Recommendations to strengthen pharmacy contractor representation could require additional funding of up to £2.2 million from contractors, an independent review has concluded.
‘System-wide’ changes should be made, to give community pharmacy a stronger collective voice, suggests a review, led by Professor David Wright, Professor of Pharmacy Practice, at the University of East Anglia, commissioned to examine the value and outcomes that contractors receive from the Pharmaceutical Services Negotiating Committee (PSNC).
A national council of LPC chairs should be introduced, replicating the structures used by the General Practitioner Committee and Community Pharmacy Scotland, and ensure that contractors are better listened to, it is recommended. The first action of the national council and governance body should be to develop a national strategy for community pharmacy, suggested the review.
The PSNC should be renamed ‘Community Pharmacy England,’ with a ‘Community Pharmacy [area]’ title also adopted by LPCs. It is recommended that LPC committees are reduced to 10 people or less, and that smaller LPCs merge.
‘With ‘providing value for money for contractors’ driving this review, we honestly feel that there is the need for the system-wide changes we propose,’ said Professor Wright.
The changes would ‘allow the contractor’s voice to be better heard both locally and nationally, the contractor’s money to be used to best represent them and where outcomes from both national and local negotiations ultimately ensure appropriate and fair remuneration,’ he said.
While the proposal is ‘far more radical’ than envisaged at the outset of the project, ‘we believe that it is fully supported by the evidence,’ he said.
LPCs told the review that they recognise that the PSNC executive team has been under-resourced. ‘To improve performance within negotiations there were repeated requests for a more effective negotiating team, who are extensively trained, prepared and supported for the role. We therefore strongly recommend that increased funding for the executive and an employed negotiating team is a priority,’ says the report.
PSNC should be generally less London-based, and stronger negotiation expertise for those speaking to government be achieved, it is recommended.
The review, commissioned jointly by PSNC and LPCs, costing £70,000 to conduct, was supported by a Pharmacy Review Steering Committee. LPCs and PSNC are funded through an automatic levy of £11.3 million pounds per year taken by the NHS business Services Authority (NHSBSA) at source from contractors.
The majority of LPCs took part in a survey, and interviews with a number of LPC chairs and chief officers were conducted.
Although delaying publication of the report, new ways of working during the Covid-19 pandemic ‘demonstrated the value provided to contractors by much closer working between LPCs and PSNC,’ by having a direct line of communication with the PSNC executive team and a more formalised national network, Professor Wright commented.
PSNC chief executive, Simon Dukes, who has been in post for two years, thanked LPC teams for taking part in the review. ‘Thank you to everyone in the sector who has helped Professor Wright to gather data for his review which has led to an ambitious set of recommendations. Professor Wright’s report sets out a blueprint for change, and one which PSNC and LPCs cannot ignore.’
There will be ‘difficult decisions’ ahead, he said, ‘but there is now no doubt that changes must be made, and at the heart of those changes must be the contractors we are all working for’.
The recommendations of the review will be considered by the PSNC committee, and then by LPCs at a virtual meeting on 8 July.