Contractors voted for significant changes to PSNC and the LPCs network. What did the proposals include, and what happens next?

New names for PSNC, LPCs – and the phasing out of ‘chemist’

The vote will see PSNC change its name to Community Pharmacy England (CPE) and LPCs will be rebranded as Community Pharmacy Local (CPL). An optimum LPC committee size of 10 to 12 members will be recommended, with local flexibility.

LPCs will also align more closely with NHS Integrated Care Systems (ICS) and reconsider their size in terms of numbers of contractors represented, in line with the Wright Review recommendation that LPCs with a minimum of 200 contractors provide better value. Any changes would be subject to the views of contractors via a local vote, which might ultimately lead to 39 to 42 LPCs.

The use of the term ‘chemist’ is to be phased out in England and replaced with community pharmacy or pharmacist where ‘appropriate’.

Independent governance of LPCs and PSNC

Pharmacy representation regions will be reorganised to match the seven NHS regions: East of England, London, Midlands, North East & Yorkshire, North West, South East and South West.

PSNC and LPC membership of committees and subcommittees will be limited to 12 years of service, with a new governance subcommittee to help set a governance framework for national and local organisations, which will sit alongside PSNC’s working subcommittees, with membership drawn from PSNC and LPCs.

Policy and advisory subcommittees at PSNC will be updated to include the ability to hear from external (non-contractor) policy groups, experts and working groups when needed – although the RSG believes that only elected contractors and nominated contractor representatives should have voting rights.

Immediate additional external independence would be introduced into the governance structures at PSNC, including through an external independent member of the Review and Audit Panel (RAP).

The development of a governance framework rolled out across PSNC and the LPCs would also include a code of conduct for all members, local and national Key Performance Indicators (KPIs) and expectations regarding transparency and communication.

Examples of local KPIs could include average local service commissioning income per contract, LPC running cost per contract, and committee and governance cost and staff costs.

The numbers of PSNC members will be reduced while maintaining the balance between independents and multiples.

Funding

An additional 13% of funds from LPCs will be diverted to PSNC, to ‘appropriately resource PSNC to carry out national representation functions for the sector’. The contributions that LPCs make to PSNC will increase on a trajectory of an additional £1.5m per year by the levy year beginning April

2024, starting with an additional £750,000 in 2023/24 and a further £750,000 in 2024/25, with PSNC to subsequently develop a process to review annually.

There will also be the creation of a PSNC/CPE transformation fund, and all LPCs will make payment to PSNC/CPE automatic and visible to contractors. The transformation fund will see PSNC allocate £250,000 to support this, with LPCs self-funding local changes and transformation from excess reserves.

PSNC will also strengthen activities which support negotiating such as health economics, project management, analytical and insights capability, and influencing, while developing a bank of evidence and monitoring data to better support negotiating, implementation and evaluation of funding impacts and market trends – for example market data, pressures surveys, patient surveys and public opinion polling.

The existing negotiating team functions will be retained, but executive and nonexecutive (contractor) roles should be more clearly defined.

Better contractor engagement

A national forum of LPC contractor representatives will be created to help further advise PSNC on local matters.

Open PSNC meetings will be live-streamed, and systems will be built in to ensure PSNC subcommittees hear from wider contractor voices (such as on rural issues, DSPs) including working groups when required and cross-sector policy groups, that can help to inform policy and decision making.

The role of PSNC members will be better defined to include clear standards for how committee members will engage with contractors and the wider sector; a regular programme of PSNC events for contractors that allow for two-way dialogue will be launched; and PSNC will work with Community Pharmacy Wales to define its representation and support requirements.

Next steps

PSNC members will consider the vote outcome and next steps at the July meeting with a view to subsequently updating contractors, and to putting together a more detailed action plan and timelines for the sector over the summer.

Although PSNC will not receive any extra proportion of levy funds until 2023/24, some of the work, such as developing a new vision for the sector and supporting LPCs through the next election cycle and to become ready for facing into ICS will be prioritised. It is anticipated all changes will have been implemented by the end of 2023/24. The RSG has suggested a review take place in the next two years.