This PSNC Briefing contains an update on a number of matters related to NHS England which will either be of interest to pharmacy contractors and LPCs or may require action at a local level.

Primary Care Bulletin

The July 2013 edition of NHS England’s Primary Care Bulletin, issued by the primary care team within the Operations Directorate, contains a focus on pharmacy matters with some content LPCs may find useful at a local level. Two points of particular note are:

• Guidance to Area Teams (ATs) about the need to issue hard copies of the Drug Tariff to pharmacy contractors. Some ATs have decided to stop sending out hard copies; if this happens in your area, this decision should be challenged by the LPC using the content in this newsletter. If the AT does not agree to re-commence distribution of Drug Tariffs, please contact PSNC so we can escalate the matter to the central support team;
• NHS England’s pharmacy procedures are now available on their website; and
• More guidance on commissioning of Enhanced services, further to previous guidance to ATs.

At the 2013 LPC Secretaries and Chairs meeting, Alastair Buxton, Head of NHS Services, gave a brief presentation on the various commissioning options for locally commissioned community pharmacy services; a summary of the  options can be found in this slide deck.

Local Professional Network (LPN) operating framework

The draft LPN operating framework was previously circulated to LPCs; the final version has now been published by NHS England.

If you read the document you will note that it says that LPN members will not be appointed to represent a professional interest or particular sector. It also notes that ‘Membership can include Local Representative Committees (LRCs). The latter statement seemed to contradict other text in the document and our previous understanding of NHS England’s policy on this matter. PSNC has sought clarification on the note from the LPN lead in the central operations team and based on that discussion has suggested that they should clarify its meaning in communications to ATs. The note should be interpreted as meaning that prospective members of LPNs who have the requisite knowledge and skills to be appointed would not be excluded from membership due to them also being a member of an LRC.

Mike King, Head of LPC and Contractor Support is a member of the national LPN steering group and will be pleased to provide LPCs with support and guidance on LPN issues and to receive feedback on local progress with development of LPNs.

Review of NHS England’s Mandate

The Department of Health has initiated a consultation on a review of NHS England’s mandate. This includes proposals around improving the care of vulnerable older people, which is a key focus for the Secretary of State for Health. The Mandate review is detailed in this PSNC Update on the Health and Care Landscape. LPCs may wish to consider making a response to the review of the Mandate.

NHS England strategy development – national

On 11^th July 2013 NHS England called on the public, NHS staff and politicians to have an open and honest debate about the future shape of the NHS in order to meet rising demand, introduce new technology and meet the expectations of its patients.

This is set against a backdrop of flat funding which, if services continue to be delivered in the same way as now, will result in a funding gap which could grow to £30bn between 2013/14 to 2020/21. The call for the debate was set out in the publication The NHS belongs to the people: A call to action which is also summarised in the latest PSNC Update on the Health and Care Landscape.

Local events on this call to action are being arranged and LPCs will want to ensure they can input into those discussions. PSNC will shortly be issuing a narrative document to accompany PSNC’s vision for community pharmacy services, which we agreed in early 2012, which is intended to illustrate how the vision could be implemented via changes to the pharmacy contract. This document will hopefully be of assistance to LPCs in local discussions on developing NHS England’s strategy.

NHS England strategy development – primary care

NHS England’s commissioning development directorate is responsible for developing a primary care strategy – now being described as a strategic framework – which will sit alongside the wider strategy for the organisation.

The strategy is expected to try to define what aspects of policy and operation need to be undertaken centrally and what can be left to local AT discretion. There are thirteen workstream groups being formed to progress development of the framework, in some cases informed by existing policy and also by the policy priorities of the Secretary of State. The groups are largely populated by NHS England staff, but with some CCG input. Wider stakeholder input will be sought for the groups in due course. The groups are:

1. Vision (Dr Keith Ridge, Chief Pharmaceutical Officer, sits on this group)
2. Empowering patients
3. Empowering clinicians (this group is likely to focus on empowering CCGs)
4. Data and transparency
5. Support for innovation and improvement
6. Incentives
7. Premises
8. Workforce
9. Safe, controlled investment in primary care (which is likely to examine barriers to CCG commissioning from GP practices and other primary care providers)
10. Market management
11. Pharmacy
12. Dentistry
13. Eye care

NHS England is aiming to get an initial framework completed by October 2013, but a more substantive document is likely to be published in April 2014.

LPCs should have an opportunity to feed in to the development of the framework via their AT and it will be important for this opportunity to provide input via the ‘bottom up’ route is used alongside the work PSNC will undertake with the central team. Again, the forthcoming narrative document on PSNC’s vision will hopefully be a useful resource for LPCs to use in local discussions on the primary care framework.

Updating the Approved Particulars

Steve Lutener, Head of Regulation is working with NHS England to update the Approved Particulars that detail certain aspects of the clinical governance requirements within the pharmacy contract. The changes required are largely incidental to the shift of the contract from PCTs to NHS England, but two substantive changes will be a clarification on what type of patient safety incidents need to be reported to the National Reporting and Learning System and updated content requirements for practice leaflets (to reflect the dissolution of PCTs and the move from NHS Direct to NHS 111). Once the changes are agreed, the new requirements and timescales for implementation will be communicated to pharmacy contractors and LPCs.

Communicating with pharmacy contractors

The development of NHS England and the other new organisations within the new healthcare landscape creates the need to update pharmacy contractors on these changes and the implications they have for the future development of community pharmacy services. Via PSNC’s various communication routes we have provided information on the changes aimed at contractors and we know all LPCs have also worked hard over the last year to ensure their contractors are kept up to date with the new healthcare environment.

The new PSNC website contains a section dedicated to the healthcare landscape, which will be developed to provide a resource to contractors and LPCs on the new world. We do however recognise that some contractors prefer to absorb new information by routes other than websites and publications, so PSNC would like to remind LPCs that Alastair Buxton, Head of NHS Services, is happy to talk to groups of contractors about the new environment and the implications for service development at LPC organised meetings.

For more information or queries on this briefing please contact, Alastair Buxton, Director of NHS Services.

To browse other PSNC briefings on the healthcare landscape click here.