Since the beginning of 2022, it has become ever clearer that there is a new health ecosystem that runs right from national political thinking into actual local service delivery.

We are hearing a lot about a “once-in-a-generation change” at present.

A bit like buses coming along all at once, we are now faced with an overhaul of the way the Pharmaceutical Services Negotiating Committee (PSNC) and local pharmaceutical committees (LPCs) run at the same time as new local NHS structures such as integrated care systems (ICSs) find their feet.

In May, we also had the Fuller stocktake report into how the whole of primary care (and, for once, that included real interest in community pharmacy), needs to be supported as the integrated systems evolve.

Read more: ‘Pharmacy should be given a fighting chance in the current broken primary care system’

Far too frequently, community pharmacy sits on the sidelines and complains to itself about not being invited to the healthcare design and delivery party. With ICSs, it is a whole new ball game, and as it stands everyone is being given a go. Any failure to get involved now will hamper our future as new ways of working, thinking, and caring are crafted without us.

The national contract needs an overhaul for sure. Whatever deal is struck, though, is going to be more service orientated.

Implementing these services on a local level will almost certainly require pathway integration into processes and local platforms.

There still seem to be many people striking a negative position about local integration – but the rise of local is a fact presenting both an opportunity and risk to be tackled.

This risk must be handled expertly and energetically by a rejuvenated LPC network that gets the right support from our national leadership bodies.

Read more: Everything you need to know about the RSG proposals

The National Pharmacy Association (NPA) has championed the need for integration all through PSNC’s Review Steering Group (RSG) proposals, as well as when the Fuller Report was being shaped. We are continuing to do so right now in our work with influential stakeholders.

The move to a delegated contract, whereby ICSs rather than NHS England and NHS Improvement will oversee community pharmacy commissioning, is imminent. Once the transition is mapped, it should provide an opportunity for each system to get the best out of community pharmacy.

To be cradled in a local system rather than sitting outside it in the national box will surely create opportunities for community pharmacy. So, what can contractors do now and what are the next steps?

Firstly, try and stay hopeful. Without hope we are truly lost; we can and must leverage the power of local now.

Secondly, work with your LPC. Support, challenge, and take interest in what they are doing to make local integration happen. Get involved as the RSG proposals play out and LPCs map their future.

Lastly, the NPA is actively shaping how community pharmacy contractors can be supported in the new local NHS. Please come and join us at our September NPA conference, where I will be exploring practical advice for contractors. Join us at the Pharmacy Show, too, for key sessions on the same topic.

Read more: Contractors vote to push through pharmacy representation overhaul

We need to both optimise how we best get contractor representation with our LPC network colleagues and make the voice of collective independent pharmacy more clearly heard within the newly constructed national body “PSNCv2”.

Perhaps the RSG over-egged a national outlook in its focus and concerns – sometimes at the cost of downplaying the rising importance and opportunity of local.

Perhaps this is due to a desire or operational need for single health economy consistency. However, this is an over-simplification of reality, given the obvious direction of ICS formation and decision delegation.

Many now see the need for contractor networks to be locally agile and see the need for autonomous local representative bodies in ICSs. We have held fast to the principled belief that representation must get both national and local decision-making right, and right at the same time, if contractors are to be best served.

There is no quick, single grand-gesture fix to integrate the sector into ICSs here. Only by taking all achievable and logically successive steps will we be able to move ahead.

Thankfully, the need to make progress on health system integration is now recognised more widely, and the NPA will continue to be a champion for progress.

 

Michael Lennox is local healthcare integration lead manager at the National Pharmacy Association. Mr Lennox will be speaking at the Pharmacy Show in Birmingham on October 16, 11:20-12:00 in the Keynote Theatre