacies provide services like this more effectively and make it easier for commissioners to audit and manage services

Draft Template Service Specifications

These DRAFT template Enhanced service specifications have not been nationally agreed and are not in their final version; they may be used to inform local discussions on service development.

Any queries relating to these service specifications should be directed to

Weight management (children)

Weight management (adults)

Alcohol screening and brief intervention 

Anticoagulant management

Independent Prescribing 

Sharps disposal

Emergency supply (at NHS expense)

Negotiating Enhanced Service Funding

PSNC has developed a costing toolkit and other guidance, for LPCs and service commissioners, which helps to identify the elements to be considered in pricing a service at a local level.

Pharmacists with a Special Interest (PhwSI)

The Department of Health and NHS Primary Care Contracting launched a national framework for Pharmacists with a Special Interest (PhwSI) in September 2006. 

It includes a definition, guidance on how PhwSI services can be put in place, a competency framework for PhwSIs and examples of current service models similar to PhwSI. Pharmacists will have to undergo extra competency based training beyond their core professional role, and become accredited, in order to demonstrate appropriate knowledge and skills before becoming a PhwSI.

Implementing care closer to home - providing convenient quality care for patients. A national framework for Pharmacists with Special Interests

Primary Care Commissioning information on PwSI

Community Equipment Services

Under the Transforming Community Equipment Services (TCES) programme it was proposed that accredited pharmacies could be reimbursed by the local service commissioner for dispensing ability aids and equipment against 'prescriptions'. Click on the link below for more information:

Transforming Community Equipment Services

Decommissioning of locally commissioned services

Where a pharmacy contractor is concerned about the potential for a locally commissioned service to be decommissioned, they should initially contact their LPC.

PSNC guidance for LPCs:

Healthcare financial constraints are prompting the review of many locally commissioned services with the risk that some may be considered for decommissioning. Where this is occurring in your area, it would be helpful if you could inform Melinda Mabbutt in order that PSNC is able to monitor this threat to pharmacy services from a national perspective.

If yourservice commissioner is considering decommissioning a locally commissioned service, we suggest that you consider the following:

  • Contractual terms - what does the service contract or SLA say about termination of the service? Does the service commissioner's proposal fit within the contractual terms?
  • What is the underlying reason for the decision to decommission? What can we learn from this for the future if it is a legitimate decision?
  • How are other service providers being treated by the commissioner? Is a fair and transparent approach being adopted?
  • How is pharmacy performing in relation to targets set for the service? Are the targets realistic?
  • What is the cost, including opportunity cost, of decommissioning the service? What are the possible unintended consequences that may add to costs elsewhere in the health and care system?
  • Have you or the service commissioner reviewed the service recently or undertaken a service evaluation (including assessment of patient satisfaction)? What does this data show? If it shows patient benefit, can you use this data to defend the service?
  • What is the impact on the Pharmaceutical Needs Assessment of withdrawal of the service? Could it create gaps in service?

Where you intend to fight against a decision to decommission a service, you may want to consider the following options, in addition to detailed discussions with the commissioner:

  • Discussions with the other LRCs in order to garner support for the ongoing commissioning of the service;
  • Discuss the decommissioning proposal with the Health and Wellbeing Board, presenting evidence on how the withdrawal of the service will impact on care;
  • Discuss the proposal with the local Member of Parliament;
  • Where appropriate seek support from local authority councillors, particularly the Cabinet member with responsibility for health and the members of the Overview and Scrutiny Committee covering health;
  • Where appropriate seek support from relevant patient groups and individual members of the public; and
  • Where appropriate seek support from the local media.

Where you are faced with the potential for a service to be decommissioned, please let PSNC know so we can monitor such activity at a national level and provide you with support to try to prevent decommissioning.