“PSNC is excited to launch this vision narrative because we hope that for the first time it will give community pharmacy teams a clear idea of how services could develop over the next few years in their pharmacies. Readers familiar with our plans and ongoing work may well feel that we have not said anything spectacularly new here, but that is the point – the narrative is intended to be a translation of our previously agreed vision into a picture of how the service developments that vision encapsulates could work in everyday practice.

As the narrative explains, we believe that in the reformed NHS work to develop community pharmacy services will need to continue to be done at both a national and local level, as it is now. Nationally, key focuses for PSNC are the development of pharmacy’s role in medicines optimisation and supporting independent living, such as through the continuation and evolution of the New Medicine Service, MURs and other support services. However, we are also working hard to help LPCs to work with local public health commissioners and we have already had discussions with Public Health England about how pharmacy can help to meet public health objectives at a national level.”
Alastair Buxton, Director of NHS Services, PSNC

“On PSNC’s Service Development Subcommittee we are working hard to ensure that the services we and LPCs have secured for community pharmacy in the past continue to be commissioned, and to identify new service opportunities for the sector. The subcommittee is made up of both independent contractors and representatives from multiple businesses and we all share the same objective: to develop the community pharmacy service in a way that benefits patients, the NHS and pharmacies, and that is manageable and sustainable for pharmacy contractors.

Our work has recently been complicated by the changes to key NHS organisations, and of course the current pressures on NHS budgets mean persuading commissioners to part with cash for new initiatives is extraordinarily difficult, even where we can prove that those initiatives help patients and represent good value for money.

However, I do think there is cause for optimism – community pharmacy has a huge amount to offer the reformed NHS and if our health service is to remain sustainable I believe it is going to have no choice but to accept some of that help. Our vision narrative outlines a number of ways in which we believe pharmacies could deliver that help and support the NHS as it works to tackle big problems like medicines waste and hospital admissions. We’ll be using it as a discussion point in our ongoing engagement with the new commissioners, many of whom are now starting to formulate their long-term strategies, and we’re hopeful that, given the challenges they face, they will be ready to listen to how we can help.”
Gary Warner, independent community pharmacy contractor and chair of PSNC’s Service Development Subcommittee

Q. Why has PSNC published a vision narrative?
A. In 2012 PSNC, which is made up of more than 30 independent contractors and people representing multiple contractors, agreed its vision for community pharmacy in 2016 (as outlined above). In a survey of contractors last year 98% said they agreed with this and PSNC is now working towards it by trying to develop the community pharmacy service in four key areas: medicines optimisation, minor ailments, public health and supporting people to live independently.
Although these vision statements set out at a high level what PSNC is working to achieve and both the Funding and Contract and Service Development subcommittees have set their work plans in line with it, we felt that contractors would like some idea of how services could develop in practice and what ‘service development’ might mean for them, their teams and their patients on a day to day basis.

Q. Can pharmacies feed into the vision narrative?
A. The vision narrative is not intended to set out what pharmacy services will definitely look like in the future, it instead sets out possible ways in which they could be developed to form the basis of discussions. PSNC always welcomes constructive views from contractors and others involved in pharmacy about service development and other relevant topics and contractors can feed into PSNC via their LPCs or, preferably, through their PSNC regional representatives.

Q. When will these services be implemented?
A. As the vision narrative only sets out possible ways in which community pharmacy services could be developed over the next few years it does not necessarily mean that services will be developed in exactly this way. All negotiations on new services have to take into account factors outside of PSNC’s control such as the wider funding environment, the tight financial constraints on all government spending at the moment and the needs and priorities of the new NHS commissioners.

Q. So what will the vision narrative be used for?
A. PSNC hopes that the vision narrative will give all those involved in and with community pharmacy a picture for how service provision might develop over the next few years. It has been written with practice in mind, and we hope it gives pharmacy contractors and teams a real feel for how the so-called move towards service provision might translate into their everyday practice.
The document is not a statement of intent as such because any services PSNC negotiates for the future will need to be in line with the priorities of the new NHS commissioners. However, we intend to promote the vision in the wider NHS to give other healthcare professionals and commissioners an idea of the way pharmacy services could be developed over time in a manageable and sustainable way. We will also be using the narrative as a tool to aid our ongoing discussions and negotiations on service development.

Q. What services is PSNC currently negotiating?
A. Alongside the core funding negotiations PSNC continues to work to ensure the ongoing commissioning and development of the advanced services including MURs and the NMS and we have begun discussions with Public Health England, the organisation now overseeing public health services in England. In these discussions we have highlighted the value community pharmacy can offer in areas such as minor ailments and smoking cessation and we continue to press for national services or templates in these and other public health areas. To persuade the government to commission any new services we will need to have a sound business case and be able to prove that community pharmacy can deliver value in an area that directly fits with NHS policy – as the new commissioners are still setting their plans and strategies, what exactly these areas might be is still difficult to predict.

If you have queries on PSNC’s vision narrative or you require more information please contact Alastair Buxton, Director of NHS Services.

In January 2015 PSNC and its subcommittees agreed their annual work plans in line with PSNC’s overall vision for community pharmacy. In 2015 PSNC will:

Community pharmacy services

• Secure the commissioning of community pharmacy services within the scope of the current NHS England negotiating mandate
• Promote alignment of GP and community pharmacy contracts and contemporaneous negotiation
• Develop models of integrated care that demonstrate the benefit of using community pharmacy services
• Ensure outcome evaluations of community pharmacy services are undertaken and collated, including robust evaluations of the costs and benefits of potential pharmacy services to the NHS
• Use all opportunities to promote community pharmacy services, within the four domains of PSNC’s Vision, and the benefits of national commissioning
• Address barriers to community pharmacy service expansion, including how to ensure all patients can benefit from services
• Work with other pharmacy bodies to promote greater commissioning of community pharmacy services

Community pharmacy funding and pricing

• Establish a sound basis for future funding of the service providing a fair return to contractors
• Ensure funding and reimbursement mechanisms are fair to contractors
• Monitor and analyse funding delivery, and agree changes to current systems that mitigate risks of under and over-delivery of agreed funding
• Examine options for financial levers to incentivise change and develop NHS England support
• Ensure EPS is resilient, efficient, and costs to pharmacy are fully funded
• Monitor payment accuracy and support contractors in resolving queries
• Resolve Drug Tariff problems where possible, including shortages and price rises, branded generic and brand prescribing policies, demonstrating the damage to NHS finances

External relationships

• Seek the best possible resolution of prescription direction
• Secure changes to the regulatory framework governing provision of pharmaceutical services that support and protect the interests of contractors
• Develop alliances and collaborate with other trade organisations to lobby for desirable changes in legislation governing supply of pharmaceutical services
• Work with DH, other pharmacy organisations and MHRA to prepare for FMD implementation and ensure financial implications for pharmacy are captured and resolved
• Develop stakeholder understanding of community pharmacy’s core role and value including finances, the pharmaceuticals market, pharmacy procurement and distribution
• Pursue action against the current practice of ‘switching’ as advised by Counsel
• Examine opportunities for a national provider company, implementing if agreed

Supporting contractors and LPCs

• Assist LPCs to promote pharmacy service provision to local commissioners
• Promote models of successful LPCs, encouraging federation and mergers
• Support LPCs in addressing contracting challenges through provider companies and other routes
• Help LPCs to improve their effectiveness by provision of support and training
• Provide the best possible information and support to contractors and pharmacy teams

The work plans of PSNC’s subcommittees are included in the individual agendas for each subcommittee meeting which are available to download from the PSNC Meetings page.