It’s crucial that community pharmacists engage with the newly-formed primary care networks (PCNs), but how can your Local Pharmaceutical Committee (LPC) help? Costanza Pearce investigates
Primary care networks (PCNs) went live across England yesterday (1 July), so community pharmacists should now start to ‘configure their teams accordingly’, says NHS England.
For the uninitiated, PCNs are groups of GP practices serving 30-50,000 patients that work collaboratively with local healthcare providers such as community pharmacies. All of this is backed by funding under the latest GP contract.
This means that community pharmacy contractors will partner with other providers in PCNs – such as local practices – to deliver services. While the upcoming pharmacy contract is expected to formalise some roles, these will vary across PCNs and it will be up to community pharmacies to negotiate their place in the network themselves.
What’s more, with an average of 10-11 community pharmacies expected to be part of each PCN, contractors will need to engage with their local network collectively and collaboratively.
If this all sounds a little overwhelming, your Local Pharmaceutical Committee (LPC) will be on hand as your first port of call for any questions about PCNs and any support you might need.
Here are the four steps NHS England says LPCs must take between now and September 2019 to ensure contractors are ‘locally ready’ to engage with their local PCN.
1. Engage with CCGs and LMCs
Clinical Commissioning Groups (CCGs) and Local Medical Committees (LMCs) have been key to the formation of PCNs – so this is where your LPC is likely to start engaging.
CCGs have been formally involved in approving network proposals put forward by practices and ensuring they meet requirements, so they are best placed to advise on the ‘developing landscape of PCNs’ in their area.
As for LMCs, they have been working with practices more locally to help them set up their PCNs, so LPCs will be liaising with their LMC colleagues to set up discussions between community pharmacies and the networks.
This will then allow contractors to align themselves with a local PCN.
2. Start the conversation between local contractors
Contractors will not only have to work collaboratively with GP practices in PCNs, but also with the other community pharmacies within their network.
NHS England recommends that these groups of contractors engage with their local PCN ‘with one voice’, so your LPC should facilitate conversations between contractors to ensure you are ‘clear and consistent’ in your negotiations with networks.
You may already have great working relationships with the community pharmacies around you or you may not have collaborated at all in the past, but your LPC will be able to help you move forward together.
NHS England added: ‘It’s important that there is no conflict of interest between meeting the clinical needs of patients and the dispensing of medicine, the provision of pharmaceutical services and pharmacy business. As collaborative relationships develop, LPCs should work with all parties to ensure adequate separation of these functions.’
3. Understand local priorities
Before groups of contractors approach their PCN, you should spend some time discussing how working collaboratively with practices, each other and more widely in networks can benefit patients.
Some areas to focus on can be the known developments coming nationally to NHS services in urgent care and minor illness, such as the Digital Minor Illness Referral Service (DMIRS) and the NHS Urgent Medicine Supply Advanced Service (NUMSAS); prevention and public health, such as flu vaccinations and public health campaigns; and potential local roles supporting the seven national service specifications for PCNs.
Five of these developments will start from April 2020: structured medication reviews and optimisation; enhanced health in care homes; anticipatory care (with community services); personalised care; and supporting early cancer diagnosis. The other two will start from April 2021: cardiovascular disease diagnosis and prevention; and locally agreed action to tackle inequalities.
NHS England recommends that LPCs help contractors work through all this, using local Joint Strategic Needs Assessments (JSNA), local Pharmaceutical Needs Assessments (PNA) and local sustainability and transformation partnership (STP) or integrated care system (ICS) delivery plans.
4. Agree ways of working between community pharmacies
Once community pharmacies have established which PCNs are operating in their area, begun working with other contractors in their PCN and agreed on their local priorities, you will have to decide how you will be represented collectively in your network. To make a success of collaborative working, community pharmacy teams will need to meet with others in their network regularly.
NHS England has recommended that ‘if possible, all pharmacies within the PCN footprint’ should be jointly represented in their PCN. It added: ‘It may be prudent, depending on local relationships, to appoint an agreed accountable individual or individuals who can engage with the PCN on behalf of local community pharmacies during initial discussions.’
LPCs should advise contractors on the most appropriate arrangement and engage with local LMCs and CCGs to understand whether there are any ‘local preferred routes’ for discussions between groups of community pharmacies and networks.
Both PSNC and NHS England will publish further guidance which will ‘provide clarity’ on community pharmacy’s developing role within PCNs as working relationships between them progress, NHS England said.