The Pharmaceutical Journal
Vol 268 No 7191 p426
30 March 2002

This article
Reprint
Photocopy

PDF* 50K

First LPS proposals expected by June

Deadlines for submitting local pharmaceutical services pilot proposals have been announced by the Department of Health. However, primary care organisations have concerns about the timing and the availability of funding. Lin-Nam Wang reports

The deadline for submitting the first wave of local pharmaceutical services pilot proposals will be in June. The exact date will depend on how quickly the necessary secondary legislation can be passed. A second wave of applications will be sought by 1 November. The Department held four seminars this month, which were aimed at helping primary care organisations prepare for LPS, and which built on preliminary guidance released in December.

Speaking at a meeting held by the King's Fund in London on 20 March, Susan Grieve, principal pharmaceutical officer at the Department of Health, said that the two waves acknowledge that many PCTs are still new organisations. There had been different responses at the Department's seminars, she said. Some PCTs are "ready to go and champing at the bit" whereas one of the seminars had been "very negative".

For example, one PCT had predicted that the process would be similar to that of personal medical services (the GPs' equivalent of LPS). It had based its work on PMS and had a proposal to submit at the meeting itself. Some PCT representatives at the meeting said that having adopted a "wait and see" policy (PJ, 15 December 2001, p839), PCTs are concerned that there will not be enough time between now and June, with few PCT board meetings scheduled during this time. Ms Grieve admitted that it would be "quite hard" for some PCTs to submit a full proposal in June. However, the Department's LPS implementation manager, Theresa Prendergast told The Journal: "LPS isn't for everyone and is completely voluntary." Those who cannot meet the June date will have an opportunity to put in their proposals by November. Ms Prendergast said that the Department is aiming to publish full guidelines on its website early in April for those hoping to be in the first wave.

At the King's Fund meeting, Ms Grieve said that LPS will be funded from both central and local sources. The money available centrally is from the global sum and the term the Department is using is "the equivalent amount of fees that the service would have attracted under pharmaceutical services". Also, the Department will not be providing any additional funding for LPS — which they did for PMS. Additional money will have to come from the PCT. Some PCTs are concerned about this because they are already overspent. Ms Prendergast said that if a PCT was interested, then LPS should have been put in its service and financial frameworks already, but those that had not set funds aside could submit proposals in November. A November submission would probably mean implementation in April 2003 and PCTs would then be able to reallocate funds to LPS in their 2003 budgets.

Will PCTs be ready?

Ian Conquest, a member of the professional executive committee of South and West Bradford PCT, said that although he doubted that his PCT would be ready by June, the main issue was that the PCT had no money available and that it had only just managed to scrape together £5,000 for clinical governance. He said that there were lots of things that the PCT would like to be able to do, but these would be difficult without more funds. Reallocation of funds, although a possibility, was limited to money that had not been set aside for long-term commitments.

Ms Grieve said that, regardless of where funding came from, it would be for the provider and PCT to negotiate payment for services. Rakesh Panesar, an executive member of Greater Yardley PCT, told The Journal: "Pharmacy can deliver good quality services that in the long run will save the National Health Service millions, but the big problems are funding and resources." He also raised a significant question: "How many pharmacists are able to talk about their businesses in terms of cost per minute?" It seems that potential providers will have to be skilled negotiators.

Primary care trusts cannot be LPS providers unlike PMS, where they can. According to Ms Prendergast, there is a "commercial aspect to pharmacy that does not exist to the same extent in medical services". PCTs as providers would "present too much of a conflict and it would be hard to demonstrate probity". Although the PCT cannot be the provider, it can develop ideas of its own and then seek providers.

The pharmacy plan indicates that there will be "changes in the distribution of the global sum" and that "pharmacies which provide the best services should gain at the expense of those who are prepared only to provide the minimum" (paragraph 4.11, Pharmacy in the Future, p18). This does not seem to be the case with LPS. There will be the same amount of money in the pot for contractors who do not participate in LPS as before. It will, however, be interesting to see what kinds of increase will be made to the global sum in the future. Mike King, head of professional development at the Pharmaceutical Services Negotiating Committee, said: "The global sum system will continue and the PSNC won't stand by and let anything prejudice the sum."

LPS pilots aim to allow PCTs to tackle local needs by changing how community pharmacy works for them but Ms Grieve said that it has been made clear that the pilots will also be used as a guide in shaping the new NHS contract. Once schemes are up and running they will be evaluated and reviewed.