The revamped NHS structure has caused "total chaos" around pharmacy services and left many commissioners confused over their new responsibilities, pharmacists have reported nearly two weeks after the reforms took effect.

There were delays in commissioning pharmacy services and processing contract applications because of the "horribly complicated" structure that has divided responsibility for pharmacy services between NHS England, clinical commissioning groups (CCGs) and local authorities, pharmacy leaders told C+D.

Nick Hunter, LPC secretary for Doncaster, Nottingham County and Nottingham City, said the division of roles had created "quite worrying" problems in his area, including confusion over who would commission pharmacy services such as the minor ailments scheme in Doncaster.

"There are still great big gaps in what's going to happen and where things will fit. It's just as chaotic as two or three weeks ago" Nick Hunter, LPC secretary	More on the NHS reforms Pharmacy leaders undecided on impact of reforms Healthwatch groups are 'powerful' platform to       showcase pharmacy Pharmacists fear losing out under GP commissioning
	"It's total chaos at the moment," he said. "There are still great big gaps in what's going to happen and where things will fit. It's just as chaotic as two or three weeks ago." Doncaster CCG stressed its commitment to keeping the minor ailments service and told C+D its future had "never been in doubt".

Noel Wardle, partner at law firm Charles Russell, said he was still unable to establish who was responsible for processing new pharmacy applications, whether it was a central office at NHS England or regional outposts.

NHS England initially told him to contact the CCG when he rang the office last week. When he challenged this, he was told a case worker would call him back.

"I am still waiting for a call," he told C+D. "The fact that they don't seem to realise what they're doing is pretty worrying, I would say."

NHS England told C+D it could not comment on the specific case, but that applications should be sent to its local area teams.

Ash Soni, community pharmacist and clinical network lead at NHS Lambeth, said the ongoing uncertainty could have fuelled the negative public opinion of the new NHS expressed in a patient survey released on Monday (April 8).

The survey, run by market researchers for ITV over two days in March, found only 18 per cent of the 2,038 respondents believed the reforms would improve patient care.

"In a way it reflects that nobody is quite sure where the system is going," he told C+D. "Nobody quite understands what difference these reforms will make to the quality of care patients get... and there's so much fragmentation in the way it's being split up."

Essex LPC chief executive Ash Pandya said the commissioning structure was starting to take shape in his area. Initial confusion over who would commission out-of-hours and minor ailments services had been resolved, he reported.

"I think we have a reasonable understanding [of the structure] so it's a matter of building on it."

How are pharmacy services in your area faring in the reformed NHS? Comment below or email us at [email protected] You can also find C+D on Twitter, LinkedIn and Facebook