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Earl Howe: Missing LPNs needed 'swiftly'

LPNs have enabled pharmacy's "professional voice" to become much more prominent locally, says pharmacy minister Earl Howe

Pharmacy minister says LPNs have enabled the sector's 'professional voice' to become much more prominent and he is encouraging area teams that have not yet set up networks to do so


Areas without a local professional network (LPN) for pharmacy must be "swiftly" persuaded to set one up, pharmacy minister Earl Howe has told C+D in an exclusive interview.

Responding to the results of a C+D investigation last month that revealed a quarter of NHS England's area teams had not created a pharmacy LPN, Earl Howe said they must be encouraged to do so.

"LPNs are a really good innovation. They have enabled pharmacy and its professional voice to be much more prominent locally," he told C+D at the Conservative party conference in Birmingham on Monday (September 29).

The minister tried to sell the importance of setting up the remaining LPNs when he addressed meetings of the networks, he added.

NHS England told its area teams to set up LPNs last year with the remit of working with commissioners and providing clinical leadership. But a C+D freedom of information investigation revealed that seven of the 27 area teams – including all three of the teams in London – had not established an LPN for pharmacy by the end of July.

Visit C+D's interactive map to see what progress the LPN in your area has made:

What are LPNs?

Last year, NHS England informed its 27 area teams that they should each set up separate local professional networks (LPNs) for pharmacy, dentistry and optometry. NHS England intended each LPN to include a chair, an administrative manager, local clinicians and other specialists, such as individuals with a public health background.

Pharmacy LPNs link up pharmacists and commissioners. They provide clinical leadership to NHS England and help implement its primary care strategy. They also collaborate with clinical commissioning groups and health and wellbeing boards to promote self-care and ensure the "robust commissioning of locally enhanced services".

Source: NHS England. LPN operating framework. June 2013

What benefits do you think LPNs can bring to the sector? 

We want to hear your views, but please express them in the spirit of a constructive, professional debate. For more information about what this means, please click here to see our community principles and information

Gerry Diamond, Primary care pharmacist

LPNs will probably be scrapped under Labour next year after they restructure the CCGs back to

Kevin Western, Community pharmacist

Obviously we dont know the background to how this article came about but if that is all the Earl could find to say about Pharmacy and its current situation, it is indicative of how successful our lobbyists have been at the conference. I wonder what was being said behind the scenes to the very large multiples and Pharma industry?

Mike Hewitson, Superintendent Pharmacist

He talked for about 30 mins detailing his party's plans for the NHS. He outlined concrete proposals on increasing the number of GPs, and practice nurses, on training for general practice, physician assistants to ease workload pressures….eventually talked about pharmacy, for which it must be said, he is a strong advocate.

I asked him when we can expect to see concrete proposals for including pharmacy, dentistry, optometry and audiology in the future of primary care….I got an answer about LPNs, which I personally think is a sop to non-medical clinical leadership as they have no power, little funding and are poorly resourced with executive support. Need to increase the pressure as the politicians ramp up into election mode.

N O, Pharmaceutical Adviser

""Need to increase the pressure as the politicians ramp up into election mode.""

The question here is WHO will do this job?? At least those who are responsible to do it are clearly not doing it. So who else can do it? We need a complete revamp of our leadership, with a strong person echoing the voice of all the Pharmacists and not just sitting their and agreeing to whatever NHS/ DoH decides. We need to send a strong signal that we wont just accept anything and everything that is proposed by the politicians and their executors. Just read the BBC news article today,

""RCGP chair Dr Maureen Baker said extra investment was needed just to keep the system afloat - never mind expanding it.""

This is the kind of statements and commitment we need from our leaders, not just trying to justify for the lower settlement as a fair deal.

Graham Phillips, Superintendent Pharmacist

Well put Mike.. and for what it's worth my own views on the pharmacy "settlement" below

The NHS clearly has NO Vision for Pharmacy: I read the latest funding announcement from PSNC with utter dismay. It can be summed-up as “more work for less money” It’s a disaster for pharmacists, patients and the NHS. It illustrates the NHS complete lack of any Vision for pharmacy. In some areas, the GPs are in melt-down. The Royal College of GPs says we need another 16,000 GPs but the NHS doesn’t have the money to train them, or the time! Meanwhile, pharmacists are in relative over-supply and some can't find work. These freshly-minted pharmacists have all the clinical and interpersonal skills to carry out enhanced and advanced services. They could quickly be trained up as prescribers and run clinics and common-ailment schemes in GP surgeries or pharmacies. They could be Healthy Living Pharmacists too and make a huge contribution to the Public’s Health. All that would be needed would be a modest additional investment by the NHS and we could have more than one pharmacist per pharmacy.

