The National Pharmacy Association has in voluntary membership all of the United Kingdom’s 12,000 community pharmacies. The pharmacies we represent provide a range of healthcare services to the public, from dispensing NHS prescriptions through to treatment of minor ailments, health promotion and support for managing long term conditions. We are pleased to comment on the consultation points in ‘Developing the annual health check in 2007/2008’.
We welcome the plan to undertake a national study to assess the impact of the Government’s white paper, ‘Choosing health’, published in 2004. Community pharmacies provide an increasingly wide rangeof accessible services and the pharmacy contractual framework provides a good platform for pharmacists and their staff to contribute to public health. However, there is scope for community pharmacy to do more, and we are concerned that, for example, a number of established community pharmacy based smoking cessation services have recently lost PCT funding. ‘Choosing health through pharmacy’ sets out action points for the Department of Health, strategic health authorities, primary care trusts and community pharmacists. We would suggest that this study should consider if any action points are not being completed, and the reason for this.
Please find below answers to specific consultation points:
Q11: Do you agree that we should focus attention on assessing commissioning, in terms of outcomes achieved and resources invested?
We support the plans for the Healthcare Commission to assess commissioning in terms of outcomes achieved for resources invested and to incorporate elements of the ‘PCT Fitness for purpose’ exercise into the assessment system. Part of this assessment of whether commissioning is cost effective will be verifying that all possible providers have access to the market.
The ‘Practice based commissioning: practical implementation’ guidance (November 2006) re-stated the policy of encouraging a plurality of provision of health services. Indeed, it included community pharmacy in a list of providers from whom services might be commissioned.
In order to maximize this range of providers, local commissioners will need to manage the commissioning landscape in such a way that all providers, new and old, have an equal opportunity to deliver a service. Consequently, there needs to be a clear entry point into the commissioning process so that new providers have an opportunity to contest service provision with established providers. Commissioners must publish service specifications and sufficient time should be allowed for new providers to prepare their proposal. All relevant demographic data and information on current service provision must be provided.
Views from potential providers could be obtained through the local providers forums – to be established under the Commissioning framework for Health and Well-being. No assumptions should be made about the parameters of community pharmacy’s role and community pharmacists must be among those to be considered by commissioners.
We suggest that genuinely inclusive PBC governance structures are mandatory and that their implementation is robustly monitored. Only then will the skills and expertise of all those who work in, with and for the NHS be effectively marshalled.
Q12: What range and type of information is required to assess commissioning?
The Health Policy forum (an umbrella organization of which the NPA is one of the members) commissioned the Health Services Management Centre at Birmingham University and the King’s Fund to produce a report on effective commissioning. The authors highlighted four areas which are immediate priorities for commissioners. The type of information required to assess commissioning could be extrapolated from these priorities. The report concluded that commissioners need to identify need and demand, shape the market, hold the market to account and that commissioners themselves should have to account for their decisions. Full and summary versions of this report are attached to this submission.
