In September 2011, NPA chief executive Mike Holden asked where local professional networks (LPNs) were going to fit into England's reformed NHS, then still to be realised. Three years later and 18 months after the reforms were implemented, the answer is still far from clear.
For starters, a quarter of pharmacy LPNs don't yet exist: seven out of the 27 NHS England area teams had failed to set one up by the end of July, according to a freedom of information (FOI) investigation by C+D.
Where they do exist, there remains confusion over LPNs' role. They were set up to be the conduit through which the profession could influence the new commissioning structures; so where does the LPC start and the LPN end, not least given that the personnel are often overlapping?
Dorset contractor Mike Hewitson believes an active LPC can cover the work of an absent LPN, while Oxfordshire LPC chief officer Fiona Castle has previously said LPNs are a distraction from the work of LPCs. In terms of where their funding comes from, it could be argued that one difference is that LPCs are accountable to contractors, whereas LPNs are accountable to the NHS.
Several health leaders have told pharmacists to get involved with their local LPNs but, with so little transparency and access, the question is: how?
If the latter is true, how are LPNs being held to account, their effect being measured? How do we know what, if anything, they are achieving? As one source heavily involved in LPNs points out, this problem is not unique to LPNs; with NHS England area teams, clinical commissioning groups, local authorities, health and wellbeing boards and more all involved in local service planning and commissioning, it's difficult to hold any of them accountable for anything.
That said, another problem with LPNs that is pretty peculiar to them is their opaqueness. In an era of increasing transparency in public services, LPNs are curiously impenetrable. There is no obvious place to seek out the names of LPN chairs, no lists of members, no minutes or even records of meetings. As academic pharmacist Joseph Bush says: "It's like they operate in 1984."
In the past 18 months, several health leaders have told pharmacists to get involved with their LPNs, find out what is happening and influence their activities. But with so little transparency and access, the question is: how?
There are, however, pockets of leading practice. As always under the local health service agenda, LPN progress varies widely between areas – and this means some are proving their worth, with Derbyshire and Nottinghamshire LPN critical to securing almost a quarter of a million pounds for domiciliary MURs in the area, according to member and LPC chief Nick Hunter.
In January, Pharmacy Voice chief executive Rob Darracott forecast that this year would see LPNs start to make an impact. Derbyshire and Nottinghamshire's success reflects kindly on his prediction, but the overall picture is that much of the rest of England's pharmacists will have to wait somewhat longer to see these fledgling organisations spread their wings.
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