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Less than a quarter of CCGs have met with LPCs to discuss services

Exclusive Just 22 per cent of England’s 211 CCGs have met with LPCs to discuss commissioning services through community pharmacies, an exclusive C+D investigation has revealed.

Just 48 of England's 211 clinical commissioning groups (CCGs) have met with LPCs to discuss commissioning services through community pharmacies, an exclusive C+D investigation has revealed.

Pharmacy Voice chief executive Rob Darracott said the figures demonstrated the challenge that LPCs face in engaging with commissioners, including local area teams and local authorities, as well as CCGs.

NHS England argued that GPs and community pharmacists needed to work together to improve patient care. Greater collaboration would "support and encourage a much greater degree of interprofessional collaboration", it said.

C+D has been collecting data under freedom-of-information requests from each of the four waves of CCGs since the first was authorised in December last year. Earlier findings, published in May, showed that 28 (28 per cent) of the first two waves of 101 CCGs had met with an LPC.  


The latest findings from the final two waves of 110 CCGs to be authorised, show that only 20 (18 per cent) had met with LPCs before May to discuss the commissioning of pharmacy services.

LPC members told C+D this week that, in some areas where there had not been formal meetings, there had been engagement on an informal level.

Barnsley LPC secretary Thomas Bisset said the LPC had met with Barnsley CCG's chief executive and medical director on an informal basis and they were now waiting for the director of public health to organise a formal meeting between the various commissioners and service providers.

"We're quite happy that nothing has happened to date, because if we'd managed to meet [formally] it would have been with individuals rather than collectively. All the services will be carried on and the CCG chief executive is keen to commission new services," he told C+D.

Essex LPC chief executive Ash Pandya said he met regularly with Mid Essex CCG's chair and head of medicines management.

"We have a seat on the area prescribing committee and the primary care forum through the LPC, so we have very good engagement with the CCG," he told C+D.

Mr Darracott added that the low number of discussions could be because there were more than twice as many CCGs as LPCs. Many CCGs that responded to C+D said Public Health England and local authorities had taken over the responsibility of commissioning pharmacy services. 

North Kirklees CCG said that, although it had not held any formal discussions with LPCs, it was reviewing the enhanced services schemes for which it had taken responsibility. Liverpool CCG said it had faxed contractors to inform them it would continue to commission a minor ailments service from pharmacists.

"NHS England area teams are currently setting up their local professional networks for pharmacy, where medicines can be addressed and collaboration with CCGs can be developed," an NHS England spokesperson added.

See C+D's interactive map for a breakdown of which CCGs have engaged with LPCs and the services they discussed.

Watch C+D reporters Emma Weinbren and James Waldron discuss the investigation in last week's news blog.

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Has your LPC been in discussions with local CCGs?

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Rajive Patel, Community pharmacist

Has nobody considered re-organizing LPC's to geographically map to CCG's. Perhaps in the instance where the LPC covers multiple CCG's, the LPC should be split into branches. Anyway, just common sense really.

Kevin Western, Community pharmacist

Most Pharmacy services will be commissioned via public health departments of councils which bear no geographical resemblance to CCGs. LPCs are already roughly aligned along council/county boundaries so with exceptions it makes more sense to remain that way.

Rajive Patel, Community pharmacist

Agreed. However, where is the focus with CCG's. CCG's operate under the framework of the Health and Social Care Act, and provide the best opportunity to get commissioned services without the need to consider European Tender Regulations.

It would be absolute folly to pin hopes of future commissioned services from the Local Authorities, since any contract over £70,000 needs to follow EU rules and publishing in the Official Journal of the European Union (OJEU). You may see this as no problem but Councils would need to assess risk, in case there is a legal challenge to awarding commissioned contracts to pharmacies. Indeed, GP's are very concerned public health commissioning could affect their ability to continue being commissioned themselves.

However, the CCG's offer the most secure and stable target to get services commissioned. However, LPC's need to strategically position themselves with key decision makers (or commission leads) and use evidence to underpin bids for developing new pathways involving the pharmacy network.

Rajive Patel, Community pharmacist

Another route LPC's could take is to develop strategic alliances with CSU's. From 1st April 2014, CSU will no longer be seen as integrated NHS organisations, however, will evolve into private enterprises. You will soon see CSU's merging or being taken over to derive scale and hence being able to offer cheaper solutions to CCG's.

Within the offering by CSU's, LPC's could develop solutions that could be packaged up and sold to the CCG's by the CSU.

Rajive Patel, Community pharmacist

On another point, it may make more sense for the LPC to liaise with the CSU rather than the CCG. In most cases, commissioning and other responsibilities are outsourced by the CCG to the CSU.

In that way the LPC could pre-pack service solutions for the benefit of the CSU to push to the CCG.

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