Only a fifth of health and wellbeing boards (HWBs) have met with LPCs to discuss commissioning services from pharmacies in the year since the NHS reforms came into effect, a C+D investigation has revealed.

Just 27 of the 127 local authorities that responded to a C+D freedom of information request confirmed that a member of their HWB had met formally or informally with pharmacy representatives between April 2013 and March this year. However, most local authorities had continued to commission services from pharmacies since they took over responsibility for public health. (Click here for details about LPC meetings with HWBs.)

Pharmacy bodies said the low level of contact between the boards and LPCs was "disappointing but not surprising". Although HWBs were set up to advise each local authority about commissioning, pharmacists might have tried alternative approaches to get services commissioned in their area, they said.

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	Community Pharmacy West Yorkshire chief executive Robbie Turner said local authorities' approach to pharmacy had been a "mixed bag", with some refusing to collaborate with LPCs.

"We've got some local authorities who are working very closely with LPCs [and] getting the views of community pharmacies about how they see their services developing. But we've got some authorities that will not speak to providers while they're coming up with services because of their procurement rules," he told C+D.

Mr Turner was worried these issues would continue to be a problem and called for NHS England to "oil the wheels" by providing national leadership for commissioners.

Central Lancashire LPC vice chairman Liz Stafford said her local professional network (LPN) had worked closely with Lancashire County Council to roll out the healthy living pharmacy pilot across three local authorities. The LPN had also formed an advisory group with local authority representatives to offer them support about PGDs and commissioning services, said Ms Stafford, who is also Rowlands Pharmacy national clinical liaison manager.

Watch the full interviews with Robbie Turner and Liz Stafford

But only six of the 10 local authorities in Greater Manchester had commissioned sexual health PGDs from community pharmacists through the commissioning support unit, Ms Stafford said. She called for a "more coherent and consistent approach" to commissioning across the country.

However, PSNC head of NHS services Alastair Buxton said influencing HWBs might not be the most effective way of securing services in the short term, as they were not themselves commissioners.

It was likely that LPCs had been focusing on meeting with commissioning officials within local authorities instead, he said.

Royal Pharmaceutical Society English Pharmacy Board chair David Branford said it was unsurprising that pharmacists were finding the boards "difficult to relate to".

"They are still very new and have little or no track record of dealing with health services. Many local authorities used the PCT network of pharmacists to provide advice and support in the past and, with their removal, local authorities are probably struggling to understand the agenda," he told C+D.

This was a "huge opportunity" for LPNs to work with LPCs and other pharmacy organisations to "plug the gap", he added.

Public Health England chief knowledge officer John Newton said it was important that all local authorities considered community pharmacy as public health providers, alongside "more familiar routes". "We have only just begun to see what pharmacy could offer," he told C+D.

C+D sent freedom of information requests to 350 local authorities. Some responded that they did not deal with commissioning decisions for the area, others said they were "in the process" of looking at existing contracts or had plans to meet with pharmacy representatives within the next year.

Public health commissioning in the reformed NHS

Services

The most common public health services commissioned from pharmacy by local authorities in order of popularity are EHC, supervised methadone consumption, smoking cessation, needle exchange, health checks and chlamydia screening.

A small number of authorities have also commissioned more unusual services. The London boroughs of Hammersmith, Fulham, Kensington and Chelsea commissioned 20 pharmacies to deliver arterial fibrillation screening for two years from April 2014. Coventry, Torbay and the City of London all commissioned a small number of pharmacies to deliver tuberculosis management, while the City of London commissioned two pharmacies for vitamin D prescribing.

Meetings

Of the 26 local authorities that confirmed they had made contact with LPCs, 19 had arranged formal meetings with pharmacy representatives, while others had discussed services informally at local government events.

In Berkshire, a team representing the health and wellbeing boards of six local authorities met with Reading LPC twice to discuss health promotion campaigns in community pharmacies. The team also oversaw the pharmacy contracts for health checks, needle exchange services, supervised methadone consumption and sexual health services, which had been rolled over from April 2013.

Other authorities kept in contact with their LPC on an informal basis. Trafford Councilsaid its commissioning staff had attended an LPC meeting in November to discuss EHC and chlamydia screening services and there had been "ongoing dialogue" about creating a pharmaceutical needs assessment (PNA) for the area.

Source: 127 responses from local authorities to freedom of information requests

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