“It is crucial” that local pharmaceutical committees (LPCs) are engaged at the highest level of regional NHS leadership if government proposals to transfer the commissioning of local pharmaceutical services to ICSs are to go ahead, the Company Chemists’ Association (CCA) said. 

ICSs are local commissioning bodies made up of representatives from community and hospital health services, mental health services and local councils.

“There must be mandatory inclusion of local representative bodies [including LPCs] within the ICS governance structures. No one group, or profession, should hold a majority position for decisions made in any system,” the CCA wrote in its submission to the Health and Social Care Committee’s inquiry on the government white paper Integration and Innovation: working together to improve health and social care.

Reforms could “improve” healthcare delivery

The report by the Health and Social Care Committee, published today (May 13), concluded that the government’s proposed reforms for the health and care system – which include delegating some commissioning responsibilities for pharmacy services to an NHS ICS body – could “improve the delivery of care services for patients”.

The committee welcomed the proposals to hold ICSs accountable through Care Quality Commission assessments, but it recommended that the government defines the “roles and responsibilities of the NHS body and the health and care partnership”, which will form an ICS.

The committee’s report also attracted written evidence from the National Pharmacy Association (NPA), the Royal Pharmaceutical Society (RPS) and the Pharmaceutical Services Negotiating Committee (PSNC) who, like the CCA, argued in favour of community pharmacy being represented at ICS level. 

PSNC: Only GPs on ICS board a “great concern”

The proposal for how an NHS ICS body board should be constituted, set out in the white paper, directly mentions that representatives could be drawn from GP practices and primary care networks, rather than primary care in general.

“This is a matter of great concern to community pharmacy, as one part of primary care – general practice – cannot be expected to effectively represent the views of all primary care providers,” PSNC wrote in its submission to the committee.

The community pharmacy sector’s voice should be “guaranteed” on the NHS ICS body board to allow the sector to share its contribution with the rest of the health and care system, PSNC argued.

RPS: Community pharmacy “marginalised” in the past

The RPS argued in its submission that community pharmacy and other primary care providers have been “at times marginalised in decision making”.

“If we are to develop innovative approaches to patient care within an ICS, working across primary and secondary care settings, pharmacy must be included alongside other partners,” it wrote.

“While the white paper states that NHS England and NHS Improvement will publish further guidance on how ICS boards should be constituted, it does not address how proposed reforms should promote more inclusive and diverse leadership across the health service,” the RPS added.

NPA: Pharmacists at ICS level can address health inequalities

The NPA also argued that community pharmacy should “have full representation” at ICS level.

“Community pharmacists and their teams witness at first hand the impact of health inequalities on their patients, and through their full representation at ICS level can influence the health strategic direction at local level,” it wrote in its submission to the committee.