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Ash Soni calls for ‘primary care contract’ across all four sectors

The president of the National Association of Primary Care (NAPC) has suggested that pharmacy, general practice, dentistry and optometry should be united under a “working collaboratively contract”.

The government needs “to create [a] primary care contract”, NAPC president Ash Soni told C+D in an exclusive interview last month (October 27).

Mr Soni, who also served as Royal Pharmaceutical Society (RPS) president from 2014-16 and again from 2017-2019, said that the four professions would still have their core contracts, “whether that is based on supply” or some services, as a “base that is funded nationally”.

But he proposed that a “primary care contract” that is “overlaying” these – which he dubbed a “working collaboratively contract” – should be put in place to achieve integration within primary care.

Mr Soni said that this joint contract should apply to “all” of the four primary care sectors “rather than saying, ‘Here's a contract for flu vaccinations for general practice and here's one for community pharmacy,’” for example.

He suggested that community pharmacy and general practice should “initially” be included “because we've got more similarity in the type of things we do”, but that eventually dentistry and optometry should be “[mapped] into” the contract too.

A “primary care contract” would require “all of primary care to work together” to “max out” the number of patients seen for services such as flu jabs, he added.


Overcoming tensions


Amid long-running tensions between different sectors within primary care, Mr Soni stressed that a joint contract would “bring those teams together more collaboratively”.

While currently, sectors “all fight about” funding, giving funding for commissioned services to “the system for delivery” rather than to general practice or community pharmacy separately would avoid sector conflict, he said.

He added that “the overall benefit” of integrated primary care “is to the patient”, as it would stop them from “[ending] up on a GP’s doorstep” when they don’t need to.

And he revealed that the NAPC is carrying out work focused on “integrated neighborhood teams”, highlighting that much of this “is just about getting people to work together more”.


Pharmacies excluded?


Mr Soni’s comments come after HSCC chair Steve Brine proposed that primary care should be brought together “in a physical sense” with pharmacies co-located with other providers at the Pharmacy Show in Birmingham last month.

Meanwhile, the British Medical Association (BMA) also said last month that dispensing GPs should have access to “all funding and services” commissioned to pharmacies.  

And lead pharmacists at integrated care systems (ICSs) also warned of a “deep-rooted culture” of excluding pharmacy at the Pharmacy Show conference.

They said that “a lot of” ICB meetings badged as “primary care” take place in which attendees are “not actually talking about primary care [but] about general medical practice”.

In September, Mr Soni said that community pharmacists need to “step up”, “take on the responsibility and deliver” when they are offered opportunities at a local level.

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