A review of the structure and organisation of PSNC and local pharmaceutical committees (LPCs), released in June last year, made 33 key recommendations, including replacing the PSNC committee with a council of LPC chairs and merging some LPCs with fewer members. A series of engagement events with the sector will gauge the wider opinion concerning the proposals.
Ahead of tomorrow’s (March 9) engagement event with contractors on the review, three representatives – an independent contractor, a member of the Association of Independent Multiple Pharmacies (AIMp) and a representative from the Company Chemists’ Association (CCA) – who sit on the review steering group (RSG), spoke to C+D about the next steps in changing how the negotiator operates.
Mark Burdon, an independent pharmacist in Newcastle and director of the Burdon Pharmacy Group, told C+D: “We’re seeking the views of actual contractors; whether they be small companies, single independents, all the way up to the very largest, they are the ones who we are acting for.”
At an engagement event with LPCs in September, Mr Burdon said contractors “just want us to get on with it”.
“If we’re doing this review, we haven’t got any space for unnecessary delays,” he added.
Though gathering reaction to the review is in its early stages, the RSG hopes to appoint a programme manager to set out a roadmap for implementing structural changes. For now, the priority is to engage with PSNC’s “base”, Stephen Thomas, a deputy superintendent pharmacist at Rowlands and external affairs manager at the CCA, told C+D.
“We have to find out what [contractors’] key priorities are. The report itself was really detailed, and obviously had the recommendations, but we need to find out how people want to engage with that going forward.”
Asked whether the group could see any potential conflict of interest between the different fractions of pharmacy, Sandeep Dhami, superintendent at MW Phillips Chemist in Birmingham and AIMp member, said: “It's not uncommon for pharmacy contractors – whether they're one [branch] or big CCA multiples – to work collaboratively. […] And that's what we'll do again.”
Some points “tick-and-pass”, others “more radical”
In the report, author Professor David Wright said some of the proposals were “far more radical than anyone envisaged at the outset”, including the suggestion that the PSNC committee be replaced by a council of LPC chairs.
This was something the RSG members agreed with.
Mr Thomas saw the recommendations falling into three camps: “A third of things that are almost tick-and-pass – so obvious that we should have done it years ago.” Recommendations in this category, they suggested, include the proposal to change the name of PSNC to Community Pharmacy England (CPE), and LPCs to Community Pharmacy Locality (CPL).
“There’s another third that needs a bit of tweaking, but is probably going to be largely acceptable to the body of contractors,” Mr Thomas continued. “And then there’s another third that […] need to have a little bit more work done on them to try and ensure that they're optimised for the structure that we want. I would say the council probably falls into that final third.”
With the details of these more contentious changes undecided, the views of contractors will help shape what structure is eventually implemented.
“It’d be interesting to see what contractors thought about that, whether they felt that their LPC chair was the right person to represent them on that or whether there was somebody else that they would want to suggest out of any of the structures that that might be more acceptable to them,” Mr Thomas added.
However, Mr Burdon cautioned about not going “down the rabbit hole just thinking about that one specific thing”, as there had been “quite an array” of different panels suggested as well, including those covering governance, policy and negotiating. “It’s got all of these different parts to fit together,” he stressed.
The review highlighted “repeated requests for a more effective negotiating team”, to help secure better financial settlements for the sector in future.
Mr Thomas questioned whether this “highly trained negotiating team” would be made up of representatives from the LPC council, “or are they drawn from external bodies and then drawn from somewhere else?”
There is also the issue of the necessary funding for this new negotiating panel. Professor Wright’s review made the recommendation to “significantly increase funding to CPE to support the negotiation processes and LPCs”, which C+D readers were a little sceptical about when commenting on the website.
Not advocating taking “dirty money”
Mr Burdon said the group would need to consider what “we reasonably expect to be able to do ourselves” within the budget and time commitments and whether external funding could be sought “where appropriate” to help manage the changes.
He reassured that this would not involve taking “dirty money from anywhere”, but could take the form of partnerships, including “co-badging, or joint working opportunities with the NHS”.
Mr Thomas added: “Lots of LPCs have some have meetings or conferences with their local contractors sponsored by the pharmaceutical industry.
“But the pharmaceutical industry itself is extremely heavily regulated on what they can and can't do. So provided it's an educational piece, then they can do it.”
LPC mergers could be on the cards
The review also suggested that LPCs representing 200 or fewer contractors consider merging with another LPC “to ensure better value for money” and reduce the size of their committees to a maximum of 10 members while “maintaining local proportional representation”.
In its submission to that review, the CCA recommended reducing the number of LPCs from 69 to 38, responsible for 300 contractors each to help “release funding”. Meanwhile, the National Pharmacy Association (NPA) suggested creating a regional layer in between LPCs and PSNC to “reduce local duplication”.
Asked if these recommendations might mean that individual contractor voices were lost, the RSG representatives remained optimistic.
“The whole purpose for setting up all of these structures is to improve all of community pharmacy,” commented Mr Burdon, noting that any structural changes to LPCs would have to account for “the ability to flex between doing things at scale, but also doing things at the super local”.
COVID-19 “changed the game”
Mr Dhami explained that Professor Wright’s report was written before the pandemic had hit last year, so could not take into account how COVID-19 had “changed the way we do business – changed the way everybody does business – and how everybody works in a workplace”.
However, while “COVID has changed the game a bit”, the review serves as a “good starting block to move forward”, he added.
“It was fortuitous that we had had the Wright review recognise a bunch of principles. But I don't think you can just take one soulless principle in its entirety.
“It’s about the broad brush of the all of the principles, giving the greatest synergistic effect on how to move LPCs and PSNC forward, and above all of that… [ensuring that it] underpins the voice of the contractor,” Mr Dhami concluded.