Pharmacy could answer so many of the NHS’s problems. It would mean aligning the GPs’ contract with ours- so they would be paid to collaborate with, not compete with, pharmacy. The additional investment would be more than re-paid by pharmacist’s optimising the use of medicines and improving the Public’s Health. it seems like a no-brainer so what’s stopping it? Answers please. Lord Howe

Stuart Hill, Community pharmacist

Graham. Concur entirely with your summation of the overall lack of interest that Westminster has for pharmacy. It is plain to see & perpetual year after year schoolboy patronisation is all we will ever receive. Of course, not completely Westminsters fault as a perfunctory glance at our profession yields a lack of cohesion, solidarity & unification of voice. The whole pharmacy picture is besmirched with ongoing factionalisation and turbidity and large multiples are damagingly bad for each and every individual pharmacist.
I will comment on your remarks on the freshly minted pharmacists as you put it. What is your evidence supporting the clinical skills & interpersonal skills that pre-reg and newly qualified pharmacists have. I can assure unequivocally that having conducted over 200 interviews for graduate position in community pharmacy the preponderance of skill and ability of these guys is way off your remark. We must be certain of the level of skill before we talk to Westminster about what we can provide. As for quickly training up to be prescribers I say hold on a second that is tantamount to a disaster. As a prescriber I have to assert this skill is developed and harnessed over time and please do not give out any vibes that the RPS can assist and support with this because that is frankly an unequivocation.
A profession is in control of it's own destiny and pharmacy falls short of that one. We must take a greater instrospective look at ourselves before we can hope to ever advance meaningfully for patient care. Sorry Graham it really is not quite a no brainer but I do see a future if we stop doing what we have always done and canvass the opinion properly and i mean properly the opinion of all pharmacists and engage with them rather than the careerist, parvenu, business driven mandarins that make every decisions for pharmacy.
Most pharmacists are righteously apathetic as their leaders are apathetic to their needs. Flinging an excess of pharmacists at the GP shortage is a very small contribution to the solution I'm afraid

Paul Samuels, Community pharmacist

I agree with your overall summary & certainly would agree that most(not all) pre-reg /newly qualified pharmacists do not possess the interpersonal or communicative skills to be able to operate the services required.
That said their clinical skills would also need bringing into real life situations--it can be done but this costs money & time!

Sue Per, Locum pharmacist

The NHS has no vision, simply because we have not demonstrated our true worth.Yes these additional services, have a place but quite frankly, there is no hard evidence that it has a positive impact on majority of the recipients of the service, value of for money. They are definitely a cash cow for the contractors, and hence the constant plead for higher limits and more services.These very same contractors also speak with a forked tongue, when they say that they will employ additional pharmacists for the additional services,instead they whip it out of the pharmacists. Yes it is true that there is a surplus of pharmacists and i believe it is likely to remain so for the foreseeable future, therefore i believe the way forward would be to have two contracts one for enhanced and advanced services, incorporating Minor ailments, and a second for dispensing and OTC + "p" meds, or alternatively, to make it a requirement for two pharmacists to be employed at each pharmacy, or a pharmacists employed at a doctors surgery. for the advanced enhanced services, plus minor ailments. etc.

N O, Pharmaceutical Adviser

""make it a requirement for two pharmacists to be employed at each pharmacy""

Are you serious ?? After reading the first part of your post it would be hard to believe you even made such a request. Have you not heard of "remote supervision" & " Hub & Spoke" ? Well these to are hot and happening topics at the moment which we are trying to fight and the multiples are lobbying hard to get them through. You would be Lucky, in next five years there is at least ONE pharmacist in each Pharmacy doing actually something that is relevant to the field of Pharmaceutical Sciences and not just Business Management.

Anyway, I wish the same as you, but there is a limit to what we wish for. Hope all our dreams come true one day !!

Sue Per, Locum pharmacist

Absolutely serious, given the responsibilities and the additional, commissioned and private services heaped on a single pharmacists, overseeing 400 items plus per day, who further have to contend with skeleton staff, and busy counters, You need to leave your vision of the 80's when the average pharmacy dispensed 1500 items p.m. to nearer 8000 p.m. these days" Remote Supervision and "Hub & Spoke" are still way off. not likely in happen in your and my lifetime..

N O, Pharmaceutical Adviser

""Absolutely serious"" Good. We are all, but are the multiples and non-independent Owners Serious?? Doubt it, at least in the current financial circumstances.

""Remote Supervision and "Hub & Spoke" are still way off. not likely in happen in your and my lifetime..""

Amen. Lets all hope this is the case.

Kevin Western, Community pharmacist

If that is all Pharmacy "needs swiftly" we are doing better than i thought!

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