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PCN strategy criticised for ignoring community pharmacists

The service objectives for England’s primary care network’s (PCN) have been criticised as a “missed opportunity” for failing to reflect community pharmacies’ role.

In its response to NHS England’s consultation on draft contract service specifications for PCNs – networks of GP surgeries covering around 30,000-50,000 patients – the Royal Pharmaceutical Society (RPS) pointed out that “there is little mention of working collaboratively with community pharmacy” in the document.

“Considering the mandatory requirement for PCNs to work with non-GP providers such as community pharmacy, this seems a missed opportunity to promote integrated services for patients,” the RPS said in its consultation response.

The draft service specifications “fail to recognise the contributions of pharmacy teams outside of general practice”, continued the RPS, which invited NHS England to review them to ensure they “enable more collaborative working between GP[s] and non-GP providers”.

The RPS said it was “pleased” that PCN pharmacists undertaking “structured medication reviews” will be encouraged to refer patients to health living pharmacies where appropriate

However, it “strongly” suggested that community pharmacies’ ability to support medicines optimisation through the new medicine service should be explicitly referenced in this specification.

Care home contribution

Moreover, the service specifications did not mention the contribution community pharmacies can make to the delivery of PCNs’ “enhanced health in care homes” specification, the RPS said.

Pharmacies “work closely with many care homes”, supplying medicines and offering advice and support, the society pointed out. This means that “there is a role for community pharmacy, working with the PCN to support this specification through activities such as education of staff on safe storage”.

Likewise, “the role of pharmacists and pharmacy teams in the ‘early cancer diagnosis’ specification has been missed”, said the RPS – which recently suggested that pharmacies could be developed to become early cancer diagnosis hubs over the decade.

“Ready and willing”

In a joint response, the Association of Independent Multiple Pharmacies (AIMp), the Company Chemists’ Association (CCA), the National Pharmacy Association (NPA), and the Pharmaceutical Services Negotiating Committee (PSNC) stated that “community pharmacies are already an integral part of primary and community healthcare and the sector stands ready and willing to support PCNs and GPs to ensure the successful delivery of the national services that are planned for the network contract from April 2020”.

But North East London local pharmaceutical committee (LPC) CEO Hemant Patel told C+D that the draft specifications do not offer “the mechanism to allow PCNs to think more broadly and engage community pharmacy into local planning and delivery”.

“GP networks see the delivery [of the PCN contract specifications] as the sole domain of the GPs, and [lack] a broader sense of collaboration”, Mr Patel claimed.

His concerns were echoed by James Wood, CEO of Community Pharmacy Surrey and Sussex LPC, who believes that “those primary care colleagues who did not already fully understand community pharmacy before all of this will struggle to [understand] our future new roles, how we fit in and our potential”.

“My organisation is working hard to address this in Sussex and Surrey, but it’s a slow process as we have over 60 PCNs, serving very diverse and different populations,” he added. 

As part of the Pharmacy Quality Scheme (PQS), community pharmacies are being encouraged to engage with PCNs and have been asked to nominate a PCN lead for all the community pharmacies wishing to engage with a local network.

What do you make of the draft PCN contract service specifications?

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