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A quarter of England is without an LPN, C+D investigation reveals

Seven of 27 area teams have failed to establish a local professional network for pharmacy, NHS England responds to FOI

A quarter of England still does not have a local professional network (LPN) to provide pharmacists with a commissioning voice, an exclusive C+D investigation has revealed. 

Seven of NHS England's 27 area teams – including all three of the teams in London – had not established an LPN for pharmacy by the end of July, according to data C+D received from NHS England in response to a freedom of information (FOI) request.

Although LPNs were set up last year to work with commissioners and provide clinical leadership, three established LPNs had met with commissioners fewer than five times, NHS England said.

The amount of money allocated to each pharmacy LPN also varied, despite each area team being given a total of £120,000 to spend on its LPNs for pharmacy, dentistry and optometry. Lancashire's pharmacy LPN was specifically allocated just £17,000 – 14 per cent of the total sum – while others, including Essex and Greater Manchester, received a full allocation of £40,000. 

Eight areas did not allocate a specific amount to their pharmacy LPN, instead splitting the overall sum between its three LPNs.

Derbyshire and Nottinghamshire LPN had had the highest number of meetings with commissioners – more than 50 since April 2013. LPN member and contractor Nick Hunter said its success was down to a "flexible" approach that allowed "anyone interested" to attend meetings.

The LPN benefitted from having a chair who also had a full-time role within the area team, which allowed her to hold informal conversations with commissioners, Mr Hunter added. 

"We have tens of thousands of [pounds of] funding for healthy living champion training [and] we've just secured the best part of a quarter of a million to work on domiciliary MURs through the LPN," he told C+D.

Seven areas were lacking an LPN: North East London; North West London; South London; Hertfordshire and South Midlands; Thames Valley; Bath, Gloucestershire, Swindon and Wiltshire; and Wessex.

Mike Hewitson, owner of Beaminster Pharmacy in Dorset, said he wasn't concerned that his local area team – Wessex – had not established an LPN: "I'm a little sceptical about LPNs; they've got very little funding. In our area the LPC is very active, so the leadership role the LPN would pick up had already been picked up by the LPC."


What are LPNs?

Last year, NHS England informed its 27 area teams that they should each set up separate local professional networks (LPNs) for pharmacy, dentistry and optometry. NHS England intended each LPN to include a chair, an administrative manager, local clinicians and other specialists, such as individuals with a public health background.

LPNs link up pharmacists and commissioners. They provide clinical leadership to NHS England and help implement its primary care strategy. They also collaborate with clinical commissioning groups and health and wellbeing boards to promote self-care and ensure the "robust commissioning of locally enhanced services".

Source: NHS England. LPN operating framework. June 2013

Rehka Shah, chief executive of LPC consortium Pharmacy London, said the delay in forming an LPN could benefit pharmacists in the capital by giving them a chance to learn from other areas.

"There's more commitment now. Maybe it's late, but maybe that's for the best. All of us have got more areas to learn from," she said.

Despite there being no established LPN in Thames Valley, the LPN chair had managed to meet with commissioners 13 times since the individual was appointed in December 2013, NHS England said. In contrast, Bristol, North Somerset, Somerset and Gloucestershire LPN established a chair in the same month but had held only two meetings with commissioners.

Kent and Medway LPN was established shortly after April 2013, but contractor Sunil Kochhar said it had failed to communicate with pharmacists and he called for the LPN to be more "transparent". "We don't know who it consists of, how we get involved, what it has spent and what it's spent on," he said.

Visit C+D's interactive map to see what progress the LPN in your area has made:

Do you think it is worthwhile having an LPN? 

We want to hear your views, but please express them in the spirit of a constructive, professional debate. For more information about what this means, please click here to see our community principles and information

Gerry Diamond, Primary care pharmacist

The Greater Manchester LPN is fairly active and go ahead in its locality.

Simon Butterworth, Superintendent Pharmacist

Cumbria Northumberland Tyne and Wear Area team hosts two Pharmacy Local Professional Networks, two Dental Networks and one for Eye Health.

I am chair of the Pharmacy LPN in Cumbria. This brings together a really effective LPC, representatives from commissioners (the CCG) and Cumbria HWB, provider trusts, Health Watch, education and CPPE and the Area Team. The key part of this is the Network as members are working together to actually deliver new services through pharmacy.

In the past year Cumbria Pharmacy has had a successful adult flu service and been a national pilot for childhood flu delivering about 20,000 doses. We are rolling out Healthy Living Pharmacy, NHS Health Checks, and are about to become the sole provider of NHS Stop Smoking Services for the County. A Minor Ailments Service has just been launched and feedback from patients and GPs is very encouraging. We have successfully trained 160 additional Stop Smoking Advisors, 60 pharmacists to provide EHC Services and currently many pharmacists are completing their annual Flu Training. Some of this would have happened without the LPN, but the fact that we have an effective network makes contacts easier and faster.

Wider contacts are being made across the Health Professions as well; we have much in common with Dentists and Optometrists, and there is a surprising amount we can do together. Our LPNs are beginning to work on this.

Nationally the Pharmacy LPNs are making links and finding ways to share work and developments. Pharmacy is high on the agenda for Urgent and Emergency Care and for Winter Care, and the LPNs are beginning to work collaboratively on this

So yes, its still early days. But my experience is that LPNs are worthwhile and are making a difference.

N O, Pharmaceutical Adviser

""Rehka Shah, chief executive of LPC consortium Pharmacy London, said the delay in forming an LPN could benefit pharmacists in the capital by giving them a chance to learn from other areas.

"There's more commitment now. Maybe it's late, but maybe that's for the best. All of us have got more areas to learn from," she said.""

Normally London area is always considered as the pioneers/ trend setters/ leaders. But here we see a completely different scenario.

What a silly reason for not doing something. No wonder we are not considered a profession and are not entrusted with more services, as we wait for others to try.

N O, Pharmaceutical Adviser

""LPNs link up pharmacists and commissioners.""

""all three of the teams in London – had not established an LPN for pharmacy by the end of July""

RPS is head-quartered in London, right? So are, most of its higher ranked members/ chair, I believe? Yet no LPN in London? RPS claims to be the voice of Pharmacy Profession, yet no LPN? And we are debating elsewhere about a sole Professional Body !!!

Don't tell me it is only the responsibility of the area teams and not individual healthcare provider !!!

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