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PSNC review recommends dramatic overhaul of the negotiator

An independent review of PSNC has made 33 key recommendations for improvement, including restructuring and rebranding the organisation into Community Pharmacy England (CPE).

  • Led by Professor David Wright, the review calls for the renaming of PSNC to "Community Pharmacy England”, and of LPCs to “Community Pharmacy [locality] (CPL)"
  • The review calls for a “significant increase” in funding to the body, and “independent governance of both LPCs and PSNC”
  • It highlights the importance of “national vision and strategy” for community pharmacy in England
  • It suggests closer collaboration between PSNC and LPCs to “remove any distance” between them and place LPCs "at the centre of” negotiations with government

The report, published today (June 19), details the findings of an independent review of community pharmacy contractor representation that looked at the work of the Pharmaceutical Services Negotiating Committee (PSNC) and local pharmaceutical committees (LPCs) and how PSNC and LPCs can collaborate more closely.

Background to the review

The review was led by David Wright, who is professor of pharmacy practice at the University of East Anglia and was responsible for the evidence review behind the Murray report into pharmacy clinical services in 2016, with the team behind it meeting for the first time in December last year.

This review's remit included finding new ways for PSNC and LPCs to work together to help manage the requirements placed on community pharmacy by last year’s five-year funding deal, which PSNC said it was “conscious would only serve to increase the demands being made of contractors”.

Its objectives also comprised ensuring contractors are “getting the best value for money and receiving the best levels of support possible in return for the levies they pay to LPCs and, indirectly, to PSNC”.

Professor Wright has predicted that it will take at least two years for many of these changes to be fully implemented, if they are green lit to go ahead.

The review included surveys, focus groups and interviews with contractors and LPC representatives. None of its recommendations will be implemented before PSNC and LPC members meet digitally to discuss the review on July 8.

Key recommendations

Of the 33 recommendations made by the review, four were highlighted in the report as points of priority.

The first is to create an independent Community Pharmacy England governance and strategy board answerable to contractors for overseeing and monitoring the performance of CPE and LPCs. It is recommended that LPCs also be renamed, using the format Community Pharmacy [locality].

It is recommended that a “national vision and strategy” is created for community pharmacy in England and that the current PSNC is replaced by a “CPE Council” made up of chairs from community pharmacy localities (CPLs), each representing an agreed minimum number of contractors.

The report said “the evidence showed a clear drop in average levy for contractors when LPCs represent 200 or more contractors”, suggesting that this would be a “reasonable number of contractors” for each CPL to represent.

The creation of the council aims to help “remove any distance between” PSNC and LPC, which the report outlined was “repeatedly identified as a problem both by PSNC and LPC members”. The model would be similar to that used by the General Practitioner Committee for GPs and Community Pharmacy Scotland which, the report highlighted, are “both effective in negotiating their contracts”.

The creation of the CPE council would place LPCs "at the centre of all negotiation strategy with government”, which would serve to “remove the perceived secrecy that was frequently alluded to with respect to PSNC activities”, according to the report.

The final priority is to “significantly increase funding to CPE to support the negotiation processes and LPCs”.

It has not yet been decided where this funding may come from, but other financial recommendations include creating a CPE transformational fund, seeking external funding “where appropriate” and arranging for the levy to be “directly paid to each of CPE and CPLs”.

Other notable recommendations include the creation of a negotiating team “consisting of contractors and contractor representatives” who are employed and trained by CPE.

The review also suggested that LPCs representing 200 or fewer contractors consider merging with another LPC “to ensure better value for money” and reduce the size of their committees to a maximum of 10 members while “maintaining local proportional representation”.

In the report, Professor Wright said the proposals are “far more radical than anyone envisaged at the outset”, but “fully supported by the evidence”.

“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,” he added.

Simon Dukes: “Difficult decisions ahead”

PSNC CEO Simon Dukes said that when he first proposed the review, it was to ask whether contractors were “getting best value for money from their representatives”, and if there were “better ways that PSNC and LPCs could work together”.

He thanked both the review team and contractors for their participation and said that Professor Wright’s report “sets out a blueprint for change, and one which PSNC and LPCs cannot ignore.”

“There will be difficult decisions ahead, 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,” Mr Dukes added.

The report was originally due to be published in April, but the COVID-19 outbreak caused it to be delayed. However, Professor Wright said that the pandemic “demonstrated the value provided to contractors by much closer working between LPCs and PSNC”.

What do you make of the review's proposals?

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