NHS reforms explained In the first of a new series, we explain how clinical senates and LPNs will affect you from April
Catch up with the other parts of this six-part guide on C+D's NHS reforms homepage.
What are they?
Clinical senates, like clinical commissioning groups (CCGs), are being established to put clinicians in charge of the how, what and where of NHS services. Their role, according to NHS national medical director Professor Sir Bruce Keogh, is as a "trusted source of advice" for those making commissioning decisions: CCGs, health and wellbeing boards and the NHS Commissioning Board.
There will be no required list of membership for senates, other than they should involve a range of professionals from across the NHS with a broad base of expertise; membership is not meant to be representative. A core group will form a senate council, led by a chair, with a wider senate assembly of experts to give advice as required.
Local professional networks (LPNs) are being trialled for pharmacy, dentistry and optometry and are the conduit by which these professions have their say in the new NHS commissioning structure. They are not part of the commissioning structure itself – their aim is to provide local clinical leadership and engagement.
LPNs will essentially be the vehicle through which pharmacy engages with the wider NHS to make sure pharmacy services are considered as care pathways are redesigned. They will also provide a link between pharmacy and the new local education and training board.
LPNs have been piloted in 12 areas and there are no plans to standardise their format from April; so far, some have included patient groups, secondary care pharmacists, pharmacy technicians and dispensing doctors.
What will they do?
Clinical senates will cover a large geographical area in order to take a broader strategic view on what health services should look like – from maternity services to round-the-clock emergency care. They will be non-statutory advisory bodies with no executive authority or legal obligations – essentially, they will provide guidance.
Their job will not be to constrain or put the brakes on CCGs – they will not have the power of veto – but to advise where more analysis or work may be needed or identify areas where there is the potential to improve care, and provide a wider overview on topics such as cross-specialty collaboration.
FactfileImportance to pharmacy (out of five)
Clinical senates ● ● ● ● ● LPNs ● ● ● ● ●
Number in England Clinical senates 12 LPNs around 27
Weeks until the NHS reforms go live 5
This week, you should: Find out more about the creation and aims of your pharmacy LPN. Ask your LPC what is being discussed and whether there is an overall strategy in place.
They will also highlight where there is room for improvement and help to oversee major changes in the way services are provided.
Pharmacy LPNs will be funded by the NHS – the details are still being finalised. They will provide pharmacy leadership and feed in to CCGs and health and wellbeing boards about local needs, issues and priorities to ensure pharmacy remains central to planning. They will be able to report to and advise several other bodies as well, including clinical senates and the NHS Commissioning Board. Education and training will also be a key part of their role and they will be tasked with improving quality.
The pharmacy LPNs already up and running have been working on projects as varied as ensuring business continuity, advising on the NMS and medicines optimisation, and offering guidance on specifications for enhanced services. They will also have input into pharmaceutical needs assessments (PNAs).
How do they fit into the new structure?
Clinical senates sit between the CCGs and the NHS Commissioning Board and health and wellbeing boards in their areas, with feedback and collaboration flowing both ways. There will be 12 clinical senates nationally: North East; Yorkshire and the Humber; Greater Manchester, Lancashire and South Cumbria; Cheshire and Mersey; West Midlands; East Midlands; East of England; Bucks, Oxon and Berks; South West; Hampshire, Dorset and Isle of Wight; London; and South East Coast.
LPNs will be more local in focus, and their link will primarily be with local commissioners, public health, and education and training bodies. They will also engage with their local NHS Commissioning Board outpost.
How will pharmacists interact with them?
With clinical senates, the interaction from pharmacy remains to be seen and could well depend on the composition of senate membership. It is sensible to assume LPNs will be able to feed into this structure as required.
For community pharmacists, the LPN will be essential, and interaction is primarily, at this stage, through the LPC. The type of work the pharmacy LPN may undertake includes building a case for a local service, putting in place relevant training, and liaising with GPs over a pathway redesign.
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