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Pharmacists not benefiting from new NHS as cost of reforms rockets

NHS reformsPharmacists have not yet seen the benefits of the new NHS landscape, LPCs have warned in response to the revelation that the reforms have cost 15 per cent more than anticipated.

Pharmacists have not yet seen the benefits of the new NHS landscape, LPCs have warned in response to the revelation that the reforms have cost 15 per cent more than anticipated.

Figures from the National Audit Office show that the implementation of NHS reforms cost £1.1bn to March 2013 - 15 per cent more than anticipated.

The NHS is expected to have spent £1.7bn by the time the reforms have been implemented fully, which is £215 million more than the business case estimate, the NAO reported last week (July 10).  

Health secretary Jeremy Hunt revealed in October that the NHS reforms would cost between £1.2bn and £1.3bn. However, that cost has soared  

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The NAO revealed that staff redundancies accounted for 40 per cent of the reform costs to the end of March, including 44 health authority board managers and PCT chief executives who received an average of £277,273 each in redundancy payments, About 10,000 staff were made redundant and 2,200 of them were subsequently re-employed by the NHS, the NAO said.

The expected administration costs savings of £2.4bn would outweigh the costs of the reforms and contribute to the efficiency savings that the NHS needed to make, the NAO said. More than £2bn had already been made it said. However, some parts of the system were less ready than others and "much remains to be done" to complete the transition, it warned.

Ealing, Hammersmith & Hounslow LPC chairman Hiten Patel said there had been a lack of communication between NHS England's London area team and his LPC since the reforms were introduced in April.

"If you look at actual costings or the expense that's been incurred to bring about the change, we still haven't seen the benefit," he told C+D. "Not to say there won't be benefits in the future, however that expense has been incurred."

NHS England's London and the South of England area team said it had "regular meetings" with London's LPCs. They had met in May and would be meeting again on July 25, a spokesman said.

Cumbria LPC chief officer Jeff Forster said the changes meant the LPC now had conversations with a greater range of commissioners. However, the reduced number of administrative staff made the commissioning process more complicated, he said.

"The commissioners we're dealing with now are 70 or 80 miles away, because we've got an enormous geographical area. There are likely to be difficulties when it comes to the contractual arrangements for the new enhanced services," he told C+D.

Many clinical commissioning groups (CCGs) had conditions placed on them because of shortcomings in their commissioning and financial plans, and the NAO expressed concern that CCGs would not be able to make savings and remain financially viable.

Rotherham CCG head of medicines management Stuart Lakin said it was difficult for the CCG to monitor its expenditure and commissioning contracts as they no longer had access to data that could identify patients.

The movement of staff between organisations because of the reforms meant there was still confusion about who was responsible for different areas of the health system, he told C+D.

The NAO concluded that each of the 240 commissioning bodies needed to reach a "stable footing" and the Department of Health, NHS England and Public Health England had to help "knit together" the various organisations in the health system.

Less than a quarter of CCGs had met with LPCs to discuss commissioning services through community pharmacies up until May this year, an exclusive C+D investigation revealed last week.

What benefits or disadvantages have you seen from the NHS reforms so far?

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Dorothy Drury, Locum pharmacist

We need a health secretary who has worked or has knowledge of the NHS. This position should not be shuffled every 5 minutes. We need someone who knows the difference between prescribing and dispensing for a start. Then we need continuity.

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