The government published a white paper yesterday (February 12), in which it presents its vision for making the health and care system “fit for the future” – including giving more accountability to local health and care systems.

As part of this, the commissioning of pharmacy services would largely fall under the remit of an integrated care system (ICS) NHS body instead of NHS England and NHS Improvement (NHSE&I). ICSs are local commissioning bodies made up of representatives from community and hospital health services, mental health services and local councils.

However, under the proposals, NHSE&I would “retain the ability to specify national standards or requirements for NHS ICSs in relation to…existing direct commissioning functions”.

NHSE&I’s 2019 proposals to the DH for a more joined up care model represent the foundation of the white paper, according to the document.

Commissioning pharmaceutical services

Following a further consultation with stakeholders in November last year, NHSE&I concluded that, among other reforms, an NHSICS statutory bodies should sit within existing ICSs, making the commissioning process more targeted and local

This new body should have “stronger responsibilities for commissioning primary medical, dental, ophthalmology and pharmaceutical services, and a wider statutory health and care partnership”, according to NHSE&I.

“Having considered the response to the NHS England consultation, the government has concluded that the allocative functions of clinical commissioning groups should be held by a system level body responsible for integrated care – what we are calling an ICS NHS Body,” the DH said in its white paper.

In a document published yesterday, NHSE&I also set out its recommendations for how the government should recognise ICSs as statutory bodies.

Within that document, it reiterated that “provisions should enable the transfer of responsibility for primary medical, dental, ophthalmic and community pharmacy services by NHS England to the NHS ICS statutory body”.

Asked whether this means that ICS NHS bodies will be responsible for commissioning community pharmacy services in England, a DH spokesperson told C+D today (February 12) that it is exploring NHSE&I’s recommendation further and “will bring forward legislative proposals in due course”.

Commenting on the white paper’s proposals, Association of Independent Multiple Pharmacies (AIMp) CEO Dr Leyla Hannbeck told C+D today that a new ICS NHS statutory body would need to “engage with community pharmacy leaders at a very early stage in any planning of commissioning services, so that we can help with forming relevant services that can be delivered efficiently for the benefit of patients in the communities that we serve.

“We [would] also urge the new body to work proactively on breaking down the barriers and misunderstandings that currently exist between general practice and pharmacy, encouraging effective collaboration,” Dr Hannbeck added.

Company Chemists’ Association CEO Malcolm Harrison said that, while “it is not yet clear how the national and local commissioning of services will work in this new system, it is vital that everyone can access consistent care across the country, and that the good intentions of the white paper do not lead to a healthcare ‘postcode lottery’”